Stds Epidemiology-Sexual Transmitted Diseases Sexually

STDS

Epidemiology-sexual transmitted diseases

Sexually transmitted diseases: Primary, secondary, and tertiary prevention

Sexually transmitted diseases: Primary, secondary, and tertiary prevention

Primary: Health promotion and specific prevention strategies

Despite the increased publicity regarding the role of condom use in the prevention of sexually-transmitted diseases, there are an estimated 19 million new STD infections in the United States every year. "In 2006, more than 45,000 (of 56,300) new cases of HIV / AIDS have been attributed to sexual transmission; in addition, more than 1 million cases of Chlamydia and 355,991 cases of gonorrhea were reported in 2007" (Scott-Sheldon et al. 2009, p.1). Ignorance of how to prevent STDs with condoms is one, but not the only cause of these sobering statistics: "Patients in STD clinics often report other health-related problems, such as high levels of alcohol and drug use that may exacerbate their risk for HIV and/or STDs" (Scott-Sheldon et al. 2009, p.1). STD prevention, to be effective, cannot merely focus on condom use: encouraging teens and adults to limit substances that can impair good judgment and to understand the seriousness and commonness of all STDs is critical to the prevention of the spread of these public health threats. Teens and adults must understand that the consequences of STDs, including syphilis, Chlamydia, and the human papillomavirus virus (HPV) cannot be easily dismissed and cured by simply taking an antibiotic. The rise of antibiotic-resistant infections, the risks of undetected STDs, and more serious consequences, such as an increased risk of cervical cancer in the case of HPV are all the results of inadequate preventative strategies.

Educational efforts must be direct, have impact, and also speak the target audience's language in. One video-based waiting room intervention, entitled Safe in the City, specifically designed to address the needs of New York City residents was found to lower STD incidence among attendees at an STD clinic patients by a statistically significant margin. Researchers "found that patients who were exposed to a 23-minute HIV/STD prevention video had nearly a 10% reduction in new infections compared with those who were not exposed to the video" (Klausner 2003). STD prevention strategies are often more effective if targeted to specific populations -- the stress must be that the disease 'can happen to you' rather than seem like a theoretical threat. Teens must understand they are not invincible; adults must understand that despite the existence of antibiotics, STDs are often dangerously asymptomatic and are not discovered before serious damage is done. Women are also more likely to contract STDs from men than vice versa, and should be aware of their elevated risk. Regarding one specific STD, the genital human papillomavirus virus, vaccination is an additional option. "Vaccines can protect males and females against some of the most common types of HPV" (HPV, 2009, CDC).

Secondary: Early diagnosis and treatment

Early detection is critical in the treatment of sexually transmitted diseases. For example, undetected Chlamydia, the most common bacterial sexually transmitted disease (STD), can progress to pelvic inflammatory disease (PID), infertility, ectopic pregnancy, and chronic pelvic pain. However, many young women do not know about the disease's ability to damage their future fertility, or its largely asymptomatic nature.

In 1989, the U.S. Preventive Services Task Force (USPSTF) recommended routine Chlamydia screening of sexually active young women. From 2000 to 2007, annual Chlamydia screening rates generally increased among sexually active females aged 16-25 years enrolled in U.S. commercial and Medicaid health plans. Reasons women resisted screening included "1) inability to pay the copayment of a screening test, and 2) lack of knowledge of the asymptomatic nature, high prevalence, and possible adverse long-term reproductive effects of Chlamydia infection" (Ahmed et al. 2009). Eliminating co-pays for STD tests might be one way to increase detection, as well female-specific education strategies.

While screening for some STDs, such as HIV / AIDS, has increased, individuals may still resist because of 'not wanting to know' or fear of social stigma. The effects of HIV / AIDS can be mitigated with early drug intervention. This underlines the fact that detection and screening must become routine amongst high-risk populations for all STDs, regardless of the type of disorder.

Tertiary: Limiting disability/epidemic spread