Generally, you expect to see preventable diseases decline in advanced societies. Not so with some sexually transmitted diseases (STDs) in California.
Syphilis cases in the Golden State jumped by 18 percent from 2010 to 2011, according to new data released by the California Department of Public Health (CDPH). There was also a 5 percent increase in chlamydia cases and a 1.5 percent increase in gonorrhea cases.
Across the board, the STD rates among African Americans continue to be strikingly high, especially in comparison to the other racial groups.
In regards to why African American women contract STDs at far higher rates than women of other races, Robert Fullilove, a clinical sociomedical professor at Columbia University Health and chairman of the HIV/AIDS committee at the Centers for Disease Control and Prevention, said on "Fresh Air" that it is partly because fewer African American men are available.
Because of incarceration, homicide and AIDS, Fullilove said, "A large number of marriageable men were taken out of the community. When you have this kind of population imbalance, many of the rules that govern mating behavior in the community are simply going to go out the window."
"The competition for a man becomes so extreme ... all of the prevention measures [like condom usage] that we've been trying to create over the last 30 years go out the window."
But Heidi Bauer, chief of the health department's STD control branch, told The Huffington Post that Fullilove's theory is hard to prove, and that the department has not found a smoking gun explaining any of the disease increases. It may be that individuals have more partners and use fewer condoms or that, especially given cuts to local health departments and clinics, there is less access to care, she said.
Regarding education, Bauer said that California law mandates HIV education but that schools have a lot of autonomy over what other curriculum, if any, they provide -- as long as it's accurate.
The health department is concerned with the increase in state rates because these STDs can lead to infertility, passing a disease on to a newborn and increasing the risk of HIV, Bauer told HuffPost.
Across all races, chlamydia affected the highest number of people in California, with about 164,000 cases reported in 2011. Click through the slideshow below to see the California counties with the highest rates of the STDs.
Across the board, the chlamydia rates were about twice as high for women than for men. This is largely because the disease is often asymptomatic, but women are screened annually up to age 25 and therefore diagnosed more often, Bauer explained. The rates were highest for men and women between 20 and 24 years old, with the exception of African American women, with whom the highest rate is women between 15 and 19 years old. Here is the racial breakdown:
Chlamydia rates (per 100,000 population):
- African American - 1,030.3
- Latino - 332.6
- Native American - 216.4
- White - 141.9
- Asian/Pacific Islander - 118
There were 27,000 gonorrhea cases in California in 2011. Gonorrhea rates were higher -- sometimes twice as high -- for men than for women (except for Native Americans) because of men having sex with men and because women with gonorrhea often don’t have symptoms. The highest gonorrhea rates were in San Francisco (276.5), followed by Fresno (127.2) and Sacramento (126.7). Here is the racial breakdown:
Gonorrhea rates (per 100,000 population):
- African American - 303.8
- Latino - 40.7
- Native American - 37.7
- White - 33.3
- Asian/Pacific Islander - 17.2
There were about 2,500 syphilis cases, and men had vastly higher rates as it largely affects men who have sex with men. The highest syphilis rate was in San Francisco (46.2), followed by Berkeley (14.8). It is the only STD out of the three discussed where whites had the second-highest rate:
Syphilis rates (per 100,000 population):
- African American - 16.6
- White - 6.2
- Latino - 5.4
- Native American - 4.9
- Asian/Pacific Islander - 2.3
Nationally, in 2010, chlamydia rates increased, gonorrhea increased slightly and syphilis decreased (but increased among black men), according to the Centers for Disease Control.
10. Alameda - 435.9
9. San Diego - 491.8
8. Los Angeles - 510.6
7. Long Beach (city in LA County)- 518.3
6. San Bernardino - 522.5
5. San Joaquin - 543.8
4. San Francisco - 586.9
3. Sacramento - 634.7
2. Fresno - 657.0
1. Kern - 663.2