Unprotected sexual intercourse accounts each year for 12 million new cases of sexually transmitted disease (STD) — including chlamydia, gonorrhea and syphilis — that can cause infertility in men and women, affect the health and survival of babies, and increase the risk of HIV transmission.  Prevention initiatives to reduce rates of STDs, as well as hepatitis C and HIV, ideally include interventions to improve knowledge about prevention strategies, efficacy, and access to resources, such as condoms, to help reduce risk.  Although rates of HIV infection in particular have decreased overall in the last 20 years, rates are uneven across ethnic lines.  Nationally, the CDC is tracking a resurgent HIV epidemic among young homosexual or bisexual men of color and increasing rates of infection among heterosexual women.

How are we doing?

In 2002, the city-wide average rate of sexually transmitted diseases (chlamydia, gonorrhea, and syphilis) in Boston was 758 incidents per 100,000 residents, an increase of 5% above the 2000 rate.  The rate in South Dorchester was 2.4 times the city-wide average.  Mattapan, Roxbury, North Dorchester, Fenway, and Jamaica Plain were also above the Boston average.  The incidence of STDs in the Fenway neighborhood spiked in 2002, and fell back near its 2000-2001 levels, well below the city-wide average, in 2003, the latest year for which data are available.

In 2003, the city-wide incidence of STDs climbed over 7% to 815 per 100,000 people, which is 13% higher than the rate in 2000.  South Dorchester's incidence increased faster than that of Boston as a whole, growing to 2.6 times the city-wide average.  Mattapan, Roxbury, North Dorchester, and Jamaica Plain remained above the Boston average.  Mattapan's rate of STD incidence was the fastest-growing among those neighborhoods, with an increase of 21%, but that rate was surpassed by the South End's rise of 29%, which brought its frequency of cases above Boston's average.

HIV incidence rates in 2004 were highest among the 40-49 age group (154 per 100,000), followed by the 30-39 age group (137 per 100,000).

Despite major strides in reducing rates of AIDS mortality since the mid-1990s (49 deaths per 100,000 in 1992 versus 14.4 deaths per 100,000 in 2002), AIDS remains among the top five leading causes of death among people in the prime of their lives — ages 25 to 64 years.

There are dramatic differences in rates of AIDS incidence across race/ethnicity in Boston.  For example, the incidence rate for Latino men is 1.2 times the rate for white men, while the incidence rate for black men is 1.9 times the rate for white men.  Latinas have an incidence rate 5.6 times the white female rate, and black women have an incidence rate 11.6 times the white female rate. 

The incidence of hepatitis C grew dramatically between 1998 and 2000, remained at the higher rate through 2002, and declined slightly in 2003.