Medical Moment: STDs in Telluride, How Common?

28 Feb Medical Moment: STDs in Telluride, How Common?

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Dr. Sharon Grundy, Medical Director of Primary Care, Board Certified in Internal Medicine

Dr. Sharon Grundy answers this week’s related questions: Are sexually transmitted infections more common in Telluride? And what type do docs see most? 

I discussed this topic with June Nepsky, public health director at San Miguel’s Department of Human Health and Environment. STIs are reportable to the State and tracked regularly to detect outbreaks, here’s what I learned: Telluride has similar rates of STI infections as the rest of the nation, if not lower. Events do occur, however they are not the norm. So living here doesn’t put you at a higher risk. Being young however, does!

The Center for Disease and Control (CDC) reports annually on Sexually Transmitted Illnesses, this past year the CDC released a report on the statistics of infection rates in the US and the economic impact, their analysis suggests there are more than 110 million STIs overall among men and women nationwide, affecting around a third of the population. This estimate includes both new and existing infections.  

Nearly 20 million new infections occur each year – and half of them occur among the Nation’s young women and men between ages 15-24. The number of new infections is roughly equal among young women and young men (49 percent of incident STIs occurs among young men, vs. 51 percent among young women).

The cost to the health care system is 16 billion annually and while most STIs will not cause harm, some have the potential to cause serious health problems, especially if not diagnosed and treated early.

CDC’s analyses in 2013 included eight common STIs: Chlamydia, gonorrhea, hepatitis B virus (HBV), herpes simplex virus type 2 (HSV-2), human immunodeficiency virus (HIV), human papillomavirus (HPV), syphilis, and trichomoniasis.

The most common in our region is Human papillomavirus followed by Herpes Virus 2 then Chlamydia. HIV, Gonorrhea and Syphilis have very low rates of occurrence. Many of these infections go undetected because they often have no symptoms.

Four of the STIs included in the analysis are easily treated and cured if diagnosed early: Chlamydia, gonorrhea, syphilis, and trichomoniasis. Undiagnosed and untreated Chlamydia or gonorrhea, for example, can put a woman at increased risk of chronic pelvic pain and life-threatening ectopic pregnancy, and can also increase a woman’s chance of infertility.

CDC estimates that HPV accounts for the majority of newly acquired STIs. While the vast majority (90 percent) of HPV infections will go away on their own within two years and cause no harm, some of these infections will take hold and potentially lead to serious disease, including cervical cancer. The CDC estimates 79 million people have HPV.

Some prevalent infections – such as HSV-2 (24 million) and HIV (1 million) – are treatable but lifelong infections. These infections have potentially severe health consequences. For example, HSV-2 can lead to painful chronic infection, miscarriage or premature birth, and fatal infection in newborns. HBV can lead to cirrhosis, a life-threatening liver disease. And HIV damages a person’s immune system over time, increasing an infected person’s susceptibility to a number of diseases. Additionally, nearly 18,000 people in the United States die with AIDS each year.

I am often told by patients “my new partner was told they were negative for any infections.” The warning for patients is, if you need to ask, you need to be screened.

A routine female exam only screens for Human papillomavirus and young men usually do not get checked unless they specifically come to see the provider with this concern.

Doctors screen patients who have high-risk factors, which include:  

• Having unprotected sex
• Having sexual contact with multiple partners
• Using Intravenous Drugs
• Being a sexually active female under 25
• Having any history of STIs
• Abusing alcohol or other drugs that inhibit judgment

If the patient is at high risk, the recommendation is to discuss the risk and screen as appropriate for the high-risk activity and geographic area. Screening is available in the Telluride region at the Telluride Medical Center, San Miguel Health Department (on Colorado Avenue) and the Uncompahgre Clinic in Norwood.

Prevention includes: abstaining from sex, reducing the number of sexual partners, and consistency and correctly using condoms. Vaccines are also available for Hepatitis B virus and some types of Human papillomavirus

Editor’s note: The Telluride Medical Center is the only 24-hour emergency facility within 65 miles. As a mountain town in a challenging, remote environment, a thriving medical center is vital to our community’s health.

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