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Alabama near top in STDs
State teens among most vulnerable to sexually transmitted diseases

By Kate Brumback
Associated Press Writer

MONTGOMERY — Alabama was among the states with the highest rates in the country for syphilis, gonorrhea and chlamydia last year, according to a report by federal health officials.

Alabama ranked second highest in the rate for syphilis, fourth for gonorrhea and fifth for chlamydia, according to a recently released report from the Centers for Disease Control and Prevention.

Explanation not simple

Sandra Langston, director of the STD prevention division of the Alabama Department of Public Health, said Thursday there is no single explanation for the relatively high rates of these STDs in Alabama. She said a number of different factors contribute to the problem, including a lack of access to care and screening for the most affected populations, staff shortages in the state's STD prevention program and level funding for the program over the last few years.

The age group most affected by chlamydia and gonorrhea is 15 to 19-year-olds, followed by 20 to 24-year-olds. The rate seems to drop after 25 years of age, a trend that has been consistent for at least the past five years, the state health department said in a statement Thursday.

Langston said several studies have shown that the tissue of the young cervix is more susceptible to infection, which could partially explain the higher rate in women aged 15 to 24. She said teens and young adults may also be less informed about the risks involved with sexual activity, which could also contribute to their higher rates of certain STDs.

Women and some men do not experience any symptoms of chlamydia, which is the most commonly reported bacterial STD. That can cause the disease to go undetected and untreated, which can cause serious problems such as pelvic pain and infertility.

"The most effective change would be more screening, more testing because often a young woman doesn't show symptoms" of chlamydia, Langston said.

In the fall of 2005, the state Bureau of Clinical Laboratories acquired the technology to use urine-based testing for chlamydia and gonorrhea. The testing is being used for routine screening in all state public health clinics.

This amplified test has made screening easier and less time-consuming and has dramatically increased the number of people tested, the health department said. The sensitivity of the test has resulted in the diagnosis and treatment of more infections.

The report shows that the rate of syphilis is declining nationwide. But Alabama still has a relatively high rate of early syphilis cases. Syphilis is most easily transmitted early on in the infection.

In 2006, Jefferson County had the highest rate of syphilis in the country, according to the health department. The population most affected by syphilis in that county were sex workers and drug users, Langston said.

She said sex workers and drug users frequently don't have access to screening, meaning they may not even know they are infected. She said that even if one of them is screened and tests positive, it is hard to track down their past sexual partners to tell them they may have been exposed to the disease.

Langston said syphilis reached its lowest level nationwide and in Alabama in 2000. Since then, the rate has crept up again, reaching a peak in 2006, she said.

"We still hope to eliminate syphilis, and it's discouraging to see the numbers creeping up again," Langston said.

Chlamydia, gonorrhea, syphilis and HIV are the most frequently reported STDs in Alabama, according to the health department.

"The data serve as a reminder that sexually transmitted diseases pose a serious and ongoing health threat to millions of Americans," Charles Woernle, assistant state officer for disease control and prevention, said in a statement. "Nearly 19 million new cases occur in the United States each year, affecting Americans of all ages and in all walks of life."

Copyright 2005 Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

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