Faculty Abstracts

Sexually Transmitted Diseases in Young Women and Female Adolescents in Florida: The Burden of the Disease

Background: Sexually transmitted diseases (STDs) remain a major public health challenge in the United States. Adolescents continue to have the highest rates of STDs in Florida. The CDC estimates that 19 million new infections occur each year, almost half of them among young people ages 15 to 24. In 2004, Florida had over 40,000-reported cases of STDs in the 15-24 year old group. 70% of those cases were in women. 
Policy and Programs: Recent research has revealed that adolescents learn about STDs  “word of mouth”. Community values and the stigma surrounding STDs and sexuality education contribute to the problems. Adolescents needs for accessing services have been identified in the past; little has changed in the delivery system to meet these needs.

Non-judgmental education regarding sex, sexuality, refusal skills and protective skills should be delivered accurately to those who need it the most, adolescents, and young adults. Education regarding STDs and sexuality needs to be in the schools and involve parents and the community. Failure to publicize, market and coordinate the services offered by agencies available to provide care is a major obstacle.

According to multiple studies, comprehensive sexuality education, not abstinence promotion, is most effective in reducing teenage pregnancy levels.

Implications for Programs: STDs will continue to be a silent plague until the system is changed to facilitate education, parental involvement, prevention and access to care across economic, age and gender lines.

Proposal

Background: Sexually transmitted diseases (STDs) remain a major public health challenge in the United States. Regionally, the south has higher rates of chlamydia, gonorrhea and primary and secondary syphilis. The reasons for this are not generally understood though it is believed that it may include differences in the racial/ethnic distribution of the population, poverty, and the availability and quality of health care services are primary factors. Adolescents continue to have the highest rates of STDs in Florida. The CDC estimates that 19 million new infections occur each year, almost half of them among young people ages 15 to 24. In 2004, Florida had over 40,000-reported cases of STDs in the 15-24 year old group. 70% of those cases were in women.

Policy and Programs: Adolescents lack knowledge about sex, sexuality, STDs, negotiation and resources. Recent research has revealed that adolescents learn about STDs  “word of mouth”. Community values and the stigma surrounding STDs and sexuality education contribute to the problems. Adolescents needs for accessing services have been identified in the past; little has changed in the delivery system to meet these needs.

Adolescents, in particular, need walk in services since they have limited control over their lives. These limited controls include their ability to keep what is perhaps a secretive appointment, and physically getting to get to the clinic. Adolescents think very much “in the moment” and therefore often cannot plan several weeks ahead. Adolescents do not want to disclose their need to be seen for a suspected STD or family planning to a clerk on the telephone. They may be unable to discuss the nature of their visit due to lack of privacy when they are making the telephone call.

Non-judgmental education regarding sex, sexuality, refusal skills and protective skills should be delivered accurately to those who need it the most, adolescents, and young adults. Education regarding STDs and sexuality needs to be in the schools and involve parents and the community. Failure to publicize, market and coordinate the services offered by agencies available to provide care is a major obstacle. According to multiple studies, comprehensive sexuality education, not abstinence promotion, is most effective in reducing teenage pregnancy levels.

Implications for Programs: Adolescents are different. They have a different view of the world, a failure to think in the long term, and a strong belief in their invincibility. Elements that should be included in programs directed to teens are culturally appropriate information and instructors, comprehensive sexuality education, access and opportunities. One of the most obvious ways societies socialize youth about attitudes and expectations related to sexual and reproductive behavior is through school based sexuality education. Guided by the principles of autonomy and beneficence, we should provide comprehensive STD/HIV prevention education to adolescents. STDs will continue to be a silent plague until the system is changed to facilitate education, parental involvement, prevention and access to care across economic, age and gender lines.