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| March 30, 2007 |
Sexually Transmitted Diseases and Substance Use
In Brief
- In 2005, 0.8 percent of persons aged 12 or older and 2.1 percent of young adults aged 18 to 25 had a sexually transmitted disease (STD) in the past year
- Among young adults aged 18 to 25, 1.4 percent of those who did not drink alcohol in the past month had a past year STD compared with 2.5 percent of those who drank but did not binge on alcohol in the past month, 2.4 percent of those who engaged in past month binge alcohol use but not heavy use, and 3.1 percent of past month heavy alcohol users
- Having an STD in the past year was more common among persons aged 18 to 25 who used both alcohol and an illicit drug in the past month (3.9 percent) than those who used neither alcohol nor an illicit drug (1.3 percent), those who used alcohol but no illicit drugs (2.1 percent), and those who used an illicit drug but not alcohol (2.1 percent)
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Sexually transmitted diseases (STDs) are infections transmitted mainly through sexual activity, although some STDs can be transmitted by sharing drug injection equipment. In the United States in 2005, there were 976,445 new cases of chlamydia, 339,593 new cases of gonorrhea, 266,000 new cases of herpes, and 8,724 new cases of syphilis.1 Sexually active adolescents and young adults may be at higher risk of acquiring STDs than older adults. Recent estimates suggest that persons aged 15 to 24 represent about 25 percent of all persons who were ever sexually active, but nearly half of all new STD cases.2 In addition, research has documented the association between substance use and STDs.3,4
The National Survey on Drug Use and Health (NSDUH) asks questions to examine health conditions, including STDs. Respondents are provided with a list of health conditions and are asked to indicate whether they have ever been told by a doctor or other medical professional that they had each of these conditions. Individuals who report having ever been told they had any of these conditions then are asked to indicate whether they had been told by a doctor or other medical professional that they had each of the conditions in the past year. One of the conditions asked about is STDs, such as chlamydia, gonorrhea, herpes, or syphilis.5
NSDUH also asks persons aged 12 or older to report on their use of alcohol and illicit drugs in the past month. Those who report having used alcohol are asked about binge and heavy use. Binge alcohol use is defined as drinking five or more drinks on the same occasion (i.e., at the same time or within a couple of hours of each other) on at least 1 day in the past 30 days. Heavy alcohol use is defined as drinking five or more drinks on the same occasion on each of 5 or more days in the past 30 days; all heavy alcohol users are also binge alcohol users. Illicit drugs refer to marijuana/hashish, cocaine (including crack), inhalants, hallucinogens, heroin, or prescription-type drugs used nonmedically.6
This report examines STDs among the civilian, noninstitutionalized U.S. population aged 12 or older, with a focus on young adults aged 18 to 25. In addition, rates of past year STDs are presented by level of past month alcohol use and combination of past month alcohol and illicit drug use among young adults aged 18 to 25.7 Past month, rather than past year, substance use is presented because most young adults have had at least one drink of alcohol in the past year, thus making past month use a better indicator of recent drinking behavior. All findings presented in this report are based on 2005 NSDUH data.
Prevalence of Sexually Transmitted Diseases, by Demographic Characteristics
In 2005, 0.8 percent of persons aged 12 or older (2.0 million persons) had an STD in the past year (i.e., the year prior to the survey). Persons aged 18 to 25 were more likely to have had an STD than were persons in any other age group (Figure 1). Females aged 12 or older were more likely to have had a past year STD than were their male counterparts (1.2 vs. 0.5 percent). Blacks were more likely to have had a past year STD than were Hispanics, whites, Native Hawaiians or Other Pacific Islanders, Asians, and persons of two or more races (1.7 vs. 0.9, 0.7, 0.2, 0.2, and 0.3 percent, respectively).
Figure 1. Percentages Having Past Year Sexually Transmitted Diseases among Persons Aged 12 or Older, by Age Group: 2005
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Figure 1 Table. Percentages Having Past Year Sexually Transmitted Diseases among Persons Aged 12 or Older, by Age Group: 2005
| Age Group |
Percentage |
| 12 to 17 |
0.4 |
| 18 to 25 |
2.1 |
| 26 to 34 |
1.6 |
| 35 or Older |
0.5 |
| Source: SAMHSA, 2005 NSDUH. |
Prevalence of Sexually Transmitted Diseases among Persons Aged 18 to 25
In 2005, 2.1 percent of young adults aged 18 to 25 had a past year STD. Females aged 18 to 25 were 4 times as likely to have had a past year STD as their male counterparts (3.4 vs. 0.8 percent). Black young adults were more likely to have had a past year STD than were white, Hispanic, and Asian young adults, as well as young adults of two or more races (Figure 2).
Figure 2. Percentages Having Past Year Sexually Transmitted Diseases among Young Adults Aged 18 to 25, by Race/Ethnicity*: 2005
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Figure 2 Table. Percentages Having Past Year Sexually Transmitted Diseases among Young Adults Aged 18 to 25, by Race/Ethnicity*: 2005
| Race/Ethnicity |
Percentage |
| Black |
3.7 |
| American Indian/Alaska Native |
3.5 |
| White |
2.0 |
| Hispanic |
2.0 |
| Two or More Races |
1.7 |
| Asian |
0.2 |
| Source: SAMHSA, 2005 NSDUH. |
Rates of Past Year Sexually Transmitted Diseases, by Past Month Alcohol Use among Persons Aged 18 to 25
The likelihood of having an STD in the past year was related to the frequency of alcohol use during the past month. Among young adults aged 18 to 25, 1.4 percent of those who did not drink alcohol in the past month had a past year STD compared with 2.5 percent of those who drank but did not binge on alcohol in the past month, 2.4 percent of those who engaged in past month binge alcohol use but not heavy use, and 3.1 percent of past month heavy alcohol users (Figure 3). Similar patterns were found for males and females.
Figure 3. Percentages Having Past Year Sexually Transmitted Diseases among Young Adults Aged 18 to 25, by Level of Past Month Alcohol Use and Gender: 2005
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Figure 3 Table. Percentages Having Past Year Sexually Transmitted Diseases among Young Adults Aged 18 to 25, by Level of Past Month Alcohol Use and Gender: 2005
| Alcohol Use |
Total |
Male |
Female |
| No Past Month Alcohol Use |
1.4 |
0.4 |
2.1 |
| Past Month Alcohol Use, but Not Binge Use |
2.5 |
0.8 |
3.6 |
| Past Month Binge Alcohol Use, but Not Heavy Use |
2.4 |
1.0 |
4.2 |
| Past Month Heavy Alcohol Use |
3.1 |
1.3 |
7.3 |
| Source: SAMHSA, 2005 NSDUH. |
Rates of Past Year Sexually Transmitted Diseases, by Past Month Alcohol and Illicit Drug Use among Persons Aged 18 to 25
Having an STD in the past year was more common among persons aged 18 to 25 who used both alcohol and an illicit drug in the past month (3.9 percent) than those who used neither alcohol nor an illicit drug (1.3 percent), those who used alcohol but no illicit drugs (2.1 percent), and those who used an illicit drug but not alcohol (2.1 percent) (Figure 4). Similar patterns were found for both males and females.
Figure 4. Percentages Having Past Year Sexually Transmitted Diseases among Young Adults Aged 18 to 25, by Past Month Alcohol and Illicit Drug Use and Gender: 2005
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Figure 4 Table. Percentages Having Past Year Sexually Transmitted Diseases among Young Adults Aged 18 to 25, by Past Month Alcohol and Illicit Drug Use and Gender: 2005
| Alcohol and Illicit Drug Use |
Total |
Male |
Female |
| Neither Alcohol nor Illicit Drug Use |
1.3 |
0.3 |
2.1 |
| Alcohol Use, but Not Illicit Drug Use |
2.1 |
0.8 |
3.4 |
| Illicit Drug Use, but Not Alcohol Use |
2.1 |
1.0 |
3.3 |
| Both Alcohol and Illicit Drug Use |
3.9 |
1.5 |
7.9 |
| Source: SAMHSA, 2005 NSDUH. |
End Notes
1 Centers for Disease Control and Prevention, Division of STD Prevention. (2006, November). Sexually transmitted disease surveillance, 2005. Atlanta, GA: U.S. Department of Health and Human Services. [Available at http://www.cdc.gov/std/stats/]
2 Weinstock, H., Berman, S., & Cates, W., Jr. (2004). Sexually transmitted diseases among American youth: Incidence and prevalence estimates, 2000. Perspectives on Sexual and Reproductive Health, 36(1), 6-10.
3 Centers for Disease Control and Prevention. (2000, November; updated 2001, January). Sexually transmitted diseases. In Healthy People 2010: Volume II: Objectives for improving health (Part B, Focus Area 25) (2nd ed.). Retrieved on February 20, 2007, from http://www.healthypeople.gov/document/tableofcontents.htm#partb and http://www.healthypeople.gov/document/html/volume2/25stds.htm
4 Marx, R., Aral, S. O., Rolfs, R. T., Sterk, C. E., & Kahn, J. G. (1991). Crack, sex, and STD. Sexually Transmitted Diseases 18, 92-101.
5 Questions on the acquired immunodeficiency syndrome and the human im-munodeficiency virus (AIDS/HIV) were asked separately and are not included in this analysis.
6 NSDUH measures the nonmedical use of prescription-type pain relievers, sedatives, stimulants, or tranquilizers. Nonmedical use is defined as the use of prescription-type drugs not prescribed for the respondent by a physician or used only for the experience or feeling they caused. Nonmedical use of any pre-scription-type pain reliever, sedative, stimulant, or tranquilizer does not include over-the-counter drugs. Nonmedical use of stimulants includes methamphet-amine use.
7 Level of past month alcohol use is categorized as (1) no past month alcohol use; (2) past month alcohol use, but not binge use; (3) past month binge alcohol use, but not heavy use; and (4) past month heavy alcohol use. Combination of past month alcohol and illicit drug use is categorized as(1) neither alcohol nor illicit drug use; (2) alcohol use, but not illicit drug use; (3) illicit drug use, but not alcohol use; and (4) both alcohol and illicit drug use.
Figure Note
* Race/ethnicity categories are determined by combining the responses from two separate questions. For this report, respondents identifying themselves as Hispanic were assigned to the Hispanic group regardless of their racial iden-tification. Respondents identifying themselves as non-Hispanic were grouped according to their racial identification. Thus, "white" refers to those identifying themselves as non-Hispanic and white. Estimates for Native Hawaiian or Other Pacific Islander are not shown due to low precision.
Suggested Citation
Substance Abuse and Mental Health Services Administration, Office of Applied Studies. (March 30, 2007). The NSDUH Report: Sexually Transmitted Diseases and Substance Use. Rockville, MD.
The National Survey on Drug Use and Health (NSDUH) is an annual survey sponsored by the Substance Abuse and Mental Health Services Administration (SAMHSA). Prior to 2002, this survey was called the National Household Survey on Drug Abuse (NHSDA). The 2005 data are based on information obtained from 68,308 persons aged 12 or older, including 45,774 persons aged 18 or older. The survey collects data by administering questionnaires to a representative sample of the population through face-to-face interviews at their place of residence.
The NSDUH Report is prepared by the Office of Applied Studies (OAS), SAMHSA, and by RTI International in Research Triangle Park, North Carolina. (RTI International is a trade name of Research Triangle Institute.)
Information on NSDUH used in compiling data for this issue is available in the following publication:
Office of Applied Studies. (2006). Results from the 2005 National Survey on Drug Use and Health: National findings (DHHS Publication No. SMA 06-4194, NSDUH Series H-30). Rockville, MD: Substance Abuse and Mental Health Services Administration.
Also available online: http://www.oas.samhsa.gov.
Because of improvements and modifi cations to the 2002 NSDUH, estimates from the 2002 to 2005 surveys should not be compared with estimates from the 2001 or earlier versions of the survey to examine changes over time.
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(formerly The NHSDA Report) is published periodically by the Office of Applied Studies, Substance Abuse and Mental Health Services Administration (SAMHSA). All material appearing in this report is in the public domain and may be reproduced or copied without permission from SAMHSA. Additional copies of this report or other reports from the Office of Applied Studies are available online: http://www.oas.samhsa.gov. Citation of the source is appreciated. For questions about this report, please e-mail: shortreports@samhsa.hhs.gov.
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