An increase in alcohol tax appears to have decreased gonorrhea rates in Maryland

http://www.eurekalert.org/pub_releases/2015-12/uof-aii120915.php

Public Release: 9-Dec-2015
An increase in alcohol tax appears to have decreased gonorrhea rates in Maryland
University of Florida

Increasing state alcohol taxes could help prevent sexually transmitted infections, such as gonorrhea, according to University of Florida Health researchers, who found that gonorrhea rates decreased by 24 percent in Maryland after the state increased its sales tax on alcohol in 2011.

Multiple prior studies have shown that increases in alcohol taxes decrease alcohol consumption. Less drinking reduces risky sexual behavior, such as having unprotected sex or having sex with new partners. In 2014, the rate of infection from gonorrhea, chlamydia and syphilis increased substantially nationwide, and young people accounted for nearly two-thirds of the cases of gonorrhea and chlamydia. This UF Health study is one of the first to quantify the effect of alcohol taxes on the rate of sexually transmitted infections.

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Sexually transmitted diseases can cause pain, infertility and certain types of cancer. In Maryland, the tax increase resulted in 2,400 fewer statewide cases of gonorrhea during the 18 months after the tax increase went into effect, according to findings published today (Dec. 9) in the American Journal of Preventive Medicine.

The tax increase in Maryland was only $0.03 per $1. The tax increased from 6 percent, which had been the sales tax rate on alcohol since July 1, 2008, to 9 percent on July 1, 2011.

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To attribute the effects the team observed to the increase in alcohol taxes, the researchers compared the trends in sexually transmitted diseases in Maryland with three groups of other states.

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The research team did not find any effect on chlamydia rates or any differences across age, race or ethnicity, or gender. This lack of difference across various demographics suggests the tax may have influenced all individuals similarly, Staras said.

The lack of effect on chlamydia rates could be due to the fact that chlamydia infections are more likely to be asymptomatic or mild compared with gonorrhea, which means people are less likely to seek testing and therefore the cases are less likely to be reported. In addition, gonorrhea infections are more geographically concentrated and restricted to higher-risk populations, magnifying the influence of small changes, such as a decrease in alcohol consumption. High-risk populations include individuals who engage in risky sexual behavior with concurrent partners or those who have sexual partners within an interconnected social group.

"Right now, the only population-level intervention for STIs recommended by the Centers for Disease Control and Prevention is condom distribution," Staras said. "However, the effects we observed in this study are comparable to the effectiveness of condom distribution, and taxes generate revenue rather than spend it -- making it a powerful option for policymakers to consider."