Women impacted differently than men

Infection rates are about equal for men and women, but the consequences for women are often worse than for men, said Adina Nack, Ph.D., professor of sociology at California Lutheran University and senior research fellow for the Council on Contemporary Families. She is the author of “Damaged Goods? Women Living with Incurable STDs.”

“Physically, many STDs have no noticeable symptoms, and gonorrhea and chlamydia can lead to infertility in women, and certain types of human papillomavirus (HPV) can cause potentially life-threatening cancers in both women and men. There are greater differences in the negative health consequences of STD stigma for women. My book explains why we’re more likely to view a female STD patient as promiscuous and damaged than a male STD patient. The root of STD stigma is the gender-based double standard of sexual morality: male social status typically increases as their number of sexual partners increases, whereas female social status typically decreases,” Nack said.

“There are individual health costs and public health costs to STD stigma: for example, an STD-infected person might experience anxiety and depression from fear that others will them negatively and also be less likely to tell their sexual partners about their STD status, leading to more infections,” she said.

Many people with STDs are unaware that they’re infected, making it far more likely for them to unknowingly spread the disease. Less than half of US adults under the age of 45 have been tested for STDs, other than HIV.

How to prevent STDs

Nack said, “Correct and consistent use of condoms and other barrier methods (male condoms, female condoms and dental dams) reduces the risk of STD transmission during sex – including oral sex. However, the two most common incurable STDs – herpes and HPV – are transmitted by skin-to-skin contact that can occur even when condoms are used. That’s why regular testing for all types of STDs is necessary for sexual health. In addition to testing and treatment, we need to advocate for de-stigmatizing STDs and for medically-accurate, age-appropriate sexual health education to be more accessible.”

STD statistics

The NCSH provides current statistics on STDs and STIs. All women should check out the new guide from the NCSH, "Take Charge of Your Sexual Health: What you need to know about preventive services" to learn how to protect themselves from STIs.

Women suffer more frequent and serious complications from STIs than men. These consequences can include pelvic inflammatory disease, infertility, ectopic pregnancy, pelvic pain and cancer.

Among women, approximately half of all new STIs occur among those ages 15-24. And women ages 20-24 have the highest number of sexually transmitted infections of any age group.

STIs are also a concern for older women back on the dating scene. The number of chlamydia cases among women ages 45-60 nearly tripled from 2000 to 2010. And there are low rates of condom use among men ages 50 and over: only 28% report using a condom versus 50% of men ages 18-39.

Approximately 24,000 women become infertile each year from undiagnosed sexually transmitted infections (e.g., chlamydia, gonorrhea).

Chlamydia

Chlamydia is the most commonly reported disease in the US. Chlamydia can have serious consequences, including PID and infertility, if left untreated. Many women don’t know they have it since they often don’t experience symptoms.

There are an estimated 2.86 million new cases annually among women and men.  The case rate among females, 643/100,000, is about two times higher than among males. Rates are highest among those aged 15-24.

Annual screening for all sexually active women ages 24 and younger, and those at risk, is recommended and covered by the Affordable Care Act. Yet, less than 50% of women are being screened. If detected early, chlamydia can be easily treated with antibiotics.

HPV

The most common STI, it is estimated that 79 million women and men are currently infected, and that 14 million are newly infected with HPV each year. Nearly everyone will contract HPV at some point in their lives.  HPV is associated with 26,200 cases of cancer and 360,000 cases of genital warts each year.

According to national surveys, 42.5% of females ages 14-59 have HPV. Specifically, women ages 20-24 have the highest prevalence at 53.8%, followed by women ages 25-29 (46.8%), ages 30-39 (44.2%), and ages 40-49 (42.4%).

While 90% of cases clear up on their own within two years, 10% do not. HPV is the leading cause of cervical cancer, and of a subset of cancers and genital warts.

A safe and effective HPV vaccine is now available for females and males that can prevent cancer-causing strains of HPV. It is recommended for all males and females at ages 11 or 12, but can be given to women up to the age of 26. Yet, only 33.4% of adolescent girls received all three doses in 2012.

HIV

Women accounted for 20% of new HIV infections (9,964 cases) and 24% of those living with HIV infections (264,000). The number of new infections has been remained relatively stable over the past several years.

It is recommended that everyone be tested for HIV at least once during their lifetime, and more often if they are at increased risk for HIV. However, 50% of women have never been tested.  And, it is estimated that one in six people are unaware that they are infected.

Early detection and treatment are essential to improving and maintaining the health of people living with HIV.

Gonorrhea

In 2012, 334,826 cases among women and men were reported. This is the second most commonly reported disease, and similar to chlamydia it often has no symptoms, but can result in PID, infertility, and ectopic pregnancy.

There are slightly higher rates in women than men. The highest rates are among adolescents. Among women, the largest increases are among those ages 40-44.

Be aware and be smart

Be aware of your body and your sexual partner’s health. Dr. Yvonne Kristin Fulbright said, “Many people may be carriers of an STD, but never have an outbreak (so they're unlikely to know that they can infect others). Women have a harder time than men identifying a possible STD, e.g., a symptom goes unnoticed or they mistake it for something else. Women are more vulnerable to STDs, like HIV, than men because semen is directly deposited into her body during unprotected sex.”