Articles, Reports, Policies, Commentaries, Resources, etc.

2nd Quarter 2010

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Adolescents	Males (no content this quarter)	Social Policy/Health Policy/Law (no content this quarter)
AI/AN Health	Other Topics and Resources	Special Populations (no content this quarter)
Behavior (no content this quarter)	Partner Services	STD Guidelines (no content this quarter)
Data & Statistics (no content this quarter)	Performance Measures (no content this quarter)	Transmission (no content this quarter)
Health Care Reform	Provider & Patient Education Materials (no content this quarter)	Treatment
Laboratory (no content this quarter)	Screening & Prevention

Adolescents

2009 Youth Risk Behavior Survey Data
The Division of Adolescent and School Health (DASH) released the 2009 national, state, and local Youth Risk Behavior Survey (YRBS) data in an MMWR Surveillance Summary. YRBS monitors six categories of priority health-risk behaviors among high school students — behaviors that contribute to unintentional injuries and violence; tobacco use; alcohol and other drug use; sexual behaviors that contribute to unintended pregnancy and sexually transmitted diseases, including HIV infection; unhealthy dietary behaviors; and physical inactivity — plus the prevalence of asthma and obesity.

This year’s Surveillance Summary includes results from the 2009 National YRBS and from 42 state and 20 local YRBSs. A CDC press release presents new data on the prevalence of prescription drug abuse among high school students and highlights promising trends in nutrition-related health behaviors. In addition, DASH has launched an enhanced version of Youth Online, a web-based data system that allows users to view and analyze national, state, and local YRBS data (http://apps.nccd.cdc.gov/youthonline/). Youth Online provides quick access to comprehensive data on youth health risk behaviors from 1991 through 2009. The press release and the Surveillance Summary are available on the YRBS Web site (www.cdc.gov/yrbs). DASH has also created a new YRBS data widget, a small web program that national, state, and local partners can put on their organization’s Web site to help disseminate YRBS results quickly and conveniently.Users will be able to customize the widget to present data specific to their state or locality and provide links to the full Youth Online for more details. The YRBS data widget is available at www.cdc.gov/widgets. For more information, please contact Chelsea Carlson Payne (cpayne2@cdc.gov), Division of Adolescent and School Health.

Youth Development Articles
An editorial by Gavin, et al., published in a special supplement of the Journal of Adolescent Health (March 2010), introduces and comments upon a compilation of articles about youth development as a strategy to promote adolescent sexual and reproductive health. Such promising discussions are relevant to continuing exploration of community-level approaches to addressing STDs.

This article by Catalano, et al., comments on future directions for positive youth development (PYD) programs, as discussed in the Journal of Adolescent Health supplement (March 2010). Authors conclude that the combination of PYD programs and education on sexuality may be a powerful interventions not only on adolescent sexual and reproductive health but also on adolescent health in general.

House, et al., through a systematic analysis, discuss the role of social and behavioral, cognitive, emotional, and moral competence as a predictor of outcomes related to sexual health practices.

Markham, et al., reviewed literature on connectedness (defined as a child’s social relationships in the family, peer group, school, community, or culture) as a predictor of sexual/reproductive health of teens.

Gavin, et al., reviewed positive youth development programs to identify and improve adolescent sexual health. Authors conclude that these programs may have a positive effect and should be part of a comprehensive approach to improving adolescent sexual health. However, more research in this area is needed.

AI/AN Health

UNITED STATES:"Sexual Partner Concurrency and Sexual Risk Among Gay, Lesbian, Bisexual and Transgender American Indian/Alaska Natives"
Sexually Transmitted Diseases Vol. 37; No. 4: P. 272-278(04..10):: Susan Cassels; Cynthia R. Pearson; Karina Walters; Jane M. Simoni; Martina Morris
Disproportionately high rates of HIV infection are among the "pervasive health disparities" found among American Indian and Alaska Natives, wrote the authors, who noted, "Sexual network dynamics, including concurrency and sexual mixing patterns, are key determinants of HIV disparities."

Navajo Nation Social Hygiene Program 2009 Annual Report
This report and slide presentation highlight the impact of STDs among Navajo residents, and highlights the increased numbers of STDs affecting the Navajo Nation.

Reproductive Health of Urban American Indian and Alaska Native Women: Examining Unintended Pregnancy, Contraception, Sexual History and Behavior, and Non-Voluntary Sexual Intercourse February 2010. Urban Indian Health Institute
A new report from the Urban Indian Health Institute presents information on reproductive health among urban Native women. The report includes findings from our recent analysis of reproductive health and sexual violence data among American Indian and Alaska Native women in urban areas in the 2002 National Survey of Family Growth. Attached is an article by the Associated Press from last week that reached nationwide audiences. Please see the report here: http://www.uihi.org/wp-content/uploads/2010/05/AIAN-Women's-Health-Report.pdf (this is a large file—it takes a few seconds to load)

Health Care Reform

UNITED STATES:"New Spending for a Wider Range of Sex Education"
The New York Times (05.11.10):: Roni Caryn Rabin
President Obama's health care overhaul will provide $375 million in comprehensive sex education grants to states over five years. Under the new law, PREP (Personal Responsibility Education Program) will encourage students to delay sexual activity but to use protection if they are already sexually active.

The May 13, 2010 New England Journal of Medicine includes 3 interesting commentaries on health reform that unpack often discussed concerns:
Health Insurance exchanges (Kingsdale)
Tensions of Federalism (Jennings and Hayes)
Cost implications of health reform (Gruber)

Partner Services

AUSTRALIA: "Innovative Resources Could Help Improve Partner Notification for Chlamydia in Primary Care"
Sexually Transmitted Diseases Vol. 36; No. 12: P. 779-783(12.01.09):: Jade E. Bilardi and others
General practitioners in Australia support a wide range of possible resources to improve partner notification for chlamydia, the current report shows.

Evaluation of an Innovative Internet-based Partner Notification Program for Early Syphilis Case Management, Washington, DC, January 2007–June 2008
DC Ehlman, et al.; Sexually Transmitted Diseases; Volume 37, Number 8, August 2010
This report from DC on their internet partner notification program should be of interest to everyone. This statement sums it up best for me: "This study found that IPN augmented traditional PN and provided a method for reaching previously untraceable sex partners."

Screening & Prevention

UNITED STATES: "Utilizing the Internet to Test for Sexually Transmitted Infections: Results of a Survey and Accuracy Testing"
Sexually Transmitted Infections Vol. 86; P. 112-116(04.01.10):: Sherria L. Owens; Nick Arora; Nicole Quinn; Rosanna W. Peeling; King K. Holmes; Charlotte A. Gaydos
Acknowledging that searching the World Wide Web for information about sexually transmitted infections is common, the authors carried out the current study to determine which Internet sites offer STI testing and to obtain information about the services and their validity.

Get Yourself Tested (GYT) Campaign Map
Just so you can keep track of the GYT campaign, check out the attached map, which shows the communities who are getting the promotional kits associated with the campaign. This is a small example of the campaign reach, but valuable to see because it shows the locations where the clinics and providers are most actively engaged.

Randomised controlled trial of screening for Chlamydia trachomatis to prevent pelvic inflammatory disease: the POPI (prevention of pelvic infection) trial
P Oakeshott, et al.; BMJ 2010;340:c1642
This study examines whether Chlamydia screening and treatment reduces incidence of PID over the subsequent 12 months. The trial was known as the Prevention of Pelvic Infection (POPI) trial and took place in England. Authors conclude that though some evidence suggests that Chlamydia screening reduces PID, the effectiveness of a single Ct test in PID prevention may be overestimated. The accompanying editorial by Sheringham expresses concerns this study raises about the feasibility of trials such as this one in informing policy related to national Chlamydia screening programs.

Commentary from Catherine Lindsey Satterwhite, Epidemiologist, Division of STD Prevention, CDC:
A few observations about the trial that I wanted to share:

The study was underpowered, and this may have made a difference. Results, though non-significant, certainly appear different, suggesting that CT screening was beneficial.
Of 26 (out of 38) women with PID who had CT results available, 16 were CT positive at PID diagnosis (16/26=62%). So, suggests that CT may be a major contributor to clinically-diagnosed PID.
However, 10 of the 16 women who were CT positive at PID diagnosis were CT negative at enrollment (when screening would have hypothetically occurred). If these women had actually been seeking healthcare when they were enrolled in the study, this would suggest that screening wouldn’t have helped these 10 women much. But, if 6/16 cases of PID might have been prevented (38%) by screening, that seems pretty good.
Cost-effectiveness studies may need to be re-done.
About 10% (7/74) of women with untreated CT (delayed screening group) developed PID over the course of the study (12-months).

Treatment

Daily Women's Health Policy Report, June 14, 2010
Published by the National Partnership for Women and Families
This British study finds vouchers for no-cost treatment beneficial for partners of Chlamydia patients.