STD Prevention: Integrating Old & New Technologies for Public Health Initiatives

1. National Coalition of STD Directors’ Meeting Highlights Infertility Prevention Program Meeting November 1, 2006

2. Navigating Change • CDC statement of vision – Dr. Fenton • Integration of new & old tech for case management • Attitudes toward adolescent sexual health • Herpes simplex virus • Human papillomavirus

3. Federal vision Drs. Fenton & Douglas • Priority STD areas • STI-related HIV transmission • Impaired fertility • Adverse pregnancy outcomes • STI-related cancer

4. Federal vision Drs. Fenton & Douglas • Reality: shrinking budgets, field staff attrition • Response: includes creating synergies & economies of scale via integration across categories, and fostering sound, work-reducing legislation (EPT) • Block granting for STD unlikely • ? Will our federal grants permit us to do less with less ?

5. Bringing together old and new technologies • Adoption of core health dept competencies • Locally-developed PHA training and certification programs • Getting hip to new technologies • Need to get staff access to/ conversant with: • Internet cruising portals • Using cell phones, PDAs to learn about partners

6. Bringing together old and new technologies • Getting hip to new technologies (cont’d) • Locales need to develop methods to notify partners on the internet • By patients • In person • Anonymously – InSpot System by ISIS* • By Health Dept • Ensuring confidentiality: increased reliance on technology poses new vulnerabilities *ISIS= Internet Sexuality Info Services

7. Attitudes toward adol sexual health • Comparison of Dutch and American parental attitudes • Normalization (i.e. readiness, self-regulation) • Dramatization (any sexuality prior to self-sufficiency = bad; raging hormones out of control)

8. Attitudes toward adol sexual health • Abstinence only funding has resulted in an erosion of comprehensive sexuality education……we need to learn to work better with abstinence only grantees. • Examples of successful collaboration given. Included: • review of the laws for loopholes • Built coalition composed of divergent viewpoints and a willingness to learn • Developed statements of agreement

9. Attitudes toward adol sexual health • Great American Condom Campaign • Domestic college campus-focused condom distribution campaign • Circumvent institutional politics by: • Establishment as political campaign (vs. 501c3) • Using students/ dorm rooms as conveyance • Condomcampaign.org

10. Herpes simplex virus • Important co-factor in HIV transmission • Importance of type-specific serologic testing • Asymptomatics can be taught to recognize Sx and take precautions at those times • Asymptomatics can be taught re: asymptomatic shedding and need for vigilance • Discordant couples can be identified & counseled

11. Human Papillomavirus • Most infxns transient (incl oncogenic strains) • Correct/ consistent condom use prevents transmission • Gardisil quadrivalent vaccine prevents types 6/11 (cause of genital warts) and types 16/18 (oncogenic)

12. Human Papillomavirus- Vaccine • Vax effective and safe • Best if given before sexual debut, but useful even if already sexually active • Recs: • Routinely for females 11-12 years • Catch-up vax for 13-26 years • NO CHANGE in Pap screening guidelines • Male studies underway

13. Human Papillomavirus- Vaccine • Need to get together leadership, coordination and support for HPV vax implementaiton • Immunization • STD Control • Cancer detection • Women’s health / Family Planning/ Maternal-Infant health • HIV/AIDS

14. Thank You !