Public Health

Health burden due to unsafe sex high in U.S.

Last Updated: 2005-01-27 15:59:52 -0400 (Reuters Health)

NEW YORK (Reuters Health) - The public health burden related to unsafe sexual activity is three times higher in the U.S. than in other developed nations, according to researchers at the Centers for Disease Control and Prevention.

Nearly all the premature deaths and adverse health consequences are preventable, the investigators maintain.

Dr. Shahul H. Ebrahim and colleagues in Atlanta, Georgia, point out that sexual behavior can lead to a variety of harmful consequences, such as unintended pregnancies and infections. They compiled data from the U.S. Burden of Disease Study for 1996 to estimate mortality and disability adjusted life years (DALYs) due to sexual behavior.

Included in their calculations were all major sexually transmitted infections and the sexual behavior attributable fraction of conditions such as infertility, abortions, HIV and viral hepatitis.

As reported in the February issue of Sexually Transmitted Infections, they found that nearly 20 million cases of adverse health conditions (7532 per 100,000 population) and 30,000 deaths (1.3% of U.S. deaths) could be attributed to sexual behavior.

The majority of this public health burden falls on women - 62% of behavior-related adverse health events and 57% of DALYs. More than half of events and DALYs were contributed by curable infections and their sequelae. Cervical cancer was the leading cause of mortality among women, followed by HIV.

Men suffered the majority of deaths (66%), primarily from HIV.

"Interventions among adolescents to delay age at first sexual contact, widespread Papanicolaou testing and use of hepatitis B vaccine, screening and treatment of curable STDs, and correct and consistent use of condoms and contraceptives can reduce the sexual behavior related public health burden substantially," Dr. Ebrahim's group writes.

Sex Transm Infect 2005;81:38-40.