My goal is to increase community awareness of sexually transmitted infections (STI), increase community STI knowledge, and to identify a plan to reduce STI transmission through the use of prophylactic measures.
Sexually transmitted infections include infectious pathogens of bacterial, viral, or parasitic origin that are transmitted through anal, oral, and vaginal sexual contact. In the United States, from 2014-2018 there was a significant increase in reported STIs, nationwide. Within this time frame, there was a 19% increase in chlamydia cases, 63% in gonorrhea cases, and 71% in both primary and secondary stage syphilis cases (CDC, 2018). The significant increase in these three ubiquitous STIs of bacterial origin demonstrates a clear deficit in the utility of present STI educational and prevention programs. An increase in these relatively common STIs may also indicate a lockstep increase in other STIs. All sexually active individuals are at risk when it comes to the transmissibility of these infections. Alcohol and drug abuse, multiple concurrent sexual partners, and aversion to condom use and STI testing all confer an increased risk for STIs (Murali & Jayaraman, 2018; Lewis et al., 2020). Of those individuals sexually active, young adults and adolescents represent the most at-risk group in the United States. Concerning all STIs, individuals aged 15-24 comprise more than half of the 20 million new STI cases each year in the United States (Saldanha, 2020). From the STI cases reported in Texas in 2019, 93,136 out of the total 145,874 cases were documented from individuals within the 15-24 age range (TDSHS, 2020). With this at risk population in mind, reformation of STI educational programs to include behavioral focused interventions may prove effective in reducing both STI incidence and prevalence.
For helping professionals, including but not limited to social workers, counselors, nurses, and physicians, behavioral focused psychoeducational STI programs appear to be the most effective intervention paradigms for reducing STI risk-associated behaviors and increasing use of effective preventative measures. The Health Belief Model (HBM) presents as a useful theory of prevention for identifying and reframing individual beliefs that dissuade people from utilizing and maintaining STI related preventative behaviors (NCI, 2005). Beliefs modulate how people perceive the risk and severity of STIs and the financial and social costs of both seeking treatment and maintaining preventative behaviors. Effective prevention must include concerted efforts at the community, institutional, and public policy levels. At the community level, psychoeducational programs are key. Training of respected community leaders in STI preventative practices, sexual health knowledge, and the effective delivery of information, as described in Young et al. (2011), will prove effective for bolstering community empowerment and disseminating risk-aversion practices. At the institutional level, psychoeducation programs in public school systems that emphasize prophylactic practices such as effective condom use, present as a useful tool for reducing risky behaviors and increasing safe sex practices. The Be Proud! Be Responsible! program created by Jemmot et al. (1992) serves as a model for such interventions. At the public policy level there must be a redressment of policies such as Section 510 of Title V of the Social Security Act of 1996 that allocate funding only to those schools that teach abstinence-only-before-marriage curriculum (Jeffries et al., 2010). Such policies should be amended to include the preventative efficacy of condom usage in the reduction of STIs. Knowledge of effective preventative practices and practical sexual health management will prove to be the most effective bulwark against the perceived barriers to STI prevention and treatment. The equitable dissemination of this information amongst the general public and at risk populations is the key to ameliorating the rising STI epidemic in the United States.