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July 2014
Sexual Health Resources

The Reducing Adolescent Sexual Risk tool,  developed in partnership with the South Carolina Campaign to Prevent Teen Pregnancy, helps health professionals design, adapt and select curriculum-based programs to effectively address critical factors that affect teens' sexual decision making. It is ideal for program planners, policy makers, district administrators and youth-serving organizations. 


CDC's Division of STD Prevention Treatment website has many resources for treating sexually transmitted infections, including treatment guidelines, self-study modules, clinical recommendations, and FAQs, information about Expedited Partner Therapy by jurisdiction; and other resources, including podcasts, Dear Colleague letters, and updates.  



 Sexually Transmitted Diseases Treatment Guidelines, released in 2010, provides current guidelines for testing for, preventing, and treating STIs. It also includes guidelines specific to vulnerable populations such as pregnant women. 

 Click here to access
a compendium of evidence-based HIV behavioral interventions compiled by the Centers for Disease Control and Prevention (CDC).


CDC's Division of STD Prevention developed the STD Treatment (Tx) Guide App for clinicians and healthcare providers. The STD Tx Guide app helps providers easily identify the recommended treatment for patients with STIs.    

CDC's Division of STD Prevention Training website provides resources, fact sheets, webinars, curriculum, and other information for healthcare providers.   

Sexually Transmitted Infections Among Young Americans  

The  CDC released this infographic that highlights the impact, causes, and consequences of STIs among young people and what they can do to protect themselves.    


The National Chlamydia Coalition is an organization that was started in 2008 with the mission to address the high burden of chlamydia, as well as gonorrhea, among adolescents and young adults by working to educate healthcare providers, and the public, translation and dissemination of research findings, and promoting equal access to comprehensive and quality health services.    
The National Network of STD/HIV Prevention Training Centers (NNPTC) is a CDC-funded group of regional centers created in partnership with health departments and universities. The PTCs are dedicated to increasing the knowledge and skills of health professionals in the areas of sexual and reproductive health. 

 The National Coalition of STD Directors works toward the development of systemic change and promotion of national awareness in the policies that govern STIs. The  NCSD recently developed a fact sheet that focuses on the innovative and collaborative ways health departments are incorporating HPV disease awareness into their program activities and clinical practices. Click here for more information. 

The Association of Reproductive Health Professionals developed a list of publications titled Hot Topics in Sexually Transmitted Infections and Associated Conditions. Click here to receive continuing education credit by viewing their webinar on Managing Prevalent and Problematic STIs.  


The  American Sexual Health Association is dedicated to improving the health of individuals, families, and communities, with an emphasis on sexual health and a focus on preventing STIs and their harmful

consequences. ASHA offers high-quality patient education materials on a wide range of STIs. Click here to access their fact sheet on 10 Things to Know about Women's Health.   
ACA News    

AIDS.gov features a list of resources and information on how the Affordable Care Act is helping people living with HIV/AIDS. It also lists videos, revised treatment guidelines, and policy information related to the ACA and HIV/AIDS.
Women's Sexual Health 
...in the South!

Most sexually transmitted infections (STIs) affect both men and women, and both can suffer symptoms, but women experience serious and more frequent, long-lasting health problems from STIs than do men. Left untreated, many STIs, such as chlamydia, gonorrhea, and syphilis, can lead to pelvic inflammatory disease, which can result in infertility or ectopic pregnancy.

Women's Reproductive Health and STIs 
Each year, untreated STIs cause infertility in at least 24,000 women in the U.S. Untreated STIs can also cause problems during pregnancy, such as early labor or transmission of the disease to the baby either in the womb, or during delivery. Genital herpes, syphilis, and HIV can be passed to babies during pregnancy and at delivery. The harmful effects of STIs in babies can include stillbirth, low birth weight, brain damage, blindness, and deafness. Untreated syphilis in pregnant women results in infant death in up to 40% of cases.

STIs can even cause cancer. The Human papillomavirus

(HPV), the most common sexually transmitted infection, is the main cause of cervical cancer in women. Unfortunately, in addition to women disproportionately bearing the burden of STI-related health problems, they are also less likely to have or notice the symptoms of STIs than men are, making it more likely that they will remain unaware of the infection and not seek timely treatment. Women aged 21 to 65, should get routine screenings as a way to prevent cervical cancer. Click here to learn more about HPV and CDC's recommended guidelines.             


Often, knowledge is not enough to help women protect themselves against STIs. The power dynamics of a relationship can make it difficult for women to negotiate safer sex practices with their partners. In the case of interpersonal violence, it can even be dangerous. In fact, women with high STI knowledge but who are under high levels of fear of abuse are less likely to consistently use condoms than women with low STI knowledge, but without fear of abuse. As a result, women who report having experienced physical abuse from a partner were found to be 3 times more likely to experience an STI than women who report not having experienced physical abuse.The frighteningly high rates of interpersonal violence that are experienced by women in the U.S., means that in order to address the issue of sexually transmitted infections, intimate partner violence screening and connection to services for those affected needs to be integrated into STI prevention programs. 


STI prevalence in the South    

Of the four regions in the U.S. (South, West, Northeast, and Midwest), the South has consistently had high rates of sexually transmitted infections. The South has the highest rates, per 100,000 people, of gonorrhea, chlamydia, and syphilis. HIV/AIDS is also more prevalent in the South. Despite making up only 37% of the population of the U.S., the South represents 50% of newly reported HIV infections, 45% of new AIDS diagnoses, and 48% of AIDS deaths. This amount of HIV/AIDS cases in the South is due in part to the disproportionate amount of other sexually transmitted infections, as infection with other STIs increases the likelihood of HIV infection. 
There are many reasons that STIs are more prevalent in the South than in the rest of the U.S. Women in the South have lower levels of educational attainment than any other region in the country, have less opportunity for financial independence, and because of widespread poverty in the South, their access to quality healthcare is limited. These factors have been found to be associated with poor sexual health. A large contributor to the high rate of STIs in the South is lack of access to complete and accurate sexual education. The South has the highest proportion of abstinence-only sex education policies in the country, meaning that youth in the South are being given less complete information about how to prevent STIs than youth in the rest of the country. Consequently, there are also vast racial and ethnic disparities in STI rates. African Americans are disproportionately affected by chlamydia, syphilis, human papillomavirus (HPV), and HIV. The largest disparity is in gonorrhea infection rates. The rate of gonorrhea infection among African Americans in the South is 16 times that of whites. These disparities mean that some minority populations are bearing the burden of sexually transmitted infections and all of the health-related and social consequences that come with them. In order to address this issue, we have to address the underlying problems of access to quality sexual health services, distrust of the health care system among some minority groups, and access to comprehensive sexual education.


Treatment-resistant Gonorrhea
The Centers for Disease Control has declared the development of antibiotic resistance in Neisseria gonorrhoeae to be an urgent public health threat. The treatment and control of gonorrhea relies on effective antibiotic therapy, and N. gonorrhoeae has developed resistance to many antibiotic drugs used to treat it, including sulfonilamides, penicillin, tetracycline, and ciprofloxacin. This emerging antibiotic resistance means that cases of gonorrhea are becoming more and more difficult to treat.While gonorrhea used to be treated by prescribing oral antibiotics on their own, in order to address potential emergence of cephalosporin resistance, current CDC treatment guidelines recommend dual therapy combining oral antibiotics with injectable cephalosporin ceftriaxone. The fact that dual therapy is now required makes complete treatment of the patient AND their partner more difficult; increasing the likelihood of the infection spreading. 
Southeast STI/HIV Initiatives

The Southern HIV/AIDS Strategy Initiative is a broad-based  coalition of HIV/AIDS advocates and their supporters lead by the Duke AIDS Legal Project at Duke University School of Law. SASI is developing research-based policy and strategy recommendations aimed at securing a federal commitment for the next steps in the implementation of the National HIV/AIDS Strategy.

 The Southern AIDS Coalition (SAC) is a regional non-profit serving the 16 southern states as defined by the US Census. SAC promotes accessible and high quality systems of HIV and STI prevention, care, treatment, and housing throughout the South, and houses an online southern resource portal with fact sheets and resources on state-specific HIV/AIDS information.

The Rural Women's Health Project is a non-profit organization that designs and implements community-based, health-education projects, trainings, and materials to assist communities in strengthening their understanding of critical health, occupational and family issues in Florida. One of their programs is Entre Nosotras (Between Us Women), an STI/HIV prevention program for Hispanic women. The program seeks to increase women's health literacy, teach about family planning and address HIV risk and prevention of HIV in the Hispanic, immigrant communities of rural North Central Florida.

The Healthy Love Workshop is a group-level STI/HIV prevention intervention. It is an interactive, educational workshop, to reduce HIV- and sexually transmitted infection-related risk behaviors among heterosexual black women. The Healthy Love Workshop is community-focused and community-responsive. It was developed by SisterLove, Inc., a community-based organization, founded in 1989, whose mission is to eradicate the impact of HIV/AIDS and other reproductive health challenges of African-American women and girls, their families and communities through education, prevention, support, and human rights advocacy in the US and around the world.

Hear from Dázon Dixon Diallo, the Founder and President of SisterLove, Inc. - the first women's HIV/AIDS organization in the southeastern U.S., as she introduces the stories of HIV+ women leaders.

Vignette #1  Intro with Dazon final (Jan 28th).wmv 
Vignette #1 Intro with Dazon D. Diallo 

Read Our Blog!    

This month's newsletter was put together by our graduate student intern Sarah Downs. Also, check out our latest blog post on the effect of STIs and women by Amanda Zabala. 

Tell Us What YOU Think!   

What other ways are public health and community groups partnering to prevent the complications of STIs and HIV in women's health? We'd love to share any resources - books, websites, apps, etc - that you find useful!

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University of North Carolina at Chapel Hill 
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