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

Community-specific intervention may be required to make major strides in the prevention of STDs across the nation. For example, racial and ethnic minorities continue manifest higher rates of sexually transmitted diseases in the United States. "These disparities may be, in part, because racial and ethnic minorities are more likely to seek care in public health clinics that report STDs more completely than private providers," but lack of access to quality health care, poverty, or greater mistrust of the medical establishment may also be factors (Faculty notes, 2009, CDC). Regardless of the specific reason, to cite one example "in 2006, the rate of Chlamydia among African-Americans was more than eight times higher than the rate among whites (1275.0 vs. 153.1 per 100,000 population), with approximately 46% of all Chlamydia cases reported among African-Americans. Additionally, the rates among American Indians/Alaska Natives (797.3 per 100,000) and Hispanics (477.0 per 100,000), were five times and three times higher than whites, respectively" (Faculty notes, 2009, CDC). Unless the specific reasons for health disparities are addressed within these communities, long-term prevention of wide-scale epidemics will...

However, the reduction of STDs should be tied to poverty reduction, increased health awareness (including reduced substance abuse), and increased access to healthcare and screening. Because of the importance of teaching the public about appropriate condom use, of providing access to screening, of encouraging self-monitoring to avoid risky situations, and of increasing access to and trust of the healthcare system, STD prevention must be part of a widespread campaign to promote healthy behaviors. The spread of these illnesses cannot be isolated from anti-poverty, education, and anti-substance abuse campaigns.
References

Ahmed, K, & S. Scholle, H. Baasiri, K.W. Hoover, R. Romaguera, & G. Tao. (2009, April 17).

Chlamydia screening among sexually active young female enrollees of health plans:

United States, 2000 -- 2007. MMWR 58(14); 362-365. Retrieved January 21, 2009 at http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5814a2.htm?s_cid=mm5814a2_e

Faculty Notes: Ready-to-use STD curriculum. (2009). Chlamydia. CDC.

Retrieved January 21, 2009 at http://www2a.cdc.gov/stdtraining/ready-to-use/chlamydia.asp

HPV. (2009). CDC. Retrieved January 21, 2009 at http://www.cdc.gov/std/HPV/STDFact-HPV.htm#prevent

Klausner, Warner L, et al. (2008) Effect of a brief video intervention on incident infection among patients attending sexually transmitted disease clinics. PLoS Med 5(6): e135.

Scott-Sheldon, Lori, Michael P. Carey, Peter A. Vanable, Theresa E. Senn, Patricia Coury-

Doniger & Marguerite A. Urban. (2009, September). Alcohol consumption, drug use, and condom use among STD clinic patients. Journal of Studies on Alcohol.

Retrieved January 21, 2009 at http://findarticles.com/p/articles/mi_hb6378/is_5_70/ai_n39191998/pg_3/?tag=content;col1