Chlamydia

HPEB 553 CHA Report

April 13, 2016

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Slippy, Chelsea
Introduction

America is not as healthy as it may seem. In fact, the US has the highest expenditures on

healthcare, and still has worse health outcomes in comparison to other countries. Those countries

include Japan, United Kingdom, Germany, Switzerland, and Taiwan. As Americans, we have a

massive amount of health problems. They range from personal health problems to community

health problems, etc. Here, were focusing specifically on community health problems which can

be defined as the difference between what is and what should be in a community in terms of

health. There are numerous community health problems which includes Chlamydia.

Epidemiological Diagnosis

According to Planned Parenthood, Chlamydia is an infection caused by a kind of

bacteria that is passed during sexual contact. It is the most common sexually transmitted

bacterial infection in the United States. This particular STI is caused by various factors such as

not using protection, having multiple sex partners, etc. Most individuals who have the STI are

unaware due to its symptoms not always being visible or immediate. This is often the reason as

to why so it goes untreated among individuals although it is curable. The symptoms vary

between men and women. For men, symptoms include discharge from their penis, burning

sensation when urinating, or pain or swelling in one or both testicles. For women, symptoms

include: abnormal discharge, burning sensation when urinating, pain during intercourse, or

bleeding between periods (CDC, 2014b; Office on Womens Health 2011).

According to the Center of Disease and Control (CDC), Chlamydia is most prevalent in

the Southern regions of the United States. The South reported having 492.3 cases of chlamydia

per 100,000 people in 2014. While both men and women can contract this particular sexually

transmitted infection, it is most prevalent among women. During 2013-2014, 627.2 cases were
reported per 100,000 females, whereas only 278.4 cases were reported per 100,000 males. Here,

you see that males and females are not affected equally by the STI. With that being said, the

cases also vary by age along with race/ethnicity. Reports of chlamydia are highest among

adolescents and young adults. The CDC considers this to be individuals between the ages of 15-

24 years old. The African American population is most affected by the infection, resulting in

higher rates than any other race. According to SCDHEC, almost half of reported chlamydia cases

involve African Americans. The rate could potentially be higher than that if you take into

consideration the unreported cases as well.

In public health, we often measure morbidity, mortality, and frequency to describe

community health problems. Morbidity encompasses both incidence and prevalence rates of a

given disease or infection. The incidence rate of chlamydia in 2014 in the United States

corresponds to the 1,441,789 cases reported which equals 456.1 cases per 100,000 individuals.

Mortality on the other hand is the number of deaths in regards to chlamydia. Untreated cases of

chlamydia can affect the fertility of both men and women causing them to become infertile.

Furthermore, it could lead to ectopic pregnancy or severe pelvic pain in women.

When creating a health promotion/education program, it would be most reasonable to

focus on/target the population in which Chlamydia is most prevalent. Therefore, we would focus

on the African American population. To go into further details we may choose to focus on a

specific group such as African American females between the ages of 15-24. Educating this

specific group of people will decrease the various rates and measures that we use to describe

public health problems in addition to other possible data changes.

Behavioral Diagnosis

Behavioral factors that contribute to the health problem include intentions to use

condoms, multiple sex partners, and communication to negotiate condom use with a partner. In

terms of discussing how these factors are present are for various reasons. With the intention to

use condoms, it is known that condoms limit the amount of bodily fluids exchanged during

sexual activities (Niccolai et, al, 2005). Having multiple sexual partners as individuals increases

the chances of engaging in sexual activity with someone who is infected with Chlamydia. In

terms with communication to negotiate condom use with the partner, it is clear that with a lack of

communication prior to sexual activity could increase the risks of contracting Chlamydia due to

not knowing their sexual history. In terms of non-behavioral factors, one might be the education

level of individuals. It is known that the education level associated with Chlamydia can be seen

as a correlation. The more educated someone is, they have a lower risk of contracting the

disease. In terms of considering factors that are most important and more changeable, having

multiple sex partners, condom use, and education level are the most important and can be more

easily changed. In a community-based health promotion/education program, these are the risk

factors that they may want to consider in the intervention.

Environmental Diagnosis

There are many environmental factors that affect incidence rates of the sexually

transmitted disease chlamydia. Staying in a location where there is already a high chlamydia

count, places where sexual education is minimal and locations where the use of sexual protection

is discouraged, low socioeconomic status or staying in an environment that promotes violence

or abuse are just a few factors. Not having a stable, safe and educational environment can be a

huge reason why sexually transmitted diseases such as chlamydia are increasing in occurrence.
Not all of these factors can be voluntarily changed; two of the factors that could be changed and

used to be implemented for a community program are sexual education in school and changing

attitudes towards sexual protection.

Sexual education in schools is always a touchy subject, but the information that is

provided could slow or decrease the incidence rate of chlamydia. The CDC says that young

adults, ages 15-24 are most effected by chlamydia so giving them information on the STI and

making sure they know that anyone can contract it, could make it easier to penetrate an already

high risk group (CDC,2015). Teaching them about all methods other than abstinence will take

the mystery away from sex making the group less likely to engage in risky behaviors. In order

for this to work we should make sure that the teachers that are selected to teach this course have

training. This will ensure that the participants can fully understand and that the teacher is well

equipped to answer all questions asked.

Another factor is changing the attitudes that could be held against using sexual

protection. Despite modern times many people are still using old myths about sex. Shying away

from not using condoms and other such protection due to the fact that they do not know or it just

does not feel good to them. Open dialogues about condom selections or better ways to have

great but still protected sex could also help absolve this issue. Coming up with interesting ways

to engage all age groups to end all stigmas is the hardest part. Encouraging consistent condom

use and trying to break down the false sense of invincibility should be a huge part of these

dialogues.

State/Local Community Based Organization

One state community based organization that encourages chlamydia testing is the New

Morning Foundation. This is a non-partisan private-sector long-term initiative to improve young

peoples reproductive health education, counseling, and clinical services throughout South

Carolina. Their goal is to have an impact on education, healthcare access, and public policy when

dealing with family planning related issues. The mission statement for this organization is to

improve the environment and access to sexual and reproductive health education, counseling,

and clinical services for South Carolinians ages 30 and younger. New Morning Foundation is a

non-profit organization that has been around since 2002. The headquarters for New Morning

Foundation is located downtown Columbia on Gervais Street but they work on their plans

throughout the entire state. Their telephone number is (803)929-0088. There are a couple of

programs and services provided by this organization. One program they have implemented is the

Pregnancy Prevention Model which has been introduced to several high schools in South

Carolina where the hope is to reduce the number of teen pregnancies in South Carolina. They are

also advocating in legislation that we have equal access to affordable, high quality reproductive

healthcare and that we have medically accurate, age-appropriate family planning education. The

New Morning Foundation is important when talking about Chlamydia because it is a sexually

transmitted disease and this foundation focuses on prevention and education about STDs and

also teenage pregnancy.

National Community Based Organization

There are many national groups that help address chlamydia such as the CDC which has

a subgroup specifically designated for sexually transmitted infections called the Division of STD

Prevention (DSTDP). There is also SIECUS which stands for Sexuality Information and

Education Council of the United States which was founded in 1964 by Dr. Mary S. Calderone

and other professionals. The focus of SIECUS is to give families, educators, and policymakers

access to fact-based sexuality information. SIECUS is an organization that takes a stand on

major sexuality issues confronting society from human sexuality, sexual rights, sexual health,

sexual education, and how sexuality interacts in society. They address sexuality throughout life,

sexuality of a disabled person, sexual orientation, gender equality, masturbation, adolescent

sexual health, HIV/AIDS, STIs such as chlamydia, sexual education in schools, training of

teachers and parents for sexual awareness, sexual and reproductive training for all healthcare

providers, and how media, religion, and sexual explicit materials can affect sexuality. They also

address reproductive health services to all people regardless of age or income, abortion rights,

and sexual exploitation such as rape, incest, and sexual abuse. SIECUS is a recognized leader in

the field of sexuality and sexuality education as they have numerous published books, journals,

and resources for professionals, parents, and the public for educational purposes. SIECUS also

has supplemental resources listed throughout their website if further help is needed besides

educational purposes for the community. SIECUS headquarters is on 1012 14th Street, NW,

Suite 1108 in Washington, DC. If someone wanted to contact SIECUS they could call the

headquarters at (202)265-2405 or if they want to send a fax to the headquarters they should use

the fax line (202)462-2340.

References

About the Division of STD Prevention. (2016). Retrieved April 11, 2016, from

http://www.cdc.gov/std/dstdp/

Chlamydia - CDC Fact Sheet (Detailed). (2015). Retrieved April 11, 2016, from

http://www.cdc.gov/std/chlamydia/STDFact-Chlamydia-detailed.htm

Chlamydia-2014 STD Surveillance. (2015, November 17). Retrieved April 11, 2016, from

http://www.cdc.gov/std/stats14/chlamydia.htm

Martinez, B. (2013, June 7). Blog Assignment #2 Chlamydia History and Associated Risk

Factors. Retrieved April 11, 2016, from http://sites.jmu.edu/nursing469/blog-assignment-

2-chlamydia-history-and-associated-risk-factors/

New Morning Foundation-Impact Areas. Retrieved April 11, 2016, from

http://www.newmorningfoundation.org/

Niccolai, L.M., Rowhani-Ranbar, A., Jenkins, H., Green, S., & Dunne, D.W. (2005). Condom

effectiveness for prevention Chlamydia trachomatis infection. Sexually Transmitted

Infection (STI) Journal, 81(3), 323-325. doi:10.1136/sti.2004.012799

SIECUS-Position Statements. (n.d.). Retrieved April 11, 2016, from

http://www.siecus.org/index.cfm?fuseaction=Page.viewPage