Rates of early death and disability that can be attributed to sexual behavior are three times higher in the United States than other so-called developed nations, a new study finds.

This finding precludes the AIDS epidemic in many African countries.



American men still die more often as a result of having a sexually transmitted disease, researchers from the U.S. Centers for Disease Control and Prevention said, but more cases are reported in American women. The findings were published in the Jan. 27 issue of the British journal Sexually Transmitted Infections.



“It certainly is disturbing,” said Dr. Cynthia Krause, assistant clinical professor of obstetrics/gynecology at Mount Sinai School of Medicine in New York City. “The challenge is how to represent this in a way that’s not alarmist, to make women aware of the real risks.”



An earlier survey had found that half of all deaths in the United States in 1990 were attributable to nine risk factors that included sexual behavior. That category alone accounted for 30,000 deaths. The researchers behind the new study didn’t think this provided a complete picture of the health toll, given that sexually transmitted diseases are associated with other problems such as infertility, psychological trauma and stigma.



They set out to quantify the public health burden of sexually transmitted diseases in 1998 by looking at national data on sexual health and reproduction, surveillance systems for infectious diseases, hospital and outpatient statistics, birth and death records as well as published research.



They then calculated “adverse health consequences,” such as infertility, cervical cancer, and HIV infections. They also factored in premature deaths and “disability adjusted life years” (DALYs), a figure indicating years of life cut short by premature death and loss of healthy living years as a result of disability.



In 1998, sexual behavior accounted for about 20 million “adverse health consequences” (equivalent to more than 7,500 per 100,000 people) and 29,782 deaths (or 1.3 percent of all deaths in the United States), the study found.



Sixty-two percent of the “adverse health consequences” and 57 percent of “disability adjusted life years” were among women. Curable infections and their consequences accounted for more than half of these health problems. Viral infections — mostly HIV/AIDS — and their consequences accounted for almost all deaths among men and women.



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