STD Quarterly
Boost efforts to close STD prevention gaps
Sexually transmitted diseases (STDs) remain a major U.S. public health challenge. About 19 million new infections occur each year, with almost half of them among young people ages 15 to 24.1 What are you doing to close the gaps when it comes to STD prevention in this age group?
The Centers for Disease Control and Prevention (CDC) is committed to working to reduce the burden of STDs among young people, says John Douglas Jr., MD, director of the Division of Sexually Transmitted Disease Prevention in the CDC's National Center for HIV/AIDS, Viral Hepatitis, STD, and Tuberculosis Prevention. STDs such as chlamydia and gonorrhea (the two most commonly reported infectious diseases in the United States) are easily detectable and treated; however, untreated, these STDs can lead to severe health consequences in women, including pelvic inflammatory disease, ectopic pregnancy, chronic pelvic pain, and infertility, notes Douglas.
"Because the majority of chlamydia and gonorrhea infections have no symptoms, they often go undiagnosed," Douglas states. "To stem the potential health threats of these diseases, screening — especially among young women — is critical."
April 2009, National STD Awareness Month, served as a kickoff to help remind health care providers to intensify efforts to reach those at risk with effective behavioral interventions and screening and treatment service. To help spread the prevention message to those under age 25, direct patients to www.gyt09.org, the web site for "Get Yourself Tested" (GYT). The site serves as an STD information resource for young people by offering tips on how to discuss STD testing with partners, parents, and health care providers. Included on the GYT09 web site is a widget that allows users to find an STD testing site near them by entering their zip code. The widget interfaces with CDC's National HIV and STD Testing Resource data base, www.findSTDtest.org. CDC provided technical assistance to MTV and the Kaiser Family Foundation, who are working with Planned Parenthood Federation of America (PPFA) and other national partners to inform young people about STDs and promote testing and treatment.
"Most people would be shocked to hear that by age 25, one in two sexually active young people will have an STD. This is not just a statistic but the reality of what Planned Parenthood health centers see every day," says Cecile Richards, PPFA president. "The GYT campaign is an excellent opportunity for people to learn what Planned Parenthood knows: that affordable testing and treatment, and education, are the tools teens and young people need to stay healthy and safe."
Check chlamydia resource
The Partnership for Prevention, a membership organization of businesses, nonprofit organizations, and government agencies aimed at advancing policies and practices to prevent disease and improve the health of all Americans, has joined with the CDC in launching the National Chlamydia Coalition web site, www.prevent.org/NCC.
At the site, providers can download a free version of a new 12-page guide, Why Screen for Chlamydia? The guide, designed to help health care providers make screening a routine part of medical care, synthesizes up-to-date screening information into a quick read.
It is worth the effort to increase chlamydia screening; if 90% of eligible young females were screened for the STD, 30,000 cases of pelvic inflammatory disease would be prevented each year.2 The new guide offers the following tips for boosting screening rates:
- Normalize screenings. During visits, inform patients in a matter-of-fact manner that routine screenings are recommended in the same way as are immunizations, Pap tests, or other routine procedures.
- Place a chlamydia swab next to Pap test or pregnancy detection materials as a visual reminder to perform chlamydia screenings. This approach works. A large commercial health plan instituted a policy of screening all eligible females for chlamydia at the time of Pap tests; overall, chlamydia screening rates increased from 63% to 81%.3
- Use urine-based screening. These tests make screening for chlamydia less invasive. Offices should have a systematic process for collecting urine, such as at the beginning of the visit, when height, weight, and blood pressure are taken, the guidance advises.
CDC posts resources on web site
The CDC has launched a STD Awareness web site at www.cdcnpin.org/stdawareness to help raise awareness about STD prevention. It offers such resources as fact sheets, STD brochures, and clinical tools for providers, such as a guide to taking a sexual health history.
STD prevention efforts are cost-effective, yet often underused, says Kevin Fenton, MD, PhD, director of the CDC's National Center for HIV/AIDS, Viral Hepatitis, STD, and Tuberculosis Prevention. "The economic impact of STDs is substantial, with an estimated cost of $15.9 billion annually to the U.S. health care system," says Fenton. "As a nation, we must increase focus on reducing the economic and health impact of STDs."
References
- Weinstock H, Berman S, Cates W Jr. Sexually transmitted diseases among American youth: Incidence and prevalence estimates, 2000. Perspect Sex Reprod Health 2004; 36:6-10.
- National Commission on Prevention Priorities. Preventive Care: A National Profile on Use, Disparities, and Health Benefits. Partnership for Prevention, August 2007.
- Burstein GR, Snyder MH, Conley D, et al. Chlamydia screening in a health plan before and after a national performance measure introduction. Obstet Gynecol 2005; 106:327-334.
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