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This story has been corrected. (See bottom for details)

In addressing Sexually Transmitted Disease Awareness Month, the Department of Health and Social Services recently released some startling findings for Alaska.

From 2000 to 2007, Alaska had the first- or second-highest nationwide chlamydia infection rate. But it is unclear whether this is attributed to more cases or more accurate testing for the disease.

According to Donna Cecere, STD program coordinator for the Division of Public Health's Section of Epidemiology, about 19 million new sexually transmitted infections are reported nationwide every year by the Centers for Disease Control and Prevention.

"For Alaska, to rate first or second in the nation means that for a given year our chlamydia case rate (number of cases per 100,000 Alaskans) was among the highest rates compared to other states," Cecere said.

She said Alaska's chlamydia rate in 2008 was 718 cases per 100,000 people. A comparison to other states won't be available until later this year, she said.

"I can tell you that in the past several years, when Alaska has come in with the second highest chlamydia case rate, it was always Mississippi that had beat us out for the number one slot," Cecere said.

According to the July 25, 2008, bulletin by the Alaska Section of Epidemiology, total chlamydia cases in Southeast Alaska alone rose from 266 to 285 cases from 2006 to 2007. Statewide, chlamydia cases rose from 4,528 to 4,911 the same years.

Mollie Rosier, a program manager for the Alaska Division of Public Health, said the annual number of newly reported chlamydia cases has been significantly increasing during the past decade. But she said it is unknown if the increase is due to more infections or more accurate screenings. Cecere made a similar speculation.

"It's been suggested to us that the quickest way to reduce the chlamydia rates would be to simply stop testing for it," Cecere said. "I'm sure it was said tongue-in-cheek, but it raises the issue of screening coverage."

And according to Cecere, the section currently has no way of knowing how Alaska's chlamydia screening coverage compares to that of other states.

"We do have several levels of STD service delivery systems here in Alaska, and we are a low-population state," she said. "Between the testing going on within the agencies of the Native health corporations, the public health nursing system, Planned Parenthood clinics and private providers, it is possible that we are reaching a higher proportion of our population than other states do."

In Anchorage, the Section of Epidemiology reaches approximately 85 percent of individuals testing positive for chlamydia, Cecere said.

"We ensure adequate treatment for them and interview them for names and information to help us locate their partner(s)," she added. "Then we find those partners and confidentially notify them and arrange for testing and treatment."

According to Rosier, women ages 15 to 24 show the highest rate of chlamydia infection.

She said chlamydia in women can lead to pelvic inflammatory disease, a cause of infertility, ectopic pregnancy and chronic pelvic pain. It also can be asymptomatic, meaning some people who have the disease are unaware.

Rosier also noted that the 2008 chlamydia rate among Alaska Natives was six times higher than the rate for Alaska's white population.

"Addressing health disparities is rather complex, and it's important to keep in mind that Alaska is not alone or unique in having much higher STD rates among the Alaska Native or American Indian population," Cecere explained. "All across the country, chlamydia case rates among whites are small in comparison to those of minority populations."

Cecere questions whether racial differences in infection rates are due to a true difference in disease incidence or other factors, such as screening rates for different populations or access to timely services.

"Also, I don't think you can look at STD disparities between races without looking at the overall problem of health disparities in general," she added. "Alaska Natives also bear a disproportionate burden of diabetes, lung cancer and tuberculosis. Why is that?

"When you're looking at issues of health disparities based on race, you need to look at associated factors, such as socioeconomic status, geographical differences and environmental factors. It's a great question, and it is an issue of concern and much pondering ... at the national, state and community levels."

But on a positive note, Alaska ranks better than many states regarding syphilis, HIV and gonorrhea, Cecere said.

According to the 2007 CDC study, Alaska reported a total of 579 gonorrhea cases that year, ranking 24th in the nation.

"For a long time, Alaska has come in around the middle of the pack when it comes to ranking of national gonorrhea rates," Cecere said, adding that Alaska has seen a steady increase in gonorrhea cases from 1998 to 2002. Since then rates have dropped.

Cecere said Alaska recently joined a Gonorrhea Control Group, along with Washington, Oregon and Idaho, and they plan to meet in July with the CDC to discuss how best to reduce gonorrhea rates.

Both gonorrhea and chlamydia infections can be cured with antibiotics, Rosier said.

The CDC recommends annual chlamydia screening for sexually active women ages 25 and younger and all pregnant woman. Gay men also should have yearly HIV and syphilis blood tests, as well as testing for other STDs, according to the CDC.

But the simplest way to avoid contracting an STD is to use the proper protection, Rosier said.

"If you are sexually active, the best way to reduce the risk of transmission of gonorrhea and chlamydia infection is to use latex condoms, consistently and correctly, or to be in a long-term mutually monogamous relationship with an uninfected partner."

• Contact Neighbors editor Kim Andree at 523-2272 or kim.andree@juneauempire.com.

Due to a misreading of the Alaska Section of Epidemiology's 2007 annual Infectious Disease Report, the statewide chlamydia cases from 2006 to 2007 were incorrectly noted as 9,056 and 9,822, respectively. The statewide cases actually rose from 4,528 to 4,911 those years.