STI Quarterly

Heighten awareness to lower chlamydia numbers

What will it take to drive down the number of chlamydia infections in young women? While routine chlamydia screening is recommended for all sexually active females age 24 years and younger, only about half (49.9%) were screened during 2008-09, according to data collected in more than 1,000 U.S. health plans.1

To reach young people directly in the places where they're already talking, the Centers for Disease Control and Prevention (CDC) is working with MTV and others on the Get Yourself Tested (GYT) campaign. The goal of GYT is to create a social movement to reduce stigma and get young people tested for sexually transmitted diseases (STDs), says Nikki Mayes, CDC spokesperson.

CDC is expanding its focus on chlamydia screening in young women through the GYT program. It has awarded nine subcontracts, valued up to $20,000 each, to support implementation and evaluation of local strategic social marketing plans to promote chlamydia and other STD screenings. Funding has been allocated to the Jackson County Health Department in Murphysboro, IL; Johns Hopkins University in Baltimore; Metro TeenAIDS in Washington, DC; Planned Parenthood of Kentucky in Lexington; Planned Parenthood of Metropolitan New Jersey in East Orange; Sacramento County — Department of Health and Human Services in Sacramento, CA; Sanford Health in Sioux Falls, SD; the University of California, San Francisco; and the University of Missouri in Columbia.

"We know that testing is among the most effective, yet underused, tools we have to prevent the spread of STDs," says Mayes. "The reality is, any sexually active person can be infected with STDs, and young women are particularly at risk for the devastating consequences of untreated STDs like chlamydia and gonorrhea — both of which can lead to painful pelvic inflammatory disease and, in some cases, infertility."

The good news is most STDs are treatable and many are curable, but early detection through testing is critical, Mayes notes. Due to scientific advances, STD testing has never been easier, she points out. Testing is fast, often confidential, and free or low-cost, says Mayes. (How can you get across the need for chlamydia screening? Use the tips, below.)

When chlamydia is transmitted from an infected individual to an uninfected individual, more than half the time, the infected individual has no symptoms, says Robert Hatcher, MD, MPH, professor of gynecology and obstetrics at Emory University School of Medicine in Atlanta. Since this situation also is true in the transmission of the other major sexually transmitted infections, young couples should almost routinely use condoms, says Hatcher.

Minnesota takes aim

Minnesota public health officials have joined hands with other community partners to develop The Minnesota Chlamydia Strategy: Action Plan for Reducing and Preventing Chlamydia in Minnesota, a comprehensive, statewide action plan to address the state's chlamydia epidemic.

A new report from the Minnesota Department of Health underscores the need for such action: chlamydia reached a record level of 15,294 cases in the state in 2010. This figure not only represents a 6% increase from the previous year, it stands as the highest number of cases ever recorded in the state in a single year since officials began tracking chlamydia statistics in 1986. Of even more concern: about 70% of 2010 cases occurred in teens and young adults ages 15 to 24, say state public health officials.

Chlamydia numbers have been rising in Minnesota for the last four or five years, says Candy Hadsall, RN, MA, STD screening specialist with the Minnesota Department of Health. Public health officials began networking with community members in 2010 to develop the Minnesota Chlamydia Partnership, a statewide stakeholder group, as a fresh approach to the problem.

Hadsall says they thought it was imperative to go out and ask people in the community for their help, "not only about what should be done, but what could they do. We recognize that chlamydia is really a social problem, as well as a medical problem."

The Partnership held a statewide summit in the summer of 2010, with groups charged to develop the action plan. Released in April 2011, the document is the result of more than 300 individuals and several organizations from across Minnesota who have worked together to create a common framework to reduce the burden of chlamydia in the state. (Review the document; go to the Partnership web page, www.health.state.mn.us/divs/idepc/diseases/chlamydia/mcp and click on the document link.)

The plan includes five long-term goals: reduce rates of chlamydia and gonorrhea in Minnesota, especially in people ages 15-25; increase awareness of chlamydia in the general public; change the behavior of adolescents so that they are reducing their risk for contracting and transmitting diseases; reduce the stigma, shame, and secrecy that surrounds STDs; decrease health inequities, especially in communities most affected by chlamydia and gonorrhea; and remove systemic barriers that contribute to high rates of STDs.

Raising public awareness about chlamydia is a key part of the plan, says Hadsall. "The general public doesn't have a very good understanding of chlamydia; that may be partially healthcare providers' fault," observes Hadsall. "Since it looks like a medical topic, people assume that people in medicine will take care of it."

Education plays a strong role in the state plan. Advocates are pushing for education in the home and in school regarding chlamydia screening, treatment and prevention. "I don't think we've done a good job of educating people that the same reasons people have unprotected sex and get pregnant are the same reasons that they have unprotected sex and get STDs," says Hadsall. "It is a multi-faceted problem, and it takes more than just a public health approach."

Reference

  1. National Committee for Quality Assurance. The State of Quality Health Care 2010: HEDIS Measures of Care. Washington, DC; 2010.

Use fast facts to boost chlamydia screening

Use these short, motivating messages developed through research conducted by the Centers for Disease Control and Prevention and the Los Angeles County, CA, Department of Public Health to help young women understand the importance of chlamydia screening:

  • Chlamydia is a sexually transmitted disease that can have serious consequences. It can affect your fertility, prevent you from having children, and hurt your unborn child.
  • Chlamydia is very common. More than one million women are diagnosed each year.
  • Chlamydia usually has no symptoms. You can have it and not even know it.
  • Chlamydia testing is not automatic. You need to ask for it and have a test every year.
  • The test is simple, quick and painless. It is often inexpensive or free, and it can be done with a urine test.
  • You should be tested because chlamydia can be cured. A simple antibiotic pill is used for treatment.

Source:
National Chlamydia Coalition. Getting More Young Women Screened for Chlamydia: Findings from Qualitative Research. Accessed at http://www.prevent.org/data.