Introduction Despite many advances in the diagnosis and treatment of sexually transmitted diseases/infections (STDs/STIs), the epidemic continues unabated. Moreover, STDs are associated with significant social, health, and economic burdens both in the USA and worldwide. In the developing countries of the world, STDs (excluding HIV/AIDS) are the second leading cause of lost healthy life among women aged 15 to 44 years. The World Health Organization (WHO) estimated in 1999 that 340 million new cases of the four curable STDs (gonorrhea, syphilis, trichomoniasis, and chlamydia) occurred in those aged 15–49 years worldwide annually. The Institute of Medicine in their report The Hidden Epidemic: Confronting Sexually Transmitted Diseases estimated that, as of 1993, 12 million new cases of STDs were occurring annually in the USA. As a result, the USA had the highest rates of curable STDs among countries in the developed world. In fact, the Centers for Disease Control and Prevention (CDC) noted in 2009 that four of the ten most frequently reported infections in the USA were STDs (chlamydia, gonorrhea, syphilis, and HIV). In its report, the Institute of Medicine noted that the economic impact of this “hidden epidemic ” was substantial, with an estimated total cost for a selected group of major STDs and related syndromes (excluding HIV) of $10 billion in 1994.
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