Sexually transmitted diseases: magnitude, determinants and consequences

Sexually transmitted diseases (STDs) including human immuno-deficiency virus (HIV) infections constitute a major reproductive health burden for sexually-active individuals. The short-term and long-term consequences of STD have been well documented and include genital and other cancers, pelvic inflammatory disease, ectopic pregnancy, infertility, and adverse outcomes of pregnancy including pre-term delivery and low birth weight. The burden of sexually transmitted infections falls disproportionately on the young, the poor, minorities and women. At the societal level, there is a continuing need to educate people, particularly adolescents, about their risk for STDs and their sequelae and to increase the use of barrier methods including condoms. Policy decisions that facilitate more open discussion of sexuality and STDs, and that expand the accessibility and acceptability of sexual risk assessment, STD screening and treatment services would help decrease STD rates in the United States to levels similar to those observed in other industrialized countries.