Sexually Transmitted Diseases in Kent County

1. Sexually Transmitted Diseases in Kent County Sara McCormick & Shenna Throop

2. Analysis • Statistics from within Kent County indicate that there has been an increase in the prevalence of Sexually Transmitted Diseases (STD) in 20-24 year olds from 2001-2010 (Michigan Sexually Transmitted Diseases Database, 2011).

3. Kent County STD Stats Selected Sexually Transmitted Diseases CasesBy Gender and Selected Age GroupKent County, 2010 Source: Michigan Sexually Transmitted Diseases Database, Sexually Transmitted Disease Section, Division of HIV/AIDS-STD, Michigan Department of Community Health; Table prepared by the Division for Vital Records and Health Statistics, Michigan Department of Community Health.

4. Selected Sexually Transmitted Diseases CasesBy Gender and Selected Age GroupMichigan Total, 2010 Source: Michigan Sexually Transmitted Diseases Database, Sexually Transmitted Disease Section, Division of HIV/AIDS-STD, Michigan Department of Community Health; Table prepared by the Division for Vital Records and Health Statistics, Michigan Department of Community Health

5. Kent vs. Michigan • When comparing the age group of 20-24 years in the tables in the above slides, you can see where the incidence of STDs is higher for this age group in Kent county when compared to Michigan as a whole.

6. Why higher incidence of STDs in Kent County • Poverty and STDs • Women living below the poverty line are much more likely to contract HPV than those living above it. • 66% of women infected with HIV had annual incomes below $10,000 • Research has shown that socioeconomic status is the greatest predictor for someone’s health status. Low-incomes, lack of access to primary care, and sexual exploitation continue to be the major factors behind women’s growing STD rates Source: Centers for Disease Control and Prevention, HIV/AIDS Among Women 2007 • Michigan and Kent County Stats • Per capita money income in past 12 months (2010 dollars) 2006-2010 $24,791(Kent) $25,135 (MI) • Median household income 2006-2010 $49,532(Kent) $48,432(MI) • Persons below poverty level, percent, 2006-2010 14.3%(Kent) 14.8%(MI) Source: US Census Bureau, State and County Quick Facts

7. Orlando's Nursing Process Discipline Theory The concepts of the theory are: function of professional nursing, presenting behavior, immediate reaction, nursing process discipline, and improvement • The function of professional nursing is the organizing principle. This means finding out and meeting the patient's immediate needs for help • Presenting behavior is the patient's problematic situation. Through the presenting behavior, the nurse finds the patient's immediate need for help • The immediate reaction is the internal response. The patient perceives objects with his or her five senses. These perceptions stimulate automatic thought, and each thought stimulates an automatic feeling, causing the patient to act • The nursing process discipline is the investigation into the patient's needs. Any observation shared and explored with the patient is immediately useful in ascertaining and meeting his or her need, or finding out he or she has no needs at that time • Improvement is the resolution to the patient's situation. In the resolution, the nurse's actions are not evaluated. Instead, the result of his or her actions are evaluated to determine whether his or her actions served to help the patient communicate his or her need for help and how it was met • Source: Nursing Theory, 2011.

8. Available resources • Kent County Health Clinic • Task force on Health Care for People of Color • Metro Health Clinic, Allendale, MI • Planned Parenthood, Grand Rapids • Most information found is for treatment, not prevention Inadequate to address the issue head on. • Other community groups who can help: • Church groups, social groups, colleges, shopping centers(farmer’s markets, malls), gyms, other public places can all help advertise prevention material.

9. Problem Statement • Risk of Sexually Transmitted Diseases (STD) in Kent County residents between the ages of 20 and 24, related to an increase of high risk behaviors, as demonstrated by the rise of documented STD incidences.

10. Interventions • Sexually Transmitted Diseases rates can be drastically reduced if certain measures are followed on a consistent basis. These primary measures include; • Abstinence • Condom Use • Limiting the number of sexual partners • Early sex education

11. Primary Prevention • Abstinence • Abstinence from vaginal, anal, and oral sexual intercourse is the only absolute way to eliminate the risk of STD transmission (CDC, 2011) • It is important to note that contact with an infected genital area, even without intercourse, can result in the transmission of some STD’s

12. Primary Interventions • Condom Use • When used consistently and correctly condoms can reduce STD transmission. • Incorrect use of condoms decreases or eliminates their protective effect, opening up the risk for STD transmission • Studies have shown that latex condoms provide an essentially impermeable barrier to particles the size of STD pathogens • May not protect against genital ulcer disease or HPV depending on the location of the soar. It is important to remember that skin-to-skin contact of the entire genital area can cause the transmission of STD’s (CDC, 2011).

13. Primary Prevention • Limiting the number of sexual partners • Studies have shown that being in a long-term, mutually monogamous relationship with an uninfected partner will eliminate the risk of transmitting STD’s (NPIN, 2011). • Decreasing the number of sexual partners directly correlates with a decrease in the transmission of STD’s (CDC, 2011)

14. Primary Prevention • Early Sex Education

15. Secondary Prevention • Secondary prevention methods can help detect and manage STD’s. • Screening: The earlier an STD is detected the less chance there is for further transmission. • Treatment: Early treatment is imperative in order to reduce the risk of long term effects. • Counseling after detection: Counseling is helpful for chronic STD/AIDS management and helps to reduce the risk of contracting another STD in the future.

16. Evidence-Based Practice • ABC

17. Evidence Based Practice • GYT (Get yourself tested campaign) • GYT is about creating a youthful and empowering social movement around getting tested for STDs. It works within a framework that recognizes a continuously high rate of HIV and STD infections among young people despite high levels of awareness about HIV/AIDS and other STDs. For a generation accustomed to communicating in shorthand, the GYT acronym presents STD testing in a context that is familiar and relatable to young people. GYT encourages testing as an act of pride, not shame, and promotes an open dialogue about STDs by encouraging young people to get themselves tested and spread the word about the campaign.

18. Evaluation • Follow willing voluntary participants for 5 years post program and survey on sexual behaviors and STD status • May be difficult to obtain accurate results, if participants are scarce/and or not truthful

19. References Centers for Disease Control and Prevention. Clinical prevention guidance. (April 12, 2007). http://www.cdc.gov/std/treatment/2006/clinical.htm Nursing Theory. Orlando’s nursing process discipline theory. (2011). http://nursing-theory.org/theories-and-models/orlando-nursing- process-discipline-theory.php STD Awareness Resource Site. GYT: get yourself tested campaign. (2012). http://www.cdcnpin.org/stdawareness/GYT.aspx Sexually Transmitted Diseases Database, Sexually Transmitted Disease Section, Division of HIV/AIDS-STD, Michigan Department of Community Health; Table prepared by the Division for Vital Records and Health Statistics, Michigan Department of Community Health. (June 2, 2011).