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Sexual
Transmitted Diseases - HIV/AIDS
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Reduce
the rate of chlamydia trachomatis infection in 15 to 24 year olds.
Developmental
Objective, baseline to be determined in 2001.
Reduce
the rate of gonorrhea.
Target:
191 new cases per 100,000 population.
Baseline, 1998: 254.7 new cases of gonorrhea per 100,000
population.
Target Setting Method: 25 percent improvement.
Reduce
the number of new cases of Primary and Secondary Syphilis.
Target:
0.25 per 100,000 population.
Baseline, 1998: 9.6 primary and secondary cases per 100,000
population.
Target Setting Method: Total elimination.
Reduce
the rate of HIV infection.
Target:
14.7 per 100,000 population.
Baseline, 1998: 19.7 new cases per 100,000 population.
Target Setting Method: represents 25 percent improvement.
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Infectious
Diseases -
Sexual Transmitted Diseases - HIV/AIDS
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| Chlamydia,
Gonorrhea, Syphilis
Sexually transmitted diseases (STDs) have
a significant health and economic impact on the people of North
Carolina, especially the young. In North Carolina, approximately
67 percent of gonorrhea and chlamydia cases occur in people ages
15-24. In 1997, the Institute of Medicine reported that STDs were
"hidden epidemics of tremendous health and economic consequence
in the United States." Despite the burdens, costs, complications,
and preventable nature of STDs, they remain a significant public
health problem, largely unrecognized by the American public, policymakers,
and many health care professionals. Confronting the growing STD
problem requires health officials to establish an effective system
for STD prevention that responds to the complex interaction between
the biological and social factors that sustain STD transmission
in populations.
In 1998, North Carolina ranked first in
the nation in the number of primary and secondary syphilis cases
and fourth in the primary and secondary syphilis rate, with the
highest percentage of cases affecting 20-39 year olds. Five North
Carolina counties (Forsyth, Guilford, Mecklenburg, Robeson and Wake)
are in the list of 28 counties in the United States that accounted
for 50 percent of all primary and secondary syphilis in the nation.
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Disparities
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Because many STDs are more likely to be asymptomatic
in women, they are at higher risk than men, and young women are biologically
more susceptible to certain STDs than are older women. STDs disproportionately
affect adolescents and young adults because this age group is increasingly
likely to have more sex partners at earlier ages and they are often
reluctant to obtain clinical services. The North Carolina incidence
of chlamydia for 15-24 years olds was reported at 1659/100,000 population
in 1998. Certain racial and ethnic groups have higher STD rates than
Whites. It should be noted however, that studies have shown that the
reporting of gonococcal infections has likely been biased towards
reporting infections in persons of minority race or ethnicity who
attend public STD clinics. STDs disproportionately affect disenfranchised
persons and persons who are in social networks in which high-risk
sexual behavior is common. Disproportionately affected groups include
sex workers (people who exchange sex for money, drugs, or other goods),
adolescents, persons in detention, and migrant workers. Often, groups
with the highest rates of STDs are the same groups in which access
to health services is most limited. In 1998, 79 percent of the syphilis
cases, 84 percent of the gonorrhea cases and 67 percent of the chlamydia
cases in North Carolina were reported among African American/Blacks. |
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Human
Immunodeficiency Virus/
Acquired Immunodeficiency Syndrome (HIV/AIDS)
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HIV/AIDS is a significant cause of illness,
disability, and death. Estimates of the number of people infected
with HIV in the United States range from 650,000 to 900,000. The number
of people infected in North Carolina was estimated to be between 9,400
to 13,400 in 1998. Sixty-five percent of all AIDS cases in North Carolina
occur in people 20-39 years of age, representing infection that may
have occurred during teens and early twenties. Lifetime costs of health
care associated with HIV are estimated at $155,000 or more per person.
These costs mean that HIV prevention efforts may be highly cost-effective
and cost-saving to society. |
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Disparities
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In the United States, African American/Blacks and
Hispanics/Latinos have been affected disproportionately by HIV/AIDS
compared to other racial and ethnic groups. In 1996, for the first
time in the United States, African American/Blacks accounted for more
AIDS cases than Whites, and this trend continues. In 1998, AIDS was
the leading cause of death for African-American males ages 25-44 and
the third leading cause among African-American females. Through the
1990s, African American/Blacks have accounted for an increasing proportion
of North Carolina’s AIDS cases. In 1999, African American/Blacks
represented almost 73 percent of all North Carolina AIDS cases. AIDS
cases are increasing among women as well. In the 1980s women represented
only about 10 percent of North Carolina AIDS cases, but they represented
almost 27 percent in 1999. The disproportionate impact of HIV/AIDS
on minorities underscores the importance of implementing and sustaining
effective prevention efforts for these racial and ethnic populations.
Social and economic factors – such as poverty, underemployment,
and poor access to the health care system – contribute strongly
to these disparities. Nationally, persons living in the South accounted
for 39 percent of United States AIDS cases in 1998. |
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Determinants/Risk
Factors
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High-risk sexual behavior, sexual coercion,
substance abuse (drugs and alcohol), limited access to health care,
and poverty |
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Infectious
Diseases - Sexual Transmitted Diseases - HIV/AIDS |
