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Teens who receive formal sex education prior to their first sexual experience demonstrate a range of healthier behaviors at first intercourse than those who receive no sex education at all. This is particularly so when the instruction they receive includes information about both waiting to have sex and methods of birth control. These findings come from a new study, "Consequences of Sex Education on Teen and Young Adult Sexual Behaviors and Outcomes," by Laura Duberstein Lindberg and Isaac Maddow-Zimet of the Guttmacher Institute. http://www.guttmacher.org/media/nr/2012/03/08/index.html
When They Break Up and Get Back Together: Length of Adolescent Romantic Relationships and Partner Concurrency. Matson, Pamela Ann; Chung, Shang-en; Ellen, Jonathan Mark; Sexually Transmitted Diseases; Volume 39, Number 4, April 2012; 281. Sex partner concurrency is an important risk factor for sexually transmitted infection transmission. Understanding how adolescents conceptualize the length of their relationships when they break up and get back together is essential to the assessment of concurrency.
Relationships Between Hours of Sleep and Health-Risk Behaviors in US Adolescent Students. LR McKnight-Eily, et al.; Prev. Med. (2011), doi: 10.1016/j.ypmed.2011.06.020. In a new study of more than 12,000 US teens, CDC researchers found that 68.9 percent reported getting less than eight hours of sleep on an average school night, and these youths were more likely to take part in risky activities than peers who reported sleeping more than eight hours. The sleep-deprived teens were more likely to be sexually active, fight, contemplate suicide, smoke cigarettes and marijuana, drink alcohol, and use a computer for more than three hours daily. They were also less likely to exercise; however, they did not watch more TV than youths who got more sleep.
Patterns of Chlamydia/Gonorrhea Positivity Among Voluntarily Screened New York City Public High School Students. JS Han, et al.; Journal of Adolescent Health Vol. 49; No. 3: P. 252-257 (09/11). Adolescents are disproportionately affected by the common STIs Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (GC), the authors wrote, and annual CT screening is recommended for sexually active female adolescents. In 2006, New York City introduced CT/GC education, screening, and treatment in public high schools.
School-Based Health Center Access, Reproductive Health Care, and Contraceptive Use Among Sexually Experienced High School Students. Ethier KA, et al.; Journal of Adolescent Health 48 (2011) 562–565. The current analyses compared receipt of reproductive health care, contraceptive use, and screening for sexually transmitted diseases (STD) among adolescentswhoare sexually experienced, with or withoutaccess to a school clinic.
Risk-Taking Behaviors of Adolescents with Extreme Obesity: Normative or Not? Ratcliff MB, et al.; Pediatrics (2011; doi:10.1542/peds.2010-2742); originally published online April 25, 2011; http://pediatrics.aappublications.org/content/127/5/827.full.html . A new analysis of federal data by psychologists at the Cincinnati Children’s Hospital Medical Center shows extremely obese teens are just as likely to engage in high-risk behaviors as their normal-weight peers.
Longitudinal Associations Among Relationship Factors, Partner Change and Sexually Transmitted Infection Acquisition in Adolescent Women. Ott MA, et al.; Sexually Transmitted Diseases Vol. 38; No. 3: P. 153-157 (03.11.11). Even when the partnerships do not overlap, new sex partners put adolescents at increased risk for sexually transmitted infections. In the current study, the authors prospectively examined associations between relationship characteristics, partner change, and subsequent STI during periods of “serial monogamy.”
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American Indians/Alaska Natives
Implications of Health Reform for American Indian and Alaska Native Populations. This brief, authored by the Center for Health Care Strategies and the National Academy for State Health Policy for the Robert Wood Johnson Foundation's State Health Reform Assistance Network, looks at opportunities presented by the ACA to improve health care access, coverage, quality, and outcomes for AI/AN populations. The brief outlines provisions that uniquely affect AI/ANs and provides strategies to help states and other stakeholders realize the potential of the ACA to improve the health and health care of AI/AN individuals. Areas addressed include: (1) coverage expansion; (2) state outreach to and engagement with federally recognized tribal groups; and (3) opportunities to fill gaps in the organization and financing of care.
"Native Voices: Native Peoples' Concepts of Health and Illness" available at: http://www.nlm.nih.gov/nativevoices/index.html This on-line exhibit at National Library of Medicine covers from "Era of First Nations" (10,000 BC-1491 AD) to "Renewing Native Ways" (1968-2011), with the text & images & interviews clearly linking issues of social justice & public health. It is helpful for improved understanding of determinants of health as they relate to Native American cultures.
Indian Health Surveillance Report - Sexually Transmitted Diseases 2009. This report presents statistics and trends for STDs among American Indians and Alaska Natives (AI/AN) in the U.S. at the national level and for the 12 IHS Administrative Areas. In 2009, AI/AN populations had the second highest rates of chlamydia and gonorrhea as compared to other race/ethnicity groups. The overall IHS chlamydia and syphilis rates were 2.0 times higher than the U.S. rates. American Indian and Alaska Native youth and young adults carry a significant burden of STD morbidity nationally, while young AI/AN women continue to experience high rates of chlamydia and gonorrhea in multiple IHS areas.
Risks to health among American Indian/Alaska Native high school students in the United States. Everett Jones S, Anderson K, Lowry R, Conner H.; Prev Chronic Dis. 2011 Jul;8(4):A76. This study examined the prevalence of some of the leading risks to health among nationally representative samples of American Indian/Alaska Native (AI/AN) high school students and compared rates across racial/ethnic groups.
PRIMARY CARE PROVIDER - A Journal for Health Professionals working with American Indians and Alaska Natives. Available online at: http://www.ihs.gov/provider/ The purpose of The IHS Primary Care Provider is to facilitate communication and share timely information that is relevant to the clinical practice of Indian Health Service, tribal, and urban Indian health care professional providers.
Back to topChlamydia trachomatis trends in the United States among persons 14 to 39 years of age, 1999-2008. Datta SD, Torrone E, Kruszon-Moran D, Berman S, Johnson R, Satterwhite CL, Papp J, Weinstock H. Sex Transm Dis. 2012 Feb;39(2):92-6.
Chlamydia Positivity Trends Among Women Attending Family Planning Clinics: United States, 2004–2008. CL Satterwhite, et al.; Sexually Transmitted Diseases, Volume 38, Number 11, November 2011. The findings of this study support previous analyses suggesting that chlamydia prevalence is not increasing despite apparent increasing rates based on case reports.
CDC Grand Rounds: Chlamydia Prevention: Challenges and Strategies for Reducing Disease Burden and Sequelae. MMWR Vol. 60 No. 12; April 1, 2011 / 60(12);370-373. Available online at: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6012a2.htm?s_cid=mm6012a2_w
2010 BRFSS Data and Documentation Now Available. The Centers for Disease Control and Prevention’s (CDC) Behavioral Surveillance Branch released the 2010 Behavioral Risk Factor Surveillance System (BRFSS) data. The BRFSS is a unique, state-based surveillance system active in all 50 states, the District of Columbia, Puerto Rico, the U. S. Virgin Islands, and Guam, which collectsinformation on health risk behaviors, clinical preventive health practices, and health care access (primarily related to chronic disease and injury). Available at: http://www.cdc.gov/brfss/technical_infodata/surveydata/2010.htm For more information about the data, please contact the BRFSS office at (404) 498-0590
Teen STD Rate Soars on Salt Lake City's West Side. Salt Lake Tribune (01.06.11):: Heather May. In west Salt Lake City, the chlamydia rate among youths far exceeds the national average. Glendale and Rose Park have the highest rates of chlamydia diagnoses, and the highest birth rates, among Utah teens.
The 2009 Chlamydia Profiles are now live on the web and added to “What’s New” on CDC’s STD home page. The Profiles link is: http://www.cdc.gov/std/Chlamydia2009/default.htm. Each of the Regional Profiles, one for each of the ten HHS regions, contains a map of the region and a bar graph showing trends in chlamydia positivity rates among women 15 to 24 years of age attending family planning clinics.
Gonorrhoea positivity among women aged 15-24 years in the USA, 2005-2007. Gorgos L, Newman L, Satterwhite C, et al. Sex Transm Infect (2011). doi:10.1136/sti.2010.046607; Downloaded from sti.bmj.com on February 14, 2011 - Published by group.bmj.com. The conclusions of this study showed that gonorrhea positivity was consistently high for young non-Hispanic black women attending family planning clinics across multiple geographical regions. A large proportion of gonorrhoea morbidity was concentrated in a relatively small number of counties in the USA among this population of young women.
Comparative performance of culture using swabs transported in Amies medium and the Aptima Combo 2 nucleic acid amplification test in detection of Neisseria gonorrhoeae from genital and extra-genital sites: a retrospective study.
L Harryman, et al.; Sex Transm Infect published 27 October 2011, 10.1136/sextrans-2011-050075. Nucleic acid amplification tests are being increasingly used for the routine diagnosis of Neisseria gonorrhoeae (GC), although culture remains essential for monitoring antimicrobial resistance. The authors investigated how symptoms and infection site influenced test sensitivity.
Clinical Evaluation of the BD ProbeTec™ Chlamydia trachomatis Qx Amplified DNA Assay on the BD Viper™ System With XTR™ Technology. Taylor, SN et al.; Sexually Transmitted Diseases. 38(7):603-609, July 2011. This study evaluated the performance of the BD ProbeTec Chlamydia trachomatis Qx (CTQ) Amplified DNA Assay on the BD Viper System with XTR Technology in a multicenter study.
First-Ever Local Area Health System Scorecard Reveals Stark Differences Across U.S. The Commonwealth Fund Commission on a High Performance Health System recently released the report, Rising to the Challenge: Results from a Scorecard on Local Health System Performance, 2012, which measures how 306 local U.S. areas are doing on key health care indicators such as insurance coverage, preventive care, mortality rates, potentially avoidable hospital use, and costs.
The NCHHSTP Atlas was created to provide an interactive platform for accessing HIV, Viral Hepatitis, sexually transmitted disease (STD), and tuberculosis (TB) data collected by CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP). This interactive tool provides CDC an effective way to disseminate data, while allowing users to observe trends and patterns by creating detailed reports, maps, and other graphics.
“Prevention of HIV/AIDS, Viral Hepatitis, STDs, and TB Through Health Care: Supporting Health Departments—Next Steps.” This document is a result of the information gained during the August 2011 consultation, “Prevention Through Health Care: Enhancing Health Departments’ Preparedness and Response.” This effort brought together leaders from state and local health departments, from national organizations, federal partners (e.g., Centers for Medicare and Medicaid Services and Health Resources and Services Administration), and the academic community and provided the venue needed to collaboratively identify and strategize on how to address the 4 identified drivers of change in health care: 1) investment in health information technology; 2) increasing role of private sector providers; 3) expansion of community health centers; and 4) expansion of Medicaid coverage (and new agency focus).Each of these can have a profound, but positive effect on public health practice.
Topical Tenofovir, a Microbicide Effective Against HIV, Inhibits Herpes Simplex Virus-2 Replication. Cell Host & Microbe (2011;10(4):379-389). An antiretroviral-based vaginal microbicide gel created to prevent HIV infections is even more effective against herpes, and a new study suggests why this is so. The tenofovir-based vaginal gel cuts HSV-2 infections by disrupting an enzyme the virus needs to make copies of itself, according to the new laboratory study, which was conducted by researchers from the National Institutes of Health, Gilead Sciences Inc. and universities in Belgium and Italy.
A Natural Fit: Collaborations between Community Health Centers and Family Planning Clinics. The Geiger Gibson Program in Community Health Policy, George Washington University. This article discusses the shared health mission, complementary strengths, policy environment promoting collaboration, and possible models of collaboration between community health centers and family planning clinics.
Report Brief: Clinical Preventive Services for Women - Closing the Gaps. Institute of Medicine of the National Academies; July 2011. The Patient Protection and Affordable Care Act (ACA) addresses preventive services for both men and women of all ages, and women in particular stand to benefit from additional preventive health services. The Department of Health and Human Services charged the IOM with reviewing what preventive services are important to women's health and well-being and then recommending which of these should be considered in the development of comprehensive guidelines. The IOM recommends that women's preventive services include, among other services, improved screening for cervical cancer, sexually transmitted infections, and HIV; a fuller range of contraceptive education, counseling, methods, and services; services for pregnant women; at least one well-woman preventive care visit annually; and screening and counseling for interpersonal and domestic violence. For more information visit www.iom.edu/preventiveserviceswomen.
Collection of social determinant of health measures in U.S. national surveillance systems for HIV, viral hepatitis, STDs, and TB. Beltran VM, Harrison KM, Hall HI, Dean HD; Public Health Rep. 2011;126 Suppl 3:41-53. We reviewed the current SDH variables collected for HIV, viral hepatitis, sexually transmitted diseases, and tuberculosis at the Centers for Disease Control and Prevention through its population-based surveillance systems and assessed specific system attributes.
Disentangling Screening and Diagnostic Chlamydia Test Positivity Among Females Testing at Title X-Funded and Adolescent Health Clinics, San Francisco 2009. Stephens, SC et al.; Sexually Transmitted Diseases. 38(7):630-633, July 2011. By using a reason-for-test code, this study compared positivity for female chlamydia and gonorrhea. At family planning clinics, there were no statistically significant differences in screening versus diagnostic positivity for either chlamydia or gonorrhea among women. However, at adolescent health clinics, diagnostic positivity was higher than screening positivity for chlamydia and gonorrhea.
Findings from the Council of State and Territorial Epidemiologists' 2008 assessment of state reportable and nationally notifiable conditions in the United States and considerations for the future. Jajosky R, et al.; J Public Health Manag Pract. 2011 May/June;17(3):255-64. Article about nationally notifiable diseases, including Chlamydia and gonorrhea.
Chlamydia partner services for females in California family planning clinics. YY Yu, et al.; Sex Transm Dis. 2011 Oct;38(10):913-8. Prompt treatment of exposed partners is critical for preventing further transmission of chlamydia, reinfection, and sequelae among females. Although overall rates of reported partner treatment were low, concurrent patient-partner treatment visits and PDPT were associated with significantly higher rates of partner treatment.
Partner Notification of Sexually Transmitted Diseases: Practices and Preferences.
PR Gursahaney, et al.; Sexually Transmitted Diseases Vol. 38; No. 9: P. 821-827(09/11). Noting that timely notification and treatment of sex partners exposed to an STD “is essential to reduce re-infection and transmission,” the authors undertook the current study to determine factors associated with patient-initiated partner notification and preferences for standard partner referral versus expedited partner therapy (EPT).
A Qualitative Study of Patients' Use of Expedited Partner Therapy. Temkin, E et al.; Sexually Transmitted Diseases. 38(7):651-656, July 2011. In randomized controlled trials of expedited partner therapy (EPT), among patients in the EPT arm, the proportion of partners believed to have taken the medication ranged from 56% to 85%. Little is known about the content of successful and unsuccessful EPT negotiations between patients and their partners. The aim of this study was to describe how patients made decisions about EPT and what they did with the EPT medication packs dispensed to them.
Evaluation of an Online Partner Notification Program. Rietmeijer, CA, et al.; Sexually Transmitted Diseases Vol. 38; No. 5: P. 359-364 (05.11). This study reports on a clinic-based and web-based evaluation of the Colorado inSPOT online partner notification program.
Provider & Patient Education Materials
Comparative effectiveness of two self-collected sample kit distribution systems for chlamydia screening on a university campus. Wiley D Jenkins, Rob Weis, Paula Campbell, Mathilda Barnes, Perry Barnes, Charlotte Gaydos; Sex Transm Infect published 7 March 2012, 10.1136/sextrans-2011-050379. The authors sought to determine the relative effectiveness, and comparative effectiveness, of two SoS kit distribution mechanisms: one which provided kits directly to students and another encouraging students to order kits from a website.
A link to a talk Dr. Charlotte Gaydos gave on Maryland Public Radio about her www.iwantthekit.org site: http://mdmorn.wordpress.com/2011/06/21/6212011/
Bacterial STDs and Perceived Risk Among Sexual Minority Young Adults.
Perspectives on Sexual & Reproductive Health Vol. 43; No. 3: doi:10.1363/4315811(09..11):: Christine E. Kaestle; Martha W. Waller. The authors of this study assessed three indicators of sexual minority status - identity, behavior, and romantic attractions - in 10,986 young adults who took part in Wave 3 of the National Longitudinal Study of Adolescent Health (2001-02). Associations between these indicators and individuals’ perceived risk for STDs and actual STD infection were examined using logistic regression analyses. Data from the 1,154 respondents with current or recent bacterial STD infections were investigated to determine if they had underestimated their risk.
Social Policy/Health Policy/Law
Gonorrhoea or chlamydia in a US military HIV-positive cohort. Spaulding AB, et al., the Infectious Disease Clinical Research Program HIV Working Group; Sex Transm Infect (2012); doi:10.1136/sextrans-2011-050173. The objective of this study was to investigate the epidemiology and risk factors of gonorrhoea (GC) or chlamydia (CT) coinfection in an HIV-positive US military cohort, focusing on the time after participants’ knowledge of HIV diagnosis.
Chlamydia Trachomatis Infection Among Women Reporting Sexual Activity with Women Screened in Family Planning Clinics in the Pacific Northwest, 1997 to 2005. Singh D, et al.; American Journal of Public Health Vol. 101; No. 7: P. 1284-1290 (07.11). The authors sought to define positivity for Chlamydia trachomatis among women who have sex with women, “a population for which sparse data on this infection are available and for whom health disparities, including challenged access to comprehensive sexual and reproductive health services, have been reported.”
Surveillance of Health Status in Minority Communities — Racial and Ethnic Approaches to Community Health Across the U.S. (REACH U.S.) Risk Factor Survey, United States, 2009. MMWR May 20, 2011 / 60(SS06);1-41. Available online at: http://www.cdc.gov/mmwr/preview/mmwrhtml/ss6006a1.htm?s_cid=ss6006a1_e CDC conducts the Racial and Ethnic Approaches to Community Health across the U.S. (REACH U.S.) Risk Factor Survey annually in minority communities. The survey focuses on black, Hispanic, Asian (including Native Hawaiian and Other Pacific Islander), and American Indian populations.
The Emerging Threat of Untreatable Gonococcal Infection. Gail A. Bolan, M.D., P. Frederick Sparling, M.D., and Judith N. Wasserheit, M.D., M.P.H. N Engl J Med 366;6 nejm.org; February 9, 2012. This editorial sounds the alarm about the fact that gonorrhoea has become less susceptible to the last available line of antimicrobial defense.
Cephalosporin Susceptibility Among Neisseria gonorrhoeae Isolates --- United States, 2000—2010. Morbidity and Mortality Weekly Report (MMWR) – Weekly; July 8, 2011 / 60(26);873-877. This report describes current trends in cephalosporin susceptibility among Neisseria gonorrhoeae isolates in the United States: minimum inhibitory concentrations (MICs) to cephalosporins are increasing, suggesting that susceptibility to cephalosporins might be declining. The prevalence of isolates with elevated MICs remains low overall.
Neisseria gonorrhoeae with Reduced Susceptibility to Azithromycin --- San Diego County, California, 2009; May 13, 2011 / 60(18);579-581 Available online at: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6018a2.htm?s_cid=mm6018a2_w
