When the Healthy People 2010 initiative made reducing sexually transmitted diseases a goal in 2000, its educational campaigns, commercials and free condoms led to a 5 percent to 10 percent decrease in reported cases.
But with methamphetamine use on the rise in Moffat County, health care officials say they don't think the decline in sexually transmitted diseases will continue.
An increase in meth use in the county likely will lead to an increase in sexually transmitted diseases, officials say.
"Meth use is associated with high-risk behavior, including sex with multiple partners and unprotected sex," said Jennifer Ruth, spokeswoman for the Centers for Disease Control and Prevention.
Methamphetamine is a stimulant that reduces inhibitions and enhances libido.
Visiting Nurse Association clients aren't likely to say they are drug users, spokeswoman Carrie Godes said. So it isn't easy to make a connection, officials say. But health care workers say they think meth use and sexually transmitted diseases are connected.
"The assumption and gut feeling is that one risky behavior puts a person at risk for another risky behavior," said public health nurse Laurie Voit-Perry, who recently began working at the Moffat County Jail after spending five years at the Visiting Nurse Association. "We definitely saw people come in who looked like they had been taking meth, but none really ever admitted it."
Between 2003 and 2004, the Craig Police Department reported an 81 percent increase in the number of drug-related violations. Craig police Chief Walt Vanatta attributes the increase solely to meth use.
About 80 percent of the crimes police investigate are in some way related to methamphetamine, whether they are fights that erupt over drug debts or between users, or burglaries by addicts hoping to steal items to pawn and pay for their habit.
The department made 59 meth-related arrests in 2005.
Many studies document the association of substance abuse with sexually transmitted disease.
According to a federally funded review on such diseases, behavioral factors that can increase STD transmission in a community include the exchange of sex for drugs, increases in the number of anonymous sex partners and decreases in attempts to seek medical treatment.
The nationwide syphilis epidemic of the late 1980s, for example, was fueled by increased crack cocaine use, officials say.
There were 18 cases of chlamydia reported in Moffat County in 1999. In 2003, there were 29.
In the same period, police reported increased meth use.
The trend is similar across the state. The Centers for Disease Control and Prevention reports a 21 percent increase in chlamydia between 1999 and 2002, though the numbers began to fall in 2003.
Eleven percent of those diagnosed with a sexually transmitted disease report contracting from intravenous drug use.
Most recent studies focus on the relationship between AIDS and HIV to drug use. Of the 250 Coloradans diagnosed with HIV in 2003, 6 percent report contracting the disease through intravenous drug use and another 5 percent report putting themselves at risk through a combination of drug use and same-sex contact.
Researchers at the San Francisco Department of Public Health found that compared with nonusers, men who used meth were 2.2 times more likely to be HIV-positive, 4.1 times more likely to have syphilis, 1.9 times more likely to have chlamydia and 1.7 times more likely to have gonorrhea.
And the risk is growing in rural areas. According to the Centers for Disease Control and Prevention, 15 percent of Colorado's AIDS-infected population lived in rural areas in 1989 compared with the 23 percent in 2003. Still, Moffat County's numbers have remained stable.
According to the Colorado Department of Public Health and Environment, there were a combined 10 cases of HIV and AIDs reported in 1999 in Moffat County. The same number was reported through September 2005.
A National Institute on Drug Abuse report found meth use is associated with rougher sex, which could lead to bleeding and abrasions.
"The combination of injection and sexual risks may result in HIV becoming a greater problem among methamphetamine abusers than among other drug abusers," according to the report. "These findings underscore the importance of substance abuse education and treatment as a key component of HIV prevention."
Voit-Perry said the community is responding to the growing meth problem, but the associated risk of sexually transmitted diseases is still on the fringe of public awareness.