Get Screened - Rampant
STDs Can Complicate
Childbirth - Easy Tests
By Marian Jones
NEW YORK - It,s not just a bothersome itch or an embarrassing rash. A sexually transmitted disease can pose very serious health risks for women, according to research presented Monday at the American College of Obstetricians and Gynecologists, annual meeting.
For women "and for their sexual partners" researchers say: Get screened and treated early for STDs.
"Evidence is mounting that vaginal infections experienced by millions of American women have more rapid and damaging consequences than previously thought," James A. McGregor, M.D., professor of obstetrics and gynecology at the University of Colorado School of Medicine in Denver, told the meeting.
* If a woman is pregnant, even a "minor" STD such as the easily curable sexually transmitted vaginal bacterial infection trichomonas vaginitis can increase the likelihood she will give birth prematurely, according to a study McGregor conducted, published in this month's issue of the journal Obstetrics and Gynecology.
* Common sexually transmitted vaginal bacterial infections can more than double a woman,s risk of acquiring HIV, McGregor said.
* Vaginal infections can rapidly move from a woman,s genitals to her upper reproductive tract, the latest research indicates. "This makes a woman more vulnerable to serious health complications such as scarring or infertility," said McGregor.
Part of the problem, though, is that many women underestimate their risk of getting an STD.
America has the highest rate of STDs in the industrialized world, with 12 to 15 million new cases a year and at least one quarter of Americans contracting an STD during their lifetime, according to estimates of The Centers for Disease Control and Prevention and the American Social Health Association.
Each year, there are an estimated 5 million new cases of trichomoniasis alone, the most common curable STD in young women. Yet only 3 percent of women in a 1998 survey believe they are at risk for any STD.
McGregor called for routine screening for reproductive tract infections in all pregnant women. For all sexually active, non-pregnant women, he advocates more frequent testing and treatment of women and their sexual partners to stop the cycle of reinfection.
"As an urgent public health matter, we must widen the net for testing, treatment and prevention of these STDs," McGregor urged.
Controversy Swirls
The issue of how frequently to screen for common STDs is controversial. Some groups believe all women under a certain age should be screened, while others recommend routine screening only for "high-risk" women " those who have had multiple sexual partners or sexually active adolescents.
For example, in the case of the bacterial STD chlamydia, which often shows no symptoms but can cause pelvic inflammatory disease, ectopic pregnancy or infertility, ACOG recommends routine yearly screening of high-risk women while the CDC recommends annual chlamydia screening of all sexually active women under age 25. Johns Hopkins university researchers recommend sexually active adolescents receive a chlamydia screening every six months.
The CDC believes all younger women should be screened for this disease since the immature cervix leaves a woman particularly vulnerable to this infection. And Johns Hopkins researchers recently found, in a study of Baltimore inner-city girls recently published in the Journal of the American Medical Association, that nearly 30 percent the girls tested positive for chlamydia.
"Even as we weigh specific screening recommendations, we need to put this infectious disease epidemic at the forefront of public health attention," noted Ralph W. Hale, M.D., ACOG executive vice president. "Women are either unaware of, or underestimate, their risk for common infections that have serious complications."
It's Easier Than Ever
New tests and treatments for STDs have made the process of getting screened and treated less painful and more rapid, McGregor said. These advances include new urine tests and single-dose treatments.
Nucleic acid amplification techniques now allow urine screening for women or men without the need for a medical exam or a blood sample.
New drugs can be taken in a single dose, providing a much more effective, convenient and inexpensive treatment than previous, multiple-dose medications.
"Before, the complicated drug regimen could be a barrier to treatment," McGregor said. "Now we have one-stop shopping."