2014 STD Prevention Conference Studies of Interest on STDs among Youth

More than 500 studies are being presented at the 2014 STD Prevention Conference, addressing a wide range of research relevant to preventing and treating sexually transmitted diseases (STDs).

Several studies will be presented on the heavy burden of STDs among young people in the United States and the need to increase screening in this population. One study presents new chlamydia prevalence estimates confirming that young women – particularly young African American women – continue to bear a disproportionate burden of disease. The new estimates also suggest that many cases go undiagnosed.

Overall, the findings underscore the critical need for national efforts to increase diagnosis and treatment of STDs among youth.

One such effort is the “Get Yourself Tested” (GYT) STD awareness campaign, a collaborative effort from the American College Health Association, the Kaiser Family Foundation, MTV, National Coalition of STD Directors, and Planned Parenthood Federation of America, with technical consultation provided by the Centers for Disease Control and Prevention. Two new evaluations of the campaign show that it has successfully increased testing and other behaviors that can reduce the risk of infection (e.g., talking to partners about STDs) among young people.

A few key studies are summarized below, followed by brief background on STD risks among young people and their potentially devastating health consequences.

Studies of Interest

Title: Prevalence of Chlamydia Trachomatis – United States, 2007-2012 (WP 4)

Overview: Using 2007-2012 National Health and Nutrition Examination Survey data, study investigators calculated new, nationally representative estimates for chlamydia prevalence overall, as well as by sex, age, and race.

• Study investigators found an overall chlamydia prevalence of 1.7 percent among survey participants (including men and women aged 14-39), which suggests that there are an estimated 1.8 million prevalent infections nationally.
• Compared to the 1.4 million infections reported annually, this prevalence estimate suggests that many chlamydial infections go undiagnosed.
• Young women continue to bear a disproportionate burden. Among sexually active female adolescents aged 14-19 years, there was an estimated chlamydia prevalence of 6.4 percent. Among sexually active male adolescents aged 14-19 years, there was an estimated chlamydia prevalence of 2.4 percent.
• Racial disparities were also noted: estimated prevalence among sexually active black female adolescents was 18.6 percent, compared to 3.2 percent among sexually active white female adolescents.

Based on these findings, the authors stress the importance of screening all sexually active young females, according to CDC guidelines, to ensure that those who are infected get diagnosed and treated. They also note that substantial racial disparities highlight the need for targeted interventions, particularly to reduce the impact of chlamydia among young African American women.

• Contact: Elizabeth Torrone, CDC
• Location: International Ballroom (M2)
• DATE/TIME: Tuesday, June 10 and Wednesday, June 11; 12:00 PM – 1:30 PM

Title: GYT Awareness and STD Testing Behaviors Among Youth and Young Adults (TP 44)

Overview: An online survey assessing awareness and impact of the GYT campaign among youth found a positive association between awareness of the campaign and STD and HIV testing. GYT promotes testing through broadcast and social media outreach as well as on-the-ground testing events in clinics, youth centers and college campuses nationwide, with efforts concentrated during STD Awareness Month each April.

• In a nationally representative survey of 4,017 respondents aged 15-25 from across the United States, 20 percent had heard of GYT, which compared favorably with awareness of similar campaigns.
• The rate of testing for STDs (excluding HIV) within the past 12 months was higher among those aware of the campaign than among those unaware (26 percent vs. 12.5 percent).
• HIV testing was also higher among those aware of the GYT campaign than those unaware (46 percent vs. 25 percent).
• Other target behaviors of the campaign (e.g., talking to sex partners and health care providers about STDs) were also more common among those aware of the campaign: 38 percent of those aware of the GYT campaign had talked with a provider and 33 percent to a romantic partner about STDs (vs. 20 percent and 15 percent, respectively, of those unaware of the campaign).

The study authors conclude that an awareness campaign like GYT can have a positive impact on key STD prevention behaviors among young people.

• Contact: Allison Friedman, CDC
• Location: Exhibit Hall (South Tower)
• DATE/TIME: Tuesday, June 10 and Wednesday, June 11; 12:00 PM – 1:30 PM

Title: Get Yourself Tested 2011-2012: Findings and Rates of Chlamydia Trachomatis and Neisseria Gonorrhea at an Urban Public Health System (TP 47)

Overview: To assess the impact of the GYT campaign in Cook County, Chicago, study investigators analyzed chlamydia and gonorrhea testing data among young people aged 15-25 during April 2011 and April 2012, two months when the campaign was implemented in their community to coincide with National STD Awareness Month. They found that testing was higher during both months compared to rates in April 2010, when no special outreach was done.

• Overall testing was 36 percent higher in April 2011 and 44 percent higher in April 2012 than in April 2010.
• Of those tested, 17 percent tested positive for either chlamydia or gonorrhea or both; 14 percent were positive for chlamydia and 5 percent were positive for gonorrhea.

This study suggests that the GYT campaign had a significant impact on increasing STD testing among high-risk young people in Cook County.

• Contact: Alicia Roston, John H. Stroger, Jr. Hospital of Cook County, Chicago
• Location: Exhibit Hall (South Tower)
• DATE/TIME: Tuesday, June 10 and Wednesday, June 11; 12:00 PM – 1:30 PM

Background on Chlamydia and other STDs among Youth

Both the risks and consequences of STDs are especially severe for young people. Young people aged 15-24 have the highest rates of chlamydia of any age group. Although they make up 25 percent of the sexually experienced population, they represent half of all new STDs overall. The high burden of chlamydia and other STDs among young women is of particular concern, as they face the most severe health risks from untreated infection. Every year, 24,000 women become infertile because of an undiagnosed STD. Young people face unique prevention challenges such as confidentiality concerns, biological factors that place young women at greater risk for STDs, lack of access to health care, and, for many, multiple sex partners. For many young African American women, risk is further compounded by contextual factors such as high background STD prevalence in their communities.

With timely diagnosis and appropriate treatment, all STDs can be treated and some can be cured. However, because they often have no symptoms, many STDs go untreated – and individuals unaware that they’re infected may unknowingly infect others. To break the cycle, it is critical to increase awareness and screening, particularly among young people.

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U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES