Tag: STI

Talking Sex with Teens: Community Health Centers ACT for Change

Today’s adolescents are engaging in risky sexual behaviors at earlier ages than ever before, resulting in nearly 250,000 teen births in 2014 and nearly 10 million new sexually transmitted infections annually. Sexually transmitted infections are a significant public health problem in the United States and of particular concern in the adolescent and young adult population. A big factor contributing to the spike is that often times, teens are reluctant to discuss their sexual health with their care team since information about sexual health related behaviors and risk factors has the potential to appear in care summaries, patient portals, insurance explanation of benefits and the like—all which adolescent and young adult patients worry can be viewed by parents and guardians. The lack of communication results in an increased risk for undiagnosed and untreated STIs, missed opportunities for behavioral health interventions, including guidance on managing risk and addressing social determinants of health, and increased disease burden in the community.

In order to improve sexual health screening and behavioral counseling in primary care, Possibilities for Change teamed up with the National Association of Community Health Centers (NACHC), the Health Center Network of New York (HCNNY), and four participating health centers across New Jersey and New York for a pilot project using the ACT Sexual Health System.

With today’s earlier onset of sexual activity comes an increased incidence of high-risk behaviors such as:

  • Early sexual intercourse (before the age of 13 years)
  • Multiple sexual partners (history of 4 or more lifetime partners)
  • Inconsistent condom and contraceptive use
  • Drug or alcohol use prior to sex

Research suggests that several key factors have a significant influence on sexual decision-making including: substance use prior to sex, depression and low self-esteem, homelessness, school failure, sexting, and history of abuse and dating violence. Our nation’s public health institutions have recognized the need to improve adolescent health care in the United States and are calling attention to this important issue. The Institute of Medicine (IOM), National Research Council, Pediatric Health 2011 Report concluded that “improving health outcomes for adolescents is essential to achieving a healthy future for the nation.”

In 2014, the Journal of the American Medical Association published a study that reported one-third of all adolescent health maintenance exams were completed without any discussion of sexual health. For those providers who did introduce the subject, an average of 36 seconds was spent discussing sexual health. It was concluded that strategies need to be utilized to engage adolescents in open discussions around sexuality, promoting healthy sexual development and decision-making:

  • Prioritize adolescent sexual health and ensure that all adolescents are screened and counseled on their risk behaviors using standardized, validated tools – according to nationally-recognized guidelines;
  • Become educated and aware of the inter-relationship between adolescent sexual health, high risk behaviors, and other population disparities;
  • Participate in continuing education on effective adolescent counseling strategies that will actively engage youth in the behavior change process (such as Motivational Interviewing);
  • Develop policies and processes to ensure adolescent engagement and comfort with disclosure of sexual feelings, behaviors and experiences; and
  • Address necessary workflow modifications to ensure risk screening and behavioral counseling is consistently incorporated.

To learn more about the disparities and behaviors that contribute most to sexual risk and how primary care practices and school-based health centers can meet the needs of adolescents to positively impact their sexual health, download and view the recorded webinar.

How do you talk to adolescents about safe sex decisions? Share your experiences in the comments below!

Research Behind the RAAPS Questions (Question #17)

Do you have questions about abstinence (saying no to sex), condoms, birth control, HIV/AIDS, or sexually transmitted infections (STI)?

The increase in sexual experimentation that often occurs during adolescent years can have adverse consequences, such as sexually transmitted infections.

Did you know?
–  In 2006, an estimated 5,259 young people between the ages of 13-24 in the 33 states reporting to the CDC were diagnosed with HIV/AIDS. This number represented about 14% of all persons diagnosed that year.
–  African Americans are disproportionately affected by HIV/AIDS.  In 2004, this population accounted for 55% of all new HIV infections reported among individuals ages 13-24.
–  Minority youth also experience higher rates of STIs.
–  There are approximately 19 million new STIs each year, and almost half of them are among adolescents ages 15-24.

These statistics are particularly alarming as access to sexual health education for U.S. students in declining. The percentage of high schools in which teachers taught students how to correctly use a condom in at least one required course decreased from 49.5% in 2000 to 38.5% in 2006.

Try these messages with youth:

  • –  Many people with sexually transmitted infections don’t even know they have it.  Encourage testing at least once a year.  If you are sexually active and haven’t been tested in the last three months, encourage testing.
  • –  There are many different types of birth control, including abstinence, so make sure to talk to your health care provider about which may be best for you.

Resources for youth and providers:

  • –  The Centers for Disease Control and Prevention provides leadership in helping control the HIV/AIDS epidemic by working with community, state, national, and international partners in surveillance, research, and prevention and evaluation activities. Find a testing site, statistics, plans and further resources.  Their hotline number is: 1.800.342.2437.
  • –  The National Resource Center for HIV/AIDS Prevention Among Adolescents supports adolescent service providers by providing web-based resources, evidence-based program information, and links to training and technical assistance to help prevent HIV/AIDS among adolescents.
  • –  National STD Hotline:  800-227-8922
  • –  National AIDS Hotline: 800-342-AIDS (2437)

 

 

Research Behind the RAAPS Questions (Question #16)

Many of the consequences of adolescent sexual intercourse, such as unintended pregnancy and STI infections, occur because of lack of condom use or other methods of birth control.

Did you know?

  • –  Approximately 25% of teen females and 18% of teen males use no method of contraception at first intercourse.
  • –  Furthermore, 39% of currently sexually active high school students did not use a condom during their last sexual intercourse.
  • –  Among females ages 14-19, one in four (26%) either has HPF, Chlamydia, HSV-2 infection, or trichomoniasis, with HPV accounting for the vast majority of infections.
  • –  Additionally, 34% of young women become pregnant at least once before they reach age 20.

These actions have serious health consequences for adolescents. Despite the decline in teen pregnancy rates over the past decade, the U.S. continues to have one of the highest teen pregnancy, birth, and abortion rates in the developed world.

Youth should be educated on the best ways to ensure they do not get an STI.  Many youth  may not be aware that many people with a sexually transmitted infection don’t even know that they have it.

 Try these messages with youth:

–  You should be tested at least once a year. Schedule an appointment for STI testing if you have had sex and haven’t been tested within the last 3 months.

–  Using protection is part of having sex.  It is nothing to be ashamed of.  Talking with your partner about using protection is the best way to make sure you are both on the same page.  It shows that you respect your partner and want to protect each other.

–  However, just because you talk about using protection doesn’t mean you have to have sex.  It just means that you care about yourself and are in control of what happens to your body.

–   There are lots of different kinds of birth control, so talk to your health care provider about which may be best for you.  If you are able, talk to your parent or trusted adult about scheduling your appointment.

 Resources for Youth:

– Bedsider is an online birth control support network for women 18-29 operated by The National Campaign to Prevent Teen and Unplanned Pregnancy, a private non-profit organization.

 – The Get Yourself Tested (GYT) campaign is a youthful, empowering social movement to reduce the spread of STIs among young people through information; open communication with partners, health care providers, and parents; and testing and treatment as needed.

– CDC National AIDS/Sexually Transmitted Disease Hotline: 800-342-2437

– National STD Hotline:  800-227-8922