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STD Repeaters: Implications for the Individual and STD Transmission in a Population

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Behavioral Interventions for Prevention and Control of Sexually Transmitted Diseases

STD repeaters are important as a population of study for two primary reasons: 1) repeat infections may lead to an increased risk in STD sequelae, and 2) persons with repeat infections represent a disproportionate share of STD morbidity and may be members of the core group or core transmitters. We argue that it is likely that there are two different groups of repeaters. First, there are women who are the recipients of repeat infection as a result of the risky behaviors of their sex partners. Second, there are heterosexual and homosexual men and some women who engage in behavior that is more typical of core transmission patterns. These groups will require different interventions. We discuss these issues further later in the chapter.

It is worth delineating what we mean when we talk about “STD repeaters” or “repeat infections with STDs.” Generally, when used in the research literature, “repeaters” are individuals who acquire more than one nonviral STD infection in a specified period of time. Some studies focus solely on repeat episodes of gonorrhea (1–6); some focus exclusively on two or more infections with chlamydia (7–11). Other studies consider several different STDs when defining repeaters (12–15). What appears to be most important is that, regardless of specific disease, repeaters are an important population and are at an increased risk for STD acquisition and sequelae. Furthermore, some repeaters may be largely responsible for maintaining core transmission groups that spread disease throughout the community.

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Authors and Affiliations

  1. Division of General Pediatrics and Adolescent Medicine, Johns Hopkins, University School of Medicine, Baltimore, Maryland, USA

    Jami S. Leichliter (Ph.D.) & Jonathan M. Ellen (M.D.)

  2. Public Health Services Division, San Diego County Health and Human Services, San Diego, California, USA

    Robert A. Gunn (M.D., M.P.H.)

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  1. Jami S. Leichliter
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Editors and Affiliations

  1. Division of STD Prevention, National Centers for HIV, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA

    Sevgi O. Aral Ph.D.  & John M. Douglas Jr M.D.  & 

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Leichliter, J.S., Ellen, J.M., Gunn, R.A. (2007). STD Repeaters: Implications for the Individual and STD Transmission in a Population. In: Aral, S.O., Douglas, J.M. (eds) Behavioral Interventions for Prevention and Control of Sexually Transmitted Diseases. Springer, Boston, MA. https://doi.org/10.1007/978-0-387-48740-3_15

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