Sexually Transmitted Disease
As defined by the World Health Organization (WHO) in 2014 sexually transmitted diseases, or sexually transmitted infections (STIs) “spread primarily through person-to-person sexual contact” and include a variety of “more than 30 different sexually transmissible bacteria, viruses and parasites” (“Sexually Transmitted WHO”). This problematic issue affects untold millions of people around the globe. According to World Health Organization (2014) reports the sexually infectious conditions most commonly transmitted include cases of syphilis, genital warts, genital herpes, chlamydial infection, trichomoniasis, gonorrhea, human papillomavirus and human immunodeficiency virus (HIV). In particular instances infections may be spread via pregnancy and childbirth, causing the child to become infected by blood contact. United States data and statistics document national profile figures according to disease type.
For example, in the United States the rate of primary and secondary syphilis declined by 89.7% between the decades 1990 to 2000. A sharp rise during the following decades between 2001 and 2009 remained steady until 2011, wherein the rate increased by 11.1% (“2012 Sexually Diseases Surveillance”). The Centers for Disease Control (CDC) reported “a total of 1,422,976 cases of Chlamydia” which accounts for the most numerous instances of any reportable infections to the CDC. Chlamydia infectious cases, in the United States, represent 643.3 per 100,000 in females and 262.6 in men. According to 2013 WHO statistics “Each year, an estimated 500 million people become ill with one of 4 STIs: chlamydia, gonorrhea, syphilis and trichomoniasis” and over 530 million are presently infected with the genital herpes (HSV2) virus (“STIs Fact Sheet WHO”). In the U.S. each type of sexually transmitted disease is respectively categorized by specified disease, year, percentages, male/female, and age group. For example in the U.S. the overall reported numbers of chlamydia show that the 1,422, 976 known cases in 2012 were 70% concentrated among the 14-24 years of age group. Belenko et al. state (2009) that incarcerated juveniles in the United States “have relatively high rates of health problems, including elevated risks of the sexually transmitted diseases” (1032). This adolescent population represents a core risk group for prevention implementation. This public health discussion on sexually transmitted diseases seeks to foster an understanding of description, statistical information, intervention planning/selection, intervention implementation, intervention evaluation, and recommendation for prescriptive.
Causal Factors
The primary causal factor for acquiring sexually transmitted disease derives from behavior. Channels of transmission, according to the WHO (2013) can occur via “skin-to-skin sexual contact,” oral, vaginal, and anal sexual activity (“STIs Fact Sheet WHO”). Blood vector products, via non-sexual means, can spread sexually transmitted infections in terms of tissue transfer. Also as aforementioned, mother-to-child spread of the diseases can occur during pregnancy and childbirth according to the WHO (2013). Symptoms of sexually transmissible diseases are not always apparent. Therefore the term “sexually transmitted infections” represents a broader designation as compared to sexually “transmitted diseases” (“STIs Fact Sheet WHO”). According to the same WHO (2013) report the highest statistical incidence, and worldwide scope, of sexually transmitted infections occur in the North and South American continents.
Intervention Selection
The largest determinants and factors that contribute to the spread of sexually transmitted diseases are behavioral and mother-to-infant causes. Lack of education exasperates the problem. The spread of sexually transmitted infections causes a rise in “approximately 305 000 fetal and neonatal deaths every year and leaves 215 000 infants at increased risk of dying from prematurity, low-birth-weight or congenital disease” (“STIs Fact Sheet WHO,” 2013). STIs promote further insidious infections, in infants and adults, accounting for 305,000 neonatal deaths globally each year, infertility outcomes, and over half a million cases of cervical cancer according to a WHO (2013) report.
A key intervention selection focuses on behavioral responses as a determinant and contributing factor. Public health researchers Belenko, Dembo, Rollie, Childs, and Salvatore (2009) posit that U.S. adolescents in the justice system “in particular, have high rates of STDs that make them a potentially important core subgroup of STD transmitters” (1032). The studies, researchers cite, argue that drug-related behaviors coupled with sexual risk taking among arrested youth stimulates cause for a collaborative effort in public health to mitigate the situation. In targeting the prevention of HIV spread behavioral interventions must also ensue. In terms of intervention selection, therefore, behavior among youth and incarcerated persons potentially creates an impetus to the spread of sexually transmissible disease.
A Los Angeles study appearing in the American Journal of Public Health, entitled ‘Sexually Transmitted Infections Among Incarcerated Women: Findings From a Decade of Screening in a Los Angeles County Jail, 2002-2012’ notes that incarcerated medical health facilities provide an ideally suited locale for selection identification intervention. Public health researchers Javanbakht, Boudov, Anderson, Malek, Smith, Chien, and Guerry (2014) indicate that although certain prisons and jails have differing statistics of inmate STIs and HIV, chlamydia alone accounted for “from 7% to 22%, with gonorrhea prevalence ranging from less than 1% to 9%” (e103). The logical cause for intervention selection of the U.S. incarcerated population serves to highlight the factor of large numbers of people that cycle through the system, according to Javanbakht et al. (2014). Women of child-bearing age pose a double risk in terms of potential pregnancy-passed infections, with proportional statistics modeling rate as high as “20%” among Hispanics and African-Americans (Javanbakht, et al., 2014, e103). Youth having been incarcerated provides a ready group to collect data for later implementation for intervention, and evaluation.
Intervention Implementation
Intake procedure at the Los Angeles County Jail over the decade until 2012 has an annual rate of roughly 180,000 inmates (Javanbakht et al. 2014). Utilizing the Baseline Characteristics Model, shown in Table 1, courtesy of the Javanbakht research team (2014) the desired overall outcome is to target for sexually transmitted disease screening, and base an implementation plan to reduce the influx of infection from spreading throughout the entire population of 30-years-old and younger. Awareness, particularly among the female population along with screening and education, can prevent infant mortality and incidences of mother-transfer of sexually transmitted infections to children. The reason the intervention implementation plan must begin in the incarcerated youth populace is because concentrated incidents of sexually transmitted disease persist. For example an 11.4% prevalence of chlamydia reflects “the highest” rates of this particular disease is rampant among “among those in the youngest age group” according to Javanbakht et al. (2014, e105). Treating and screening juvenile youth passing through the doors of incarceration allow public health data to be collected, as well as the application of educational and treatment methods to become established early in life among the group.
The approach is particularly imperative due to the factor of youth rotating in and out, of the jail population, to integrate back into mainstream society. Javanbakht et al. (2014) report that inmates may endure an incarcerated stay for as little as two days, which further demonstrates that not all women who were imprisoned had the opportunity to be treated for chlamydia. Logically, therefore, Javanbakht et al. (2014) state the data demonstrated that “fewer than half the women with chlamydia or gonorrhea were treated in custody with the primary reason for lack of treatment relating to release from custody before laboratory results became available” (e105). Plan interventions from behavior identification selection, screening, intervention implementation, and intervention evaluation situated in community/public-health facilities form the infrastructures designed to interrupt the chain of spread.
Intervention Evaluation
Recommendation Descriptive Prescriptive & Budget
Recommendations demand a focus upon the urgent risk targets, of behavioral reductions of specifically HIV and chlamydia infections. According to Eaton, Huedo-Medina, Kalichman, Pellowski, Sagherian, Warren, Popat, and Johnson (2012) “Evidence-based, single-session behavioral interventions are urgently needed for preventing the spread of HIV and other sexually transmitted infections (STIs)” (e34). Individuals must be educated and aware in order to stop the cycle of sexually transmitted diseases which emerge to affect the lives of infants, and children, sometimes resulting in death. Administrative shall include grant writer, to request federal funds.
Incarceration-Community Consortium Budget Sample
-Website = 8.5% of budget ($72,287.00) IT management, cloud security, site monitoring, etc.
-Administrative and scheduling = 17.5% of budget ($148,827.00) Hire two accountants, etc.
-5 Laboratory facilities, 3 counties = 6% of budget ($51,026.40) *Rent/lease office/computers
-Mobile staff of nurses = 28.7% of budget ($244,076.28) Nursing salaries
-7 Rotating doctors = 35% of budget ($297,654.00) Physicians pay (each area of medicine)
-Communication devices (cellphones) [final 3 categories share approximately $34K as needed]
-Satellite Clinic locations {when labs closed, skeleton office for appointment sign-ups}
-Fundraising, Advertising, and Medicine donation drives
$850,440.00 = Annual Budget
*[Include purchase of basic nurse sanitized equipment: gloves/masks, swabs, infectious disposal]
Works Cited
Belenko, Steven, Richard Dembo, and Matthew Rollie. "Detecting, Preventing, and Treating
Sexually Transmitted Diseases among Adolescent Arrestees: An Unmet Public Health
Need.” American Journal of Public Health 99.6 (2009): 1032-1041. Education Source.
Web. 10 Nov. 2014.
“Data and Statistics.” Cdc.gov Centers for Disease Control, 2012-2014. Web. 11 Nov. 2014.
Eaton, Lisa A., et al. “Meta-Analysis of Single-Session Behavioral Interventions to Prevent
Sexually Transmitted Infections: Implications for Bundling Prevention Packages.”
American Journal of Public Health 102.11 (2012): e34-e44. Business Source Complete. Web. 10 Nov. 2014.
“Fact Sheets – 2013.” Who.int World Health Organization, 2013. Web. 11 Nov. 2014.
Javanbakht, Marjan, et al. "Sexually Transmitted Infections among Incarcerated Women:
Findings from a Decade of Screening in A Los Angeles County Jail, 2002–2012.”
American Journal of Public Health 104.11 (2014): e103-e109. Business Source
Complete. Web. 10 Nov. 2014.
“Sexually Transmitted Infections.” Who.int World Health Organization, 2014. Web. 11 Nov.
2011.
“Sexually Transmitted Disease Surveillance 2012.” Cdc.gov U.S. Department for Health and
Human Services – Centers for Disease Control and Prevention (CDC), 2012. Web.
11 Nov. 2014.
