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STD prevention programs need revamping
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Despite nationwide prevention efforts, in 2015, the CDC reported that the rate of notifiable STDs in the United States hit a record high of nearly 2 million cases.
Infectious Disease News asked Versie Johnson-Mallard, PhD, ARNP, FAAN, associate professor and chair of the department of family, community and health system science at the University of Florida, about what changes are necessary to make STD prevention programs in the country stronger and more effective.
The average age at first sexual encounter is around 17 years; this age is comparable across developed nations and genders. The CDC has followed the same paradigm for STD prevention for some time, and yet the STD rates keep rising. It is time to change the paradigm.
Adolescent sexuality in the U.S. is dramatized, highlighting the dangers instead of viewing adolescent sexual health as a normal part of human development. Removing the drama means conceiving and discussing adolescent sexuality as part of ordinary young adult development. Adolescent sexual self-efficacy can be facilitated by viewing adolescent sexuality as normal individual maturity. Rather than instill fear of sexual activity, young people should be educated to recognize and communicate their desires and boundaries.
The social ecological model shows the complex relationships between factors that affect an individual’s perception, attitude and behavior at several levels: interpersonal, intrapersonal, community and societal. All four levels affect an individual’s behavior, and the levels to be considered in adolescent sexual health are interpersonal (eg, close relationships), intrapersonal (eg, self-efficacy) and community (eg, school, college, university). A key principle to the social ecological model is that lives are connected and interpersonal relationships affect individual behavior. Interpersonal relationships involve strong, emotional bonds between close friends, family and peers. Not surprisingly, significant relationships may increase risky sexual behavior if individuals are not confident in boundaries, empowered with evidence-based knowledge and have the self-efficacy to say no or to practice safer sex. Removing the drama and replacing it with evidence-based sexual and reproductive health education is offered as a new paradigm. The new paradigm should include helping young adults build the skills needed to stay true to their own sense of sexual readiness.
- References:
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- Burns FN. A Community’s Perception of Pregnancy and Sexually Transmitted Infections and Prevention Programs. 2016. http://scholarworks.waldenu.edu/cgi/viewcontent.cgi?article=3450&context=dissertations. Accessed January 31, 2017.
- Eaton DK, et al. MMWR Morb Mortal Wkly Rep. 2010;59:1-142.
- Glanz K, et al. Health Behavior and Health Education: Theory, Research, and Practice. 4 ed. San Francisco, CA: Jossey-Bass; 2008.
- Leichliter JS, et al. Sex Transm Dis. 2016;doi:10.1097/OLQ.0000000000000289.
Disclosure: Johnson-Mallard reports no relevant financial disclosures.