Traditional Sexually Transmitted Disease Prevention and Control Strategies: Tailoring for African American Communities

Abstract

African Americans carry the largest disease burden for bacterial sexually transmitted diseases (STDs) in the United States. These infections can have a devastating impact on sexual and reproductive health if they are not diagnosed and treated. Traditionally, public health efforts to prevent and control bacterial STDs have been through surveillance, clinical services, partner management, and behavioral intervention strategies. However, the persistence of disparities in STDs indicates that these strategies are not achieving sufficient impact in African American communities. It may be that factors such as limited access, acceptability, appropriateness, and affordability of services reduce the efficacy of these strategies for African American communities. In this article we describe the STD prevention strategies and highlight the challenges and implications of these strategies in addressing disparities in African American communities.Surveillance, clinical services, partner management, and behavioral interventions have been used to prevent and control bacterial sexually transmitted diseases (STDs)-gonorrhea, chlamydia, and syphilis-in the United States. These traditional strategies, with the exception of clinical services, are routinely funded in part by the Centers for Disease Control and Prevention (CDC) through a program announcement, which provides federal funding to support activities of STD prevention programs in health departments nationwide. Clinical services are an integral part of STD prevention programs. Health department programs generally support public STD clinical services through state and local funds.African Americans carry the largest disease burden for gonorrhea, chlamydia, and syphilis in the United States. 1 These infections can have a devastating impact on sexual and reproductive health if infections are not diagnosed and treated. 2 Although the traditional strategies for STD prevention and control are implemented in all communities, regardless of race or ethnicity, the annual rates of disease among African Americans have remained disparate from other racial and ethnic communities. These strategies as currently applied may be less successful in African American communities than other racial and ethnic communities.STD surveillance includes the monitoring of STDs or their sequelae, pathogen-specific antimicrobial resistance, sexual behaviors, screening, and healthcare quality and coverage. It

Intervention Induced Changes on Parenting Practices, Youth Self-Pride and Sexual Norms to Reduce HIV-Related Behaviors Among Rural African American Youths

“…In addition, our procedures did not control for several contributing factors that are known to affect sexual behavior, such as family structure, neighborhood characteristics, and family income. Finally, the ultimate target of sexual risk programs must be a reduction in the prevalence of HIV/AIDS and other STDs (Barrow et al 2008). A study to address this goal would require implementation on a much larger scale.…”

The HIV Epidemic: High-Income Countries

“…Behavior change remains a backbone of interventions in higher-income nations, although results have been somewhat disappointing as with Project EXPLORE/HIVNET 015 Koblin et al 2003Koblin et al , 2004Colfax et al 2004Colfax et al , 2005Salomon et al 2009). Combination interventions are now being explored (Barrow et al 2008;Corsi and Booth 2008;Buchbinder 2009;Rotheram-Borus et al 2009;Burns et al 2010;Cohen et al 2010;Crawford and Vlahov 2010;DeGruttola et al 2010;El-Bassel et al 2010;Read 2010;Reynolds and Quinn 2010), as are behavioral approaches with a better base in evidence Harshbarger et al 2006;Lyles et al 2006;Wingood and DiClemente 2006;Margaret Dolcini et al 2010). One strategy has been a conspicuous failure, namely "abstinence only" education, discovered to be associated with higher pregnancy rates than more comprehensive approaches that also highlighted STD prevention with condom use (Ott and Santelli 2007;Kohler et al 2008;Trenholm et al 2008).…”

The Health, Enlightenment, Awareness, and Living (HEAL) Intervention: Outcome of an HIV and Hepatitis B and C Risk Reduction Intervention

“…Introducing tailored prevention interventions and building support centers could increase HIV/AIDS knowledge and related capacities towards risk reduction among those at risk or living with HIV/AIDS [20]. Tailored interventions, such as Sisters Informing Sisters about Topics on AIDS (SISTA) and Coping with HIV and AIDS in the Rural Southeast (CHASE), have infused cultural elements towards more effective education and capacity building in safe sex negotiation with partners [22,23,24]. …”

“…Another review identified only 19% of HIV risk reduction interventions published between 1991 and 2010 targeting African Americans or Hispanics [26]. Existing STI behavioral interventions for African Americans have had only a modest impact in eliminating the HIV burden [24]. …”