SHARP Orientation for Navy Environmental Health Officers

1. SHARP Orientation for Navy Environmental Health Officers 

2. Overview

3. 1. DoN Metrics

4. SHARP Vision A Department of Navy (DoN) cultural norm in which sexual responsibility and safety is encouraged, support and expected, and a population in which all pregnancies are planned, syphilis is eliminated, and other sexually transmitted infections (STI), including HIV, are prevented.

5. SHARP Objectives Increase the proportion of pregnancies that are intended to 70% Increase the proportion of females at risk of unintended pregnancy (and their partners) who use contraception to 100% Reduce the annual rate of new HIV infections among active duty members to NMT 8 / 100K

6. SHARP Objectives (cont) Reduce the proportion of males and females aged 15-24 infected with Chlamydia to 3%. Reduce incidence of Gonorrhea to 19 /100K Reduce the incidence of Gonorrhea among active duty female Sailors and Marines to 237 /100K Eliminate sustained domestic transmission of primary and secondary Syphilis

7. SHARP Objectives (cont) Increase the proportion of sexually active adults who use condoms to 50% Increase proportion of sexually active females aged 25 and under screened annually for Chlamydia to 90% Increase proportion of providers who assess sexual risk behavior during routine outpatient encounters to 90% Increase the number of supported commands to which each MTF provided general sexual responsibility training (outreach) to at least 1 per year

8. DoN Data

11. This chart shows the percent of Navy enlisted women surveyed who said their pregnancy was planned. The HP 2010 objective is for at least 70% of all pregnancies to be planned. Other disconcerting data from the 2003 study (enlisted data only): �I would have sex without BC if my partner desired�: �yes� = 62% male, 29% female �If no BC available, I think it�s OK to take a chance and hope�: �yes� = 31% male. 15% female know about EC: male 39%, female 71% Believe EC is available where I�m stationed: male 10%, female 23% Believe BC is the woman�s responsibility: male 31%, female 56% Have seen �Give Yourself a Chance�: male 4%, female 3%This chart shows the percent of Navy enlisted women surveyed who said their pregnancy was planned. The HP 2010 objective is for at least 70% of all pregnancies to be planned. Other disconcerting data from the 2003 study (enlisted data only): �I would have sex without BC if my partner desired�: �yes� = 62% male, 29% female �If no BC available, I think it�s OK to take a chance and hope�: �yes� = 31% male. 15% female know about EC: male 39%, female 71% Believe EC is available where I�m stationed: male 10%, female 23% Believe BC is the woman�s responsibility: male 31%, female 56% Have seen �Give Yourself a Chance�: male 4%, female 3%

19. 2. DoD Policies and PrevMed Responsibilities DoDI 1010.10, Health Promotion Achieve national objectives for prevention of STDs, HIV and family planning �SECNAVINST 5300.30D, HIV, (6 Jan 06): �Aggressive disease surveillance, health promotion and education programs for Naval personnel will be used to mitigate the impact of HIV infection in DoN.�� � �Commanders will provide HIV prevention training in command Health Promotion Program� OPNAV 6100.2A, Health and Wellness Promotion Program (15 Mar 07): �It is Navy policy to provide education which increases responsible sexual behavior�� Sexual Health is a �required element� of the Navy Health and Wellness promotion Program. MCO P1700.29, SEMPER FIT: Annual STD prevention training required for all Marines

20. 2. DoD Policies and PrevMed Responsibilities (continued) BUMEDINST 6222.12B, STD: With HP, provide information, education and behavior change programs Support clinician with prevention counseling services Support clinician with partner referral services BUMEDINST 6222.10, MER Report communicable diseases

21. Resources - Guidelines Promoting Sexual Health guide Condom Access guide

22. NEHC SHARP website Films, posters, fact sheets, briefings, guidelines, more My personal health pages Health Educators pages Clinician pages NEHC HP Toolbox website Message for CO�s POD notes Activities / films / posters /fact sheets SHARP Toolbox CD

23. 4. Overview of PMT Training Self-study courses HIV Policy Sexual Health Primer HIV Facts Classroom courses HIV-STD Prevention Counseling Sexual Partner Counseling and Referral (PCRS)

24. 5. Training Available to EHOs and PMTs NEHC Self-study courses HIV Policy Sexual Health Primer Sexual Partner Counseling and Referral (PCRS) NEHC Classroom courses HIV-STD Prevention Counseling Sexual Partner Counseling and Referral (PCRS) Sexual Risk Assessment Promoting Sexual Health in Military Populations Web-based Courses Conferences

25. 6. PrevMed and STI Case Management Case Surveillance Case Referrals Preventive Medicine Office as an ancillary service Challenges of clinician referrals Prevention Counseling Sexual Partner Referral Case Reporting Special Issues: Confidentiality Discipline and health-seeking behavior

26. 7. PrevMed and HIV Case Management Navy HIV Central and the HETUs Case Identification and Reporting MTF role HETU role Prevention Counseling MTF role HETU role Sexual Partner Referral MTF role HETU role Epi Surveillance � local access to info

27. 9. PrevMed and Pop-level Prevention Partnership with health promotion Community-level awareness activities Condom access policies / strategies Special Issues: Sensitivity of sexual health promotion Partnerships with civilian agencies

28. Summary 1. DoN Metrics 2. DoN Policies and PrevMed Responsibilities 3. Program Guidelines and Resources 4. Overview of PMT Training 5. Training Available to EHOs and PMTs 6. PrevMed and STI Case Management 7. PrevMed and HIV Case Management 8. PrevMed and Pop-level Prevention

29. Thank you for helping our people to �chart a safe course� Michael R. (Bob) MacDonald, MS, CHES Navy and Marine Corps Public Health Center Directorate of Population HealthSexual Health and Responsibility Program (SHARP)620 John Paul Jones Circle, Suite 1100 Portsmouth VA 23708 web: http://www-nehc.med.navy.mil/hp/sharp e-mail: michael.r.macdonald@.med.navy.mil  voice: (757) 953-0974 [DSN 377]fax: x-0688