The Chlamydia cascade: enhanced STD prevention strategies for adolescents.
ABSTRACT The rising trends in Chlamydia, the prevalence in the adolescent female population, and the relevance of the sexually transmitted disease (STD) continue to be a burden in the United States. According to the World Health Organization (WHO), the most common cause of STDs is Chlamydia trachomatis, the infecting pathogen for Chlamydia, making this a worldwide health concern. The WHO also estimates that the disease burden for treating Chlamydia patients is $10 billion annually, with adolescent females in the urban setting exhibiting an incidence as high as 30%. This article will evaluate the magnitude of the problem in the adolescent female population. The latest trends in Chlamydia, the disease sequelae, and the current health statistics will be reviewed the research and evidence-based STD guidelines from the Centers for Disease Control and Prevention and the United States Preventive Task Force. Implications for clinical practice target the initiation of a primary intervention strategy through wellness care education. This wellness care plan includes sexual health promotion and STD prevention education for early adolescents approaching a highly vulnerable stage for contracting Chlamydia and STDs. Additional goals center on reinforcing STD awareness and the need for more STD prevention education in young adolescents. Finally, this article targets health care providers, educators and all other professionals who are engaged in caring for this select population.
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ABSTRACT: Chlamydia trachomatis infection (CT) is the most prevalent bacterial STD. Sexually active adolescents and young adults are the main risk group for CT. However, STD testing rates in this group are low since exposed individuals may not feel at risk, owing-at least in part-to the infection's largely asymptomatic nature. Designing new testing environments that are more appealing to young people who are most at risk of acquiring chlamydia can be an important strategy to improve overall testing rates. Here we evaluate the effect of a school-based sexual health program conducted among vocational school students, aiming to obtain better access for counseling and enhance students' STD testing behavior. Adolescents (median age 19 years) attending a large vocational school were provided with sexual health education. Students filled in a questionnaire measuring CT risk and were offered STD testing. Using univariate and multivariate analysis, we assessed differences between men and women in STD-related risk behavior, sexual problems, CT testing behavior and determinants of CT testing behavior. Of 345 participants, 70% were female. Of the 287 sexually active students, 75% were at high risk for CT; one third of women reported sexual problems. Of sexually active participants, 61% provided a self-administered specimen for STD testing. Independent determinants for testing included STD related symptoms and no condom use. All CT diagnoses were in the high-CT-risk group. In the high-risk group, STD testing showed an increased uptake, from 27% (previous self-reported test) to 65% (current test). CT prevalence was 5.7%. Vocational school students are a target population for versatile sexual health prevention. When provided with CT testing facilities and education, self selection mechanisms seemed to increase CT testing rate dramatically in this high-CT-risk population expressing sexual problems. Considering the relative ease of testing and treating large numbers of young adults, offering tests at a vocational school is feasible in reaching adolescents for STD screening. Although cost-effectiveness remains an issue counseling is effective in increasing test rates.BMC Public Health 09/2011; 11:750. · 2.32 Impact Factor
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ABSTRACT: Guided by Bandura's Social Cognitive Theory, the purpose of this study was to examine the effect of a comprehensive wellness intervention on total wellness, physical fitness, and self-efficacy for health promoting behaviors in adolescent females, ages 14 to 19, enrolled in physical education (PE) classes in Grades 9 to 12. The intervention was administered in an experimental pre-test, post-test, two group design in rural east Texas. Participants (n = 153) were randomly assigned to a 12-week intervention or control group. Independent t-tests to determine differences between the intervention and control groups were nonsignificant for overall wellness and physical fitness. The Wellness Essential-Self subscale score was significantly higher in the intervention group, t(64, 36) = 2.67, p = .005, d = .84. Self-Efficacy Health Promotion subscale scores for the intervention group were also significantly higher, t(20,28) = 2.60, p = .006, d = .74. The intervention has potential to improve overall wellness in adolescent females.Western Journal of Nursing Research 10/2013; · 1.38 Impact Factor
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ABSTRACT: Objectives: To investigate trends in notification rates of Chlamydia trachomatis in Tasmania, Australia, by population sub-groups, from 1 January 2001 to 31 December 2007.Methods: An enhanced surveillance dataset was used to supplement case notifications. Rates based on age group were analysed by sex, geographic region, indigenous status, sexual exposure, reason for testing and healthcare provider.Results: In all age groups, the notification rate increased steeply. The highest rates were seen in the ages 15–24 years; this age group represented 15% of the population but accounted for 74% of the chlamydial notifications. The increased rates in females aged 15–24 years and males 15–19 years in Tasmania were larger than the increases observed nationally. Rates were consistently higher in urban areas. Females were more likely to have been tested as a result of screening, and males were more likely to have been tested when presenting with symptoms or as a result of contact tracing. The majority of cases reported sexual exposure with opposite sex partners only.Conclusions: This study highlights the increasing significance of chlamydial infection as a public health issue, the gender differences in health-seeking behaviour, and the discrepancies in testing patterns. These findings will assist with the design of health promotion programs.Australian and New Zealand Journal of Public Health 03/2010; 34(2):120 - 125. · 1.64 Impact Factor