Sexually Transmitted Diseases

            Sexually transmitted diseases affect individuals of all ages and particularly the young people. The estimates by the Center for Disease Control and Prevention show that young aged 15-24 years make up one-quarter of the sexually active population. Sexually transmitted diseases are a significant health problem that affects the young people in both the developing and the developed countries. In the period of 1985 to 1996, there was a general decline in the cases of gonorrhea, syphilis, and Chlamydia infections in the developed countries for the general population. However, in the mid-90s, the increase in the diagnoses of the sexually transmitted diseases was reported in the European countries especially for the teenagers (Weinstock, Berman & Cates, 2004). The major problem with most of the STDs is that they are symptom-free and can be infected by another person unawares during unprotected sexual intercourse. To individuals, they can develop complications like inflammatory diseases and also ectopic pregnancies. The female adolescents have a high risk of contracting STDs than the males’ counterparts since their partners are older and more likely to be infected. An early onset of sexual activity before 16 years increases the likelihood of having many sexual partners and in return increases the chance of being infected with a sexually transmitted infection.

            Knowledge and awareness about the sexually transmitted diseases are reported to be limited in changing attitudes and behavior. However, they are important components in sex education that help to promote healthy choices. The young people should be well informed of the likely health risks linked to sexual activity and how to protect themselves and others (Samkange-Zeeb, Spallek & Zeeb, 2011). In the present world, the public health decision-makers and experts acknowledge that adolescents have sexual and reproductive needs as well as the right to a satisfying and safe sexuality. The behavior, attitudes, and beliefs of the young people shape the future health status of every country. Sexually transmitted infections are a major concern to all the people who work to improve the health status of the populations. About 60% of the new infections and half of the people living with HIV are between 15 to 24 years (Dehne & Riednerm, 2005). The sexually transmitted infections are associated with stigmatization, embarrassment, and denial among the health care workers and patients. The health risks associated with sexuality are taboo in many societies. Thus, the young people face barriers when they want to obtain the support they require to avoid problems with the sexually transmitted infections. The gender-based inequalities subject girls and young women at an increased risk of getting STIs. The inequalities also affect their access to prevention and care services.

Theoretical Framework

            The research paper addresses the need to deal with sexually transmitted diseases among the young people using both the health belief model and the theory of reasoned action. The health belief model is a psychological model that explains and predicts health behaviors (Green & Murphy, 2014). The model focuses on the attitudes and beliefs of individuals and has been adapted to explore the long-and-short-term health behaviors that include the sexual risk behaviors and the transmission of HIV/AIDS. The basis of HBM is the understanding that a person will take a health-related action if they feel that a negative health condition can be avoided. It can also be appropriate when one has a positive expectation that taking the recommended action helps to avoid a negative health condition and also by the belief that one can successfully take the recommended health action. For instance, the use of condoms is a health related action that helps to avoid a negative health condition like preventing HIV and sexually transmitted diseases. The health belief model is applicable when a patient has confidence that taking the recommended health action will successfully solve a problem. The model is reviewed regarding four constructs that represent the threats and the benefits that include perceived susceptibility, perceived severity, perceived benefits, and perceived barriers. The concepts account for the readiness to act and activate the readiness to stimulate a behavior. The health belief model fits the challenges of challenges of dealing with unhealthy behaviors and can be applicable in regards to dealing with sexually transmitted diseases among the young people (Green & Murphy, 2014).

            The theory of reasoned action (TRA) is a classic model of psychology and is used in the communication to pass persuasive messages. The reasoned action adds behavioral intention and does not predict attitudes but behavior. The theory of reasoned action stops attitude predictions by predicting behavior and discusses the factors limiting the influence of attitudes on behavior (Montano & Kasprzyk, 2015). The theory is used to predict how individuals behave by their pre-existing attitudes as well as the behavioral intentions. It has been applied in many studies as a framework to examine specific kinds of behavior, and many researchers use it to study the behaviors associated with high risks and danger. For instance, in sexual behavior for the adolescents, the theory helps to identify that sexual intercourse among adolescents has been characterized as unplanned and impulsive. The theory of reasoned action can explain the adolescent behavioral intentions to engage in early sexual behavior as influenced by their attitudes and subjective norms. Attitudes are the favorable and unfavorable dispositions towards teenage sexual behavior. The subjective norms are the social pressure felt by teenagers from their friends, classmates, and other peers to engage in sexual behavior. TRA suggests that adolescents participate in early sexual behavior due to their attitudes towards behavior and the subjective norms practiced by their peers (Montano & Kasprzyk, 2015). There is a need to address the problem of sexually transmitted diseases among the young people due to the many underlying influences to control their behavior.

Review of Literature

            Cingolani, et.al (2015) conducted a study to identify the temporal trends in the incident of sexually transmitted diseases in a group of HIV-infected people and also to assess the factors related to the risk of new diagnosis. The results of the study showed that there was an increase in the incidence of STs in the recent years. There ought to be interventions to prevent STDs and the spread of HIV especially to the younger population and those not using ART. From the study findings, it is clear that there is a high prevalence of STDs among the young people and hence important to have strategies that can reduce the rates. There ought to be widespread sensitization of the young people regarding the methods of prevention against STDs and the modes of spreading the infection to another person. Young people are easily influenced by their peers as clarified in the theory of reasoned action and tend to follow their behavioral attitudes rather than the appropriate behavior.

            As Hoover, et.al, (2015) explains, there is a need to assess the characteristics of the sexually transmitted disease clinic patients to identify their reason to seek for health services in the STDs clinics and the access to health care in other places. The study sheds more light on the need to include the care for sexually transmitted diseases in the affordable care act. Some patients use the public-funded STD clinics, and others use other care centers to seek for STDs treatments. In spite of the access to other health care facilities, many people prefer to go to the STD clinics for their sexual health care and well-being due to their convenience, low cost, and expertise care. The study reveals that STD clinics have a crucial role in preventing the sexually transmitted diseases especially to the people without an insurance cover. There is a need for the young people to access timely and quality STD diagnosis and treatment services to reduce the high prevalence rates.

            There are several factors that contribute to the high rates of infection to the sexually transmitted diseases. Sexually transmitted diseases affect a high population in the United States, and largely the young people. Depression is attributed to the high rates of infection and transmission as reported from the data extracted from the National Survey on Drug Use and Health, 2014. According to the data about the factors leading to the diagnosis of STD, the patients with major depressive conditions are at a high risk for the sexually transmitted diseases. Depression treatment can be incorporated into primary care as an effective method to deal with increased risk of sexually transmitted diseases. The use of drugs like marijuana and alcohol also increases the risk of getting the sexually transmitted diseases. Depression and the use of such drugs make a person vulnerable to various sexually transmitted diseases since they cannot make informed decisions to use appropriate protection methods.

            According to research by Seth, Sizemore, and Hogben (2015), STD clinics are more successful in serving the populations that are disproportionally affected by HIV. The testing for HIV and service delivery in the CDC-funded sexually transmitted disease clinics has a significant contribution to the fight against the spread of STDs transmission. A proportion of the people tested for HIV is identified to have new positive outcomes in the STD clinics. Some people with HIV are also likely to have STDs since the modes of transmission are similar. The STD clinics can be effective in serving the people affected by HIV through improving care and the referral services to deal with HIV.

            STDs are not a new issue for the teens since they are sexually active and have experienced most of the things related to the diseases. Some studies reveal that about 46 % of the American high school students have had sexual intercourse and are potential targets to the risk of human immunodeficiency virus and other STDs. Gonorrhea rates were high among adolescents and young adults in 2012 as observed among women aged 20 to 24 years and 15 to 19 years. The new and existing cases of infection to STIs account to more than ten million for both men and women in the U.S (CDC, 2012). There is a need to deal with the sexually transmitted diseases among the young people because they are responsible for a variety of health problems. They also have far-reaching consequences for adolescents and the young adults. A focus on the incidence data for the last decade on the common STDs shows that the incidence has decreased both for the general population and for the adolescents. However, the figures are inconsistent for syphilis whose rates have risen dramatically. In many instances, Gonorrhea incidence is higher than that of syphilis in many countries thereby affecting adolescents and young adults. The data about the prevalence rates of the STDs is a call for action to enact prevention programs, active screening strategies and improved access to diagnosis and treatment services.

            The goal of the preventive program on STDs is to promote healthy sexual behaviors and increase access to quality services to prevent the sexually transmitted diseases and their complications. Sexually transmitted diseases remain a significant public health in the United States despite their burdens, costs, and complications as well as being preventable. The problem of dealing with STDs is unrecognized by the public, the policy makers and the health care professionals making the diseases harmful and impact costly clinical complications (Healthy People 2020, 2016).

Why prevention of Sexually Transmitted disease is important

            According to the data released by the Centers for Disease Control and Prevention (CDC), there are approximately 20 million new infections of STD each year. The cost of treating STDs to the U.S health care system is more than $16 billion annually. Many cases of the sexually transmitted diseases go undiagnosed, and also some common viral infections are not reported making the reported cases only a small fraction of the true nature of the diseases in the United States. Any case of STDs that goes untreated for long leads to serious long-term health consequences for the adolescent girls and young women (Ndubani & Hojer, 2001). The untreated cases are among the leading causes of infertility among women.

            The spread of STDs is contributed to by several factors. They can be biological or the social, economic, and the behavioral factors. For most of the cases, STDs are acquired through unprotected sex with an infected person. The contributing biological factors to the high prevalence rates include the asymptomatic nature of the diseases, gender disparities, and the age disparities. Many of the STDS do not have any signs and symptoms and usually remain unnoticed making the infected persons not to seek medical assistance. Gender disparities make women suffer more frequently and serious STD complications than men (Satterwhite, et.al. 2013). The most serious complications are pelvic inflammatory disease, infertility, and chronic pelvic pain. Age disparity also influences the prevalence of STDs in which young people aged 15 to 24 years. The adolescent females have increased the likelihood to infection because of increased cervical ectopy (Healthy People 2020, 2016). 

            The spread of STDs is directly impacted by the social, economic, and behavioral factors. The factors cause obstacles to STD prevention strategies due to their impact on the social and sexual networks, the access and provision of care, the willingness to get care, and the social norms of sex and sexuality. Segregation and discrimination also influence the susceptibility to STDs. Race and ethnic disparities have a significant impact on the incidence rates of STDs. Some racial and ethnic groups especially the African-American, Hispanic, and Alaska Native populations have high rates of STDs in comparison to the whites. Race and ethnicity in the US correlate with another determinant of health status like poverty, limited access to health care, reduced frequency to get medical treatment, and are more likely to live in communities that have high rates of STDs. Many of the ethnic groups are vulnerable to high prevalence rates of STDs since they do not have easy access to health care facilities for screening and diagnosis of all the risk conditions.

             The sexually transmitted diseases affect the disadvantaged people disproportionally and people in the social networks with a high-risk sexual behavior. Such people have a compromised access to care as well as the health-seeking behavior. The access to high-quality care is important for facilitating early detection, treatment, and counseling for behavior change against STDs. The social groups with high rates of STDs are the same groups whose access to and use of health services is limited. Substance abuse and STDs are related to the fact that the use of some illicit substances affects the sexual behavior leading to the spread of STDs. Another significant social factor that contributes to the spread of STDs in the United States is the stigma associated with the diseases and the discomfort of discussing the issues related to sex (Singer, et.al. 2006). Sexual networks are the people linked to particular sexual partner which can be risky if one partner is on another network.                                     

Recommendations for policy change

            The high prevalence rates of STDs are a threat to the general health of the young people. They are the most likely to be infected with STDs, hence necessary to enact strategies to reduce the rates of infection. The policy change is necessary regarding the fight against the spread of STDs, especially to the young people. It would be necessary that each state addresses the barriers to timely treatment of the persons infected with STDs. Sexual partners should be encouraged to go for screening and if diagnosed should undergo full treatment. The sexually transmitted diseases are preventable if individuals take actions to have protected sexual engagements. According to the health belief model, people take health related actions if they feel that a negative health condition can be avoided. As such, they are likely to go for screening and also have protected sexual engagements by the belief that they will remain safe.

            The health-related agencies should gather data on the demographic and behavioral variables to help in determining the epidemiology of STDs and also to guide the prevention efforts. Accurate data about the reported cases of STDs can be essential in developing an appropriate preventive strategy. There should also be the implementation of better communication strategies to address disparity, vaccine uptake, dealing with perceptions of sexual health and STD prevention in the efforts of reducing health disparities. Another effective strategy is to coordinate STD prevention efforts with the health care delivery system to incorporate the ideas in the health reform legislation. It has been reported that social norms that value women’s passivity and subordination also lower the ability of many women to protect themselves, refuse unprotected sex, and also negotiate the use of condoms.  As such, there ought to be policies to safeguard the rights of women regarding preventing themselves against sexually transmitted disease.

References

Centers for Disease Control and Prevention (CDC) (2012) Sexually Transmitted Disease Surveillance 2011. Atlanta: U.S. Department of Health and Human Services

Cingolani, A., Zona, S., Girardi, E., Cozzi-Lepri, A., Monno, L., Quiros-Roldan, E., & ... Marcotullio, S. (2015) Incidence and factors associated with the risk of sexually transmitted diseases in HIV-infected people seen for care in Italy: data from the Icona Foundation cohort. HIV Medicine, 16(7), 412-420. doi:10.1111/hiv.12226.

Clinics in the United States, 2011-2013, American Journal of Public Health, 105(11), 2374-2381; doi:10.2105/AJPH.2015.302778

Dehne K.L & Riedner G. (2005) Sexually Transmitted Infections among Adolescents: The need for adequate health services. Department of Child and Adolescent Health and Development (CAH), World Health Organization (pdf)

Green, E. C., & Murphy, E. (2014) Health belief model: The Wiley-Blackwell Encyclopedia of Health, Illness, Behavior, and Society

Healthy People 2020 (2016) Sexually Transmitted Diseases.

Hoover, K. W., Parsell, B. W., Leichliter, J. S., Habel, M. A., Guoyu, T., Pearson, W. S., &     Gift, T. L. (2015). The continuing need for sexually transmitted disease clinics after the affordable care act: American Journal of Public Health, 105S690-S695; doi:10.2105/AJPH.2015.302839.

Jenkins, W. D., & Botchway, A. (2016) Young adults with depression are at increased risk of sexually transmitted disease. Preventive Medicine, 8886-89, doi:10.1016/j.ypmed.2016.03.020

Montano, D. E., & Kasprzyk, D. (2015). Theory of reasoned action, theory of planned behavior, and the integrated behavioral model, Health behavior: Theory, research, and practice

Ndubani P. & Hojer B. (2001) Sexual behavior and sexually transmitted diseases among young people in Zambia: Health Policy and Planning, 16 (1): 107-112

Samkange-Zeeb, F. N., Spallek, L., & Zeeb, H. (2011) Awareness and knowledge of sexually transmitted diseases (STDs) among school-going adolescents in Europe: a systematic review of published literature. BMC Public Health, 11(1), 1

Satterwhite, C. L., Torrone, E., Meites, E., Dunne, E. F., Mahajan, R., Ocfemia, M. C. B., ... & Weinstock, H. (2013). Sexually transmitted infections among US women and men: prevalence and incidence estimates, 2008, Sexually transmitted diseases, 40(3), 187-193

Seth, P., Guoshen, W., Sizemore, E., & Hogben, M. (2015) HIV Testing and HIV Service Delivery to Populations at High Risk Attending Sexually Transmitted Disease

Singer, M. C., Erickson, P. I., Badiane, L., Diaz, R., Ortiz, D., Abraham, T., & Nicolaysen, A. M. (2006) Syndemics, sex, and the city: understanding sexually transmitted diseases in social and cultural context: Social science & medicine, 63(8), 2010-2021

Weinstock, H., Berman, S., & Cates, W. (2004). Sexually transmitted diseases among American youth: incidence and prevalence estimates, 2000. Perspectives on sexual and reproductive health, 36(1), 6-10

Sherry Roberts is the author of this paper. A senior editor at Melda Research in best nursing writing services if you need a similar paper you can place your order for custom nursing papers.