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Mycoplasma genitalium Among Young Adults in the United States: An Emerging Sexually Transmitted Infection, AJPH, 6/07

Lisa E. Manhart, PhD, King K. Holmes, MD, PhD, James P. Hughes, PhD, Laura S. Houston, MS and Patricia A. Totten, PhD

Objectives. We sought to determine the prevalence of and risk factors associated with Mycoplasma genitalium infection in a nationally representative sample of young adults in the United States.

Methods. Urine specimens from 1714 women and 1218 men who participated in Wave III of the National Longitudinal Study of Adolescent Health (N=14322) were tested for M genitalium. Poststratification sampling weights were used to generate nationally representative estimates.

Results. The prevalence of M genitalium was 1.0% compared with 0.4%, 4.2%, and 2.3% for gonococcal, chlamydial, and trichomonal infections, respectively. No M genitalium–positive individuals reported symptoms of discharge. M genitalium prevalence among those who reported vaginal intercourse was 1.1% compared with 0.05% among those who did not. In multivariate analyses, M genitalium prevalence was 11 times higher among respondents who reported living with a sexual partner, 7 times higher among Blacks, and 4 times higher among those who used condoms during their last vaginal intercourse. Prevalence of M genitalium increased by 10% for each additional sexual partner.

Conclusions. M genitalium was more prevalent than Neisseria gonorrhoeae but less prevalent than Chlamydia trachomatis, and it was strongly associated with sexual activity.

Lisa E. Manhart is with the Department of Epidemiology, School of Public Health and Community Medicine, University of Washington, Seattle. King K. Holmes is with the Departments of Medicine, Epidemiology, and Microbiology, University of Washington, Seattle. James P. Hughes is with the Department of Biostatistics, University of Washington, Seattle. Laura S. Houston and Patricia A. Totten are with the Department of Medicine, University of Washington, Seattle. All authors are with the Center for AIDS and STDs, University of Washington, Seattle. Correspondence: Requests for reprints should be sent to Lisa E. Manhart, PhD, University of Washington Center for AIDS and STD, 325 9th Ave, Box 359931, Seattle, WA 98104–2499.
AJPH First Look, published online ahead of print Apr 26, 2007
June 2007, Vol 97, No. 6 | American Journal of Public Health 1118-1125
© 2007 American Public Health Association
DOI: 10.2105/AJPH.2005.074062


New STD Infection Rates “4 times higher among those who used condoms during their last vaginal intercourse”: M. Genitalium Surpasses Gonorrhea among Young Adults Reports AJPH.

A new study reveals that a relatively new sexually transmitted disease (STD) has surpassed gonorrhea in prevalence among sexually active young adults in the United States.
The disease, Mycoplasma genitalium, was first identified back in the 1980s as the smallest known bacterium in existence. Now researchers at the University of Washington in Seattle found that 1.0 percent of the several thousand participants in their study were infected with M. genitalium, whereas gonorrhea was found in a comparatively small 0.4 percent. Chlamydia infection rates were 4.2 percent.
The researchers also found that M. genitalium’s prevalence of infection, according to the study abstract, is “11 times higher among respondents who reported living with a sexual partner" and "7 times higher among Blacks.”
Notably, the study also found that infection rates were “4 times higher among those who used condoms during their last vaginal intercourse.”

The findings published in the American Journal of Public Health were based on tests of 1714 women and 1218 men between the ages of 18 and 27 years participating in Wave III of the National Longitudinal Study of Adolescent Health.

The disease can cause inflammation of the urethra in men, and inflammation of the cervix and uterine lining in women, which can lead to infertility. Many of the cases, however, are asymptomatic, like Chlamydia infections.

Other studies have shown M. genitalium to be associated with or a possible cause of cases of epididymoorchitis (inflammation of the testis and epididymis), neonatal (newborn) disease and reactive arthritis.

“This shows demonstrably that comprehensive sex-education is anything but comprehensive,” Matt Barber [Policy Director for Cultural Issues for Concerned Women for America]. “The evidence would indicate it is contributing to sexually transmitted diseases.” Instead, he pointed out, after 40 years of sex-education in the US, sexual promiscuity has skyrocketed, leaving approximately 1 in every 4 Americans currently with an STD.

The study, Barber noted, also underscored the fact that condoms are far from the “divine answer dreamed by the left" to solve problems associated with sexual promiscuity: “By pressing upon children that condom is a fail proof safety net … they are encouraging kids to walk a paper thin latex light rope…The only way we know to guarantee that you’re not going to catch all these kinds of diseases [and suffer all their consequences] is by abstinence.”

Related: HPV Condom Study Shows The Failure of Condom Education —
Study: Even with 100 % Condom Use 30% Still Contract Potentially Deadly — HPV Virus
Medical Journalist Says Reliance on Condoms Spreads HIV/AIDS —
[June 12, 2007, Peter J. Smith,

1205.html, Seattle]


“Comprehensive” Sex Education is Ineffective: Abstinence Works, Major National Study Shows
One of the largest and most comprehensive studies of teen sex education, conducted by Dr. Stan Weed of the Institute for Research and Evaluation in Salt Lake City, shows why abstinence is the most successful method of preventing physical and emotional complications resulting from pre-marital sexual activity. The study (see  followed the education and behavior of over 400,000 adolescents in 30 different states for 15 years.  followed the education and behavior of over 400,000 adolescents in 30 different states for 15 years.

The final report, entitled “Abstinence” or “Comprehensive” Sex Education? begins by pointing out the flaws in a national study on abstinence released by  Mathematica Policy Research, Inc. Conducted in April 2007, this previous study examined the progress of teens who participated in four different abstinence education programs. The final report indicated that abstinence education was ineffective and that young adolescents should receive “comprehensive” sex education, that is, sex-education that teaches about various sexual behaviors and “safe-sex” methods.

After examining the Mathematica study’s methods, the Institute found several major errors that made the study non-representative of American sex education. First, says the more recent study, it took sample teens from “high-risk” sectors of the population, such as poor African or American single-parent households. During the study, young people received abstinence education in pre-adolescence, but then received no follow-up training during adolescence. They were also examined about their sexual activity several years after any learning might have taken effect.

Dr. Stan Weed told “Within the United States, sexual activity rates have been going down among teenagers for about the last 12 or 13 years, and that coincides with when the abstinence education started. Abortion, pregnancies and out of wedlock births rates have also been going down among teens during that same time period. However, pregnancy, abortion and out of wedlock births have been rising for the older age group, between 19-25, a group that has not been targeted by abstinence programs.”

Outlining these limitations and the report’s inaccuracies, Dr. Weed highlighted the problems that sexually active teens encounter and the failure of “comprehensive” sex education to remedy such issues. These include teen pregnancy, STD’s and poor emotional health. Sexually active young people are also more often physically assaulted or raped.

“Comprehensive” sex education also fails to explain the limitation of condoms, said the recent study, pointing out that “many consequences of teen sexual activity are not prevented by condom use.” Condoms are never a total guarantee against STD’s, and so there is no kind of truly “safe” sex outside of marriage. Secondly, despite 20 years of sex education, young people even fail to use condoms consistently. Most importantly, however, condoms do nothing to prevent the heartbreak, depression and low self-esteem caused by sexual activity.

The Utah Institute researchers also investigated previous major studies on “comprehensive” sex education and found that these programs had little impact on the behavior of teens during their education and no long-term effects whatsoever. In fact, “of 50 rigorous studies spanning the past 15 years, only one of them reports an improvement in consistent condom use after a period of at least one year.” 

When evaluating abstinence programs, the Institute investigated both high-risk and moderate-risk students in programs such as Reasons of the Heart, Heritage Keepers, Sex Respect and Teen Aid. Students in these programs were far less likely to be sexually active and those who were reduced their sexual activity by a large percentage. In the Reasons of the Heart study, for example, researchers found that “adolescent program participants were approximately one half as likely as the matched comparison group to initiate sexual activity after one year. The program’s effect was as strong for the African American subgroup in the sample as it was overall.”

The most successful abstinence programs were those that emphasized the risk of pre-marital sexual activity. They showed how abstinence fully protects a young person from STD’s, teen pregnancy and emotional trauma. They underlined the importance of self-control and responsibility and gave students the positive goal of a stable and committed marriage towards which to work in future. At the same time, however, researchers also found that it was crucial to re-educate adolescents about abstinence each successive year.

Dr. Weed concludes, “Well-designed and well-implemented abstinence education programs can reduce teen sexual activity by as much as one half for periods of one to two years, substantially increasing the number of adolescents who avoid the full range of problems related to teen sexual activity. Abandoning this strategy…would appear to be a policy driven by politics rather than by a desire to protect American teens.”

These results are consistent with many other findings, including a 2005 study by Medical Issues Analyst Reginald Finger of Focus on the Family. He investigated over 7,000 people in the United States that indicated the many social and emotional benefits to remaining abstinent. (see


Bush: Abstinence Only 100 % Effective Means of Preventing Pregnancy, HIV, STDs

Abstinence Alone Protects Fully Against HIV, Ugandan First Lady Tells Youth

Abstinence Education Works

– New Report Offers More Evidence
[6/13/07, Elizabeth O’Brien,, Salt Lake City]