By fact or fiction, by stats or by stigma, a handful of groups within our population have been linked to elevated STD risk. Some assumptions feed the fallacy that only certain “types” of people acquire sexually transmitted diseases, when the plain fact is that nearly everyone who has sexual relations is vulnerable.
However, official statistics and figures culled by researchers do reveal groups that are disproportionately affected. Who are they? Are the high rates explained by factors beyond their control, and is the health care system somehow failing these people? Moreover, are the high STD rates among specific groups having an impact on the rest of the population? Let’s take a look.
As if our men and women in uniform didn’t face enough threat to their well-being, the U.S. Army, Navy, Air Force and Marines have historically had higher STD rates than the civilian population. The running theory has always been that personnel of a sexually active age with long tours away from home—especially those deployed to countries with limited health care—simply find or put themselves at higher risk.
In October 2006, a study of 1,700 women on active duty in support of the war in Iraq found that 2.5 percent were infected, most with genital herpes, chlamydia, or genital HPV. Though 95 percent of the female soldiers with STDs were redeployed without any health complications, the study was evidence of our need for more extensive STD screening in the military.
A sweeping report, this one covering sexually transmitted infections of both men and women in the military from 2000 through 2005, found elevated levels of chlamydia, gonorrhea, nongonococcal urethritis, and syphilis in all branches of the military. The Army steadily led the other three branches. However, the numbers peaked in 2002, and in 2005 the rates for gonorrhea were actually lower than among civilians.
Statistics are currently lacking but the subsequent impact on hometown communities is assumed to be significant.
Meeting someone on the Internet doesn’t have to carry more risk than any other means of hooking up. But as always, the chance of finding a safe partner dwindles when we seek an anonymous companion. Worsening the problem is that some sites allow people to connect based unapologetically on high-risk activities. The July 2007 edition of the journal Sexually Transmitted Diseases cites two studies providing evidence that “Internet-based sex partner recruitment for unprotected sex has emerged as an important risk factor for increases in syphilis among [men who have sex with men].”
One of those studies also contained a positive element. Researchers from Denver concluded that many male and female subjects had used the Internet to seek information about STDs.
Cons and Ex-Cons
The relationship between STDs and prison inmates is a revolving-door problem: There are high rates of infected people entering jail, high infection rates inside of jails, and high potential for impact on the communities where ex-cons are released.
As STI notes, many studies have shown a high prevalence of STDs among people entering jail and juvenile facilities. The authors write, “In some locations, a substantial proportion of all early syphilis cases are reported from correction facilities.” The bad news extends to men and women alike; among adolescent women entering 57 juvie halls in 2005, a 14.2 percent median (more than 50 percent higher than the national percentage) tested positive for chlamydia.
The organization Human Rights Watch has come down hard on prison officials in the United States, saying that opportunities to protect prisoners against HIV and STDs have been squandered. “Despite overwhelming evidence that condom use prevents the transmission of HIV,” the organization noted, “U.S. prison officials continue to limit the availability of condoms to incarcerated persons. Less than 1 percent of U.S. correctional facilities provide condoms to inmates.”
Correctional health and public health advocates are concerned for people on both sides of the prison wall. A recent study spanning 1997–2004 and involving 43,000 people found that screening in county jails was associated with decreased prevalence of gonorrhea and chlamydia in surrounding communities with high incarceration rates. In other words, preventing and treating STDs within prisons helped keep diseases from reaching the public.
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