March 2005: STDs Print

America's Health Burden from Sexual Activity

As part of an analysis of the burden of disease and injury in the USA, researchers identified/quantified the incidence of adverse health events, deaths, and disability adjusted life years (DALY) attributed to sexual behavior. DALY is a number that combines into a single measurement the loss of healthy years of life from an illness and the years of life cut short by premature death from an illness. While total deaths caused by sexual behavior for both men and women were 29,782, the total cost in Disability Adjusted Life Years was more than 2 million...

The study noted that its data "included more unsafe sex related conditions than were considered in previous analyses for the United States" including "hepatitis, infertility," damage to men's reproductive capabilities, "maternal conditions, and abortions." This study is unique because it measures the health ramifications of sexual conduct by counting not only death and diseases but by examining other adverse health affects related to sex. In 1998, about 20 million such events (7532/100 000 people) and 29,782 such deaths (1.3% of all US deaths) occurred, contributing to 2,161 417 DALYs (6.2% of all US DALYs). Viral infections and their sequelae accounted for nearly all sexual behavior related deaths—mostly HIV/AIDS. Sexual behavior attributed DALYs in the USA are threefold higher than that in overall established market economies. "Measuring adverse outcomes of reproduction or sexual behaviour by counting deaths or diseases alone is inadequate for a proper understanding of the dimensions of the issue. Many such adverse outcomes occur at a young age leading to a large component of lifespan lived with disability. Many deaths from such adverse outcomes occur at a young age and such loss of productive life is not captured by mortality statistics." Among the illnesses brought on by sexual behavior that are lethal for men, HIV is far and away the largest killer. There were 36,000 incidences of the virus in 1998 and 18,221 deaths accounting for 93 percent of all deaths of men from sexual behavior. For women, 8,200 contracted HIV and 4,234 died of it making it second to cervical cancer, which took the lives of 4,921 women, as the biggest killer of women. Beyond the toll of HIV - which had a DALY cost for men of 557,021 - men were hit especially hard by the Hepatitis B virus. With more than 1.5 million incidences of the virus among men the DALY cost came to 279,624. The majority of incident health events (62%) and DALYs (57%) related to sexual behavior were among females, and curable infections and their sequelae contributed to over half of these. Though it was not listed among the study's prominent findings, women's fertility takes a huge hit. There were 598,000 annual incidences of infertility resulting from sexual behavior leading to a cost in Disability Adjusted Life Years of 843,747. In fact, infertility produced the highest DALY cost of any of the negative health effects of sexually activity.

[Sex Transm Infect 2005;81:38-40, "Sexual behaviour: related adverse health burden in the United States". S H Ebrahim1, M T McKenna1 and J S Marks2:  1 National Center for HIV/AIDS, STD, TB Prevention, CDC, Atlanta, GA, USA; 2 National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta, GA. Shahul H Ebrahim MD PhD. BMJ; (CDC, Mail Stop E-46), 1600 Clifton Road, Atlanta, GA; ] [Culture of Life Foundation, Culture & Cosmos, 1Mar05, Volume 2, Number 30]

 
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