Isle STD cases rise Sexually transmitted diseases have increased markedly in the past three years after a steady decline for about 20 years, the state Health Department reports.
dramatically
By Helen Altonn
haltonn@starbulletin.com
"It's somewhat concerning," said Peter Whiticar, chief of the STD/AIDS Prevention Branch.
He said more cases of syphilis, gonorrhea and chlamydia are occurring, particularly among people age 24 and younger, but all age groups are potentially at risk.
Clinicians, nurses and other health providers will be updated on sexually transmitted diseases and AIDS in a special session from 8 a.m. to 5 p.m. Wednesday at the Ala Moana Hotel.
Whiticar's branch is joining with the California STD/HIV Prevention Training Center of Berkeley, Calif., to conduct the training session.
He said the sessions will bring state, private and military providers and laboratories together "to confront the disturbing new trends in STD infections in Hawaii."
The three sexually transmitted diseases also are increasing on the West Coast, which is a worry for Hawaii because of travel and interaction between people, Whiticar said.
He said the largest increase here has been in chlamydia, with reported cases jumping 45 percent, 22 percent and 13 percent between 1998 and 2001. "It will likely go up another 13 percent in 2002," he said.
Chlamydia is an infectious bacteria that may be found in the cervix, urethra, throat or rectum. It can cause infertility, tubal pregnancy and severe pelvic infection.
The increases initially were believed due to more sensitive testing, but "after this period of time, it's clear there's an increase in chlamydia in the state," Whiticar said.
He said 64 percent of infected patients are 24 years old or younger. Statistics show 66 percent were Asians, 21 percent Caucasians, 8 percent African Americans and 5 percent Hispanic, he said.
"The only thing we can attribute it to would be unsafe behavior," he said, and once it's established in that group, "if there is unsafe behavior, it spreads very quickly."
Chlamydia-infected women commonly have no symptoms, but the disease can be treated successfully if diagnosed, Whiticar said.
Of particular concern here is a relatively rapid increase in drug-resistant gonorrhea, the second most common sexually transmitted disease in Hawaii, Whiticar said.
Last year, there were 603 cases -- the first major increase since the 1980s and 25 percent more than 2000, he said. About half the cases occurred in 15- to 24-year-olds, but the increase seems to be primarily in people over age 25, he said.
The Health Department sent warnings to physicians when reports of resistant gonorrhea cases increased 35 percent last year and 14 percent in 2000, Whiticar said.
The new resistant form of gonorrhea initially appeared associated with people who had traveled to Asia or had partners who traveled there, he said. "Now we're seeing it is being transmitted locally."
Diseases coming across the Pacific show up here before reaching the mainland, "but it works both ways," he said, pointing to increases in the three sexually transmitted diseases on the West Coast.
Syphilis is rarer than the other two diseases but 19 cases have been reported this year -- a 90 percent increase since last year, Whiticar said.
"Of special concern is the number of men who have sex with men that have syphilis, and of particular concern are people co-infected with HIV and also syphilis or other sexually transmitted diseases."
An untreated sexually transmitted disease in an HIV negative or positive person can increase the likelihood of HIV transmission, he said.
Whiticar said the Health Department does a lot of work to make physicians aware of what's happening and tries to reach young people, particularly women, through screening when they go to clinics, health centers or doctors for family or health services.
"Some or many women may have no idea they're infected so this gives them an opportunity to learn of their disease status and be treated right then and treat partners as well."
Whiticar said it's important that everyone be aware of the trends, technology to detect the diseases and the latest recommendations for successful treatment.
A two-week informational campaign is planned by the Hawaii and California STD/AIDS partners and community groups, with lectures and training for outreach and prevention workers, nurses and others.
About 300 people have signed up for Wednesday's conference, he said.
The cost is $75 for doctors and $50 for all others, including lunch and refreshments. More information can be obtained by calling the UH Conference Center, 956-8204.
"We're taking a step back from the disease focus and looking more at individuals and risk behaviors," Whiticar said.
"We found an individual can have behavior at risk for STD, HIV and hepatitis. We consider all possibilities when dealing with an individual; otherwise there are missed opportunities."
The Health Department provides free and confidential service at its STD Clinic, 3627 Kilauea Ave. Call 733-9281 for information.
State STD information
