WASHINGTON- Sexually transmitted diseases in Baltimore decreased in 2000, but the city still had the third-highest STD rates among cities nationally, a recent Centers for Disease Control and Prevention report found.
While Baltimore’s disease rates remain well above the national average, they are an improvement over the first- and second-place rankings it has earned since 1997. And Baltimore Health Commissioner Peter Beilenson said that when 2001 figures are released, they will show further reductions in gonorrhea and syphilis cases.
Beilenson attributed the decline to an aggressive, multi-pronged prevention and treatment effort that includes partner tracking, increased staff at clinics, and a laboratory that tests people who are taken to the city’s Central Booking and Intake Facility.
Nancy Baruch, acting chief of the state’s STD program said increased funding has made those efforts possible.
“I think in large part, the rates are coming down because there is significant resources to make that happen,” she said.
Until well-publicized reports of an STD epidemic in the mid-1990s, there was little to no funding given to public health systems for education and prevention, Baruch said.
“A lot of it had to do with where communities, and where people, put their resources,” she said. “I think for Baltimore City, the additional resources perhaps came to them a little bit later than it did to the other major metropolitan areas in the country.”
According to the CDC report, gonorrhea incidence fell from 968 cases per 100,000 Baltimore residents in 1999 to 886 cases per 100,000 in 2000. The national rate, however, stood at 132 cases of gonorrhea per 100,000 people in 2000.
Gonorrhea is a sexually transmitted disease that can be diagnosed and treated with antibiotics. If left untreated, it can facilitate HIV infection and lead to pelvic inflammatory disease and infertility.
Baltimore also had the third-highest syphilis rate among cities. While Baltimore’s syphilis rates dropped from 38.9 cases per 100,000 in 1999 to 34.5 cases per 100,000 in 2000, the national rate hit an all-time low in 2000 at 2.2 cases per 100,000 people.
Baruch attributes the drop in the disease to a federally funded syphilis elimination project. The project has included increased resources for investigators and work with community-based groups that spread the word about elimination and control of the disease.
Beilenson said Baltimore’s syphilis outbreak was due in part to the crack- for-sex trade. By putting the “stat lab” at the Central Booking and Intake Facility, the city can now catch 25 percent of its syphilis cases. Everyone who comes into the facility is tested for syphilis, he said, and even if they are only there 24 hours, they get the first of three penicillin shots.
Another target population for STD prevention is younger adults and teen- agers, Baruch said. Nationally, the asymptomatic chlamydia is a disease that is most prevalent among young, sexually active women, the CDC report said.
The CDC did not offer city numbers for chlamydia, which often goes unreported. Beilenson said that while chlamydia has been level in Baltimore for the past five years, he expects to see an increase for the next few years because the city now does urinalysis, which will be more likely to catch the disease.
Baruch predicts Baltimore’s overall rates will continue to decline.
“The key for any STD is educating, making sure people who are at risk know how the diseases are transmitted, how they can prevent transmission, and what to do if they think they might be infected,” she said.