Nurs 340 – Community Health Nursing Sexually Transmitted Disease: A Problem for Kent County

1. Nurs 340 – Community Health NursingSexually Transmitted Disease: A Problem for Kent County Spring 2013 Group Project Anthony Peltier William Berlin Cheryl Veres Catherine Drzewiecki Lynn Bingham

2. Sexually Transmitted Disease (STD) in Kent County: Chlamydia, Gonorrhea, & Syphilis • Kent County experiences an elevated incidence of these STDs related to: • Social factors • Racial and ethnic disparities. African American, Hispanics, and American Indian/Alaska Native populations have elevated rates of STDs compared to whites. • Economic factors • STDs disproportionately affect poor and disenfranchised people. • Behavioral factors • High risk behavior, men having sex with men, IV drug use are significant risk factors for STDs.

3. Cost of STDs • The total estimated burden of the nine million new cases of these STDs that occurred among 15-24-year-olds in 2000 was $6.5 billion. • Viral STDs accounted for 94% of the total burden ($6.2 billion), and nonviral STDs accounted for 6% of the total burden ($0.4 billion). • Not all cost are associated with Chlamydia, Gonorrhea, and/or Syphilis, in fact, HIV and HPV are the two most costly STDs to treat.

4. Position Statement/Community Problem Diagnosis • Elevated incidence of sexually transmitted disease (STD) in Kent County related to deficient modifiable lifestyle behaviors and ineffective STD education… As Evidenced By……

5. 2011 Kent County Statistics: Chlamydia • Kent county data supports an increased risk and incidence in the 15 – 24 year old demographic • Kent county data further supports an increased risk in the female 15 – 24 year old demographic

6. Chlamydia: Kent County Vs. US Rates

7. 2011 Kent County Statistics: Gonorrhea • Kent county data supports an increased risk and incidence in the 15 – 24 year old demographic • Kent county data further supports an increased risk in the female 15 – 24 year old demographic

8. Gonorrhea: Kent County Vs. U.S statistics

9. 2011 Kent County Statistics: Syphilis • In this case the data does not support elevated rates in the 15 – 24 year old demographic. The highest rates are observed in the 25 – 44 year old demographic • Also, the data does not support the higher rates in females. Higher rates are seen in males.

10. Syphilis: Kent County Vs US rates

11. Highest incidence is seen in young people (15 – 24) for these STDs • Young people aged 15–24 years acquire nearly half of all new STDs. • Sexually active adolescents aged 15–19 years and young adults aged 20–24 years are at higher risk of acquiring STDs for a combination of behavioral, biological, and cultural reasons. • The higher prevalence may reflect multiple barriers to accessing quality STD prevention services, including lack of health insurance or ability to pay, or a lack of transportation.

12. Review of the data supports • A review of the data supports our position that an STD outreach campaign focused on testing and education in the female 15 – 24 year old demographic would provide the most value in reducing STDs in Kent County. • Our approach will include: • Public health experts lecturing at High Schools and Community Colleges in Kent County. • Increased funding for free STD testing to all females in this demographic.

13. Healthy People 2020: Emerging Issues

14. Role of Kent County Health Department and Public Health Nurses • Continually assessing the health of the community and ensuring that certain services are available and accessible for its citizens. • Investigating the causes of disease, epidemics, morbidity and mortality, environmental health hazards using vital and health statistics for epidemiological studies. KCHD also plans and implements public education and enforces public health laws.

15. Role of Kent County Health Department and Public Health Nurses (Cont.) • Assuring the provision of certain core programs in sexually transmitted diseases. • Surveillance: Is the ongoing systematic collection, analysis, and interpretation of outcome-specific data for use in planning, implementation, and evaluation of public health practice.

16. Recommendation of Behavior Counseling for Prevention of STDs • The U.S. Preventative Services Task Force (USPSTF) (2008) recommends high-intensity behavior counseling to prevent sexually transmitted diseases for all sexually active adolescents and for adults at increased risk for STDs.

17. CDC STD Prevention Guidelines • The CDC recommends the following strategies to reduce STD risks: • Abstinence • Vaccination (available for HPV and Hepatitis B) • Mutual Monogamy • Reduced number of sexual partners • Condom use • Testing http://www.cdc.gov/std/prevention/default.htm

18. Existing Resources - Community Strengths • Active public health department • Surveillance program initiated and data published and available via the interment

19. Community Barriers • High population of minorities • Inadequate monetary resources • Elevated levels of low income/poverty

20. Concept, Model, or Theory • What concept model or theory explain how the factors contribute to the problem • See slides 11, 23, and 24 of example

21. Interventions- Who, What, When, Why, How • Abstinence pledges • Presentation to area high schools and colleges highlighting reduction of high risk behaviors, encouraging safe sex practices. • Make condoms available at convenient locations http://www.cdc.gov/std/program/community.pdf

22. Interventions cont’d • Risk reduction workshops • STD prevention endorsements from community figures • Multimedia campaign aimed at utilizing CDC recommendations by target age group (Facebook, TV, billboards, radio etc).

23. Outcomes • Goals • Increase in : • STD testing, abstinence and safe sex behaviors in 15-24 year olds • Knowledge of STDs • Identification of high risk behaviors • Decrease in: • STD prevalence in 15-24 year olds • Practice of high risk behaviors

24. Evaluation • Monitoring of STD rates in 15-24 year olds • Survey given before, immediately after, 1, 6 and 12 months after presentation • Assess individual’s knowledge/feelings about STDs, prevention and high risk behaviors • Is the individual applying information to personal life? • How effective was the presentation?

25. References • Centers for Disease Control and Prevention. 2011 Sexually Transmitted Disease Surveillance. Retrieved from: http://www.cdc.gov/std/stats11/adol.htm • Blandfor, J.M., Chesson, H.W., & Gift, T.L. (2004). The Estimated Direct Medical Cost of Sexually Transmitted Diseases Among American Youth, 2000. Perspectives on Sexual and Reproductive Health. 36 (1) Retrieved from http://www.guttmacher.org/pubs/journals/3601104.html • PubMed Health. Chlamydia. Retrieved from: http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002321/ • Centers for Disease Control and Prevention. Program Operations Guidelines for STD prevention: Community and Individual Behavior Change Interventions. Retrieved from: http://www.cdc.gov/std/program/community.pdf • http://www.cdc.gov/std/prevention/default.htm