Modifications to Objectives and Subobjectives

The following discussion highlights the modifications, including changes, additions, and deletions, to this focus area's objectives and subobjectives as a result of the midcourse review.

Four objectives were modified by the addition of subobjectives, seven objectives were deleted because of lack of nationally representative data sources, one developmental objective was moved to another focus area, one developmental objective became measurable, and one objective was reworded at the midcourse review.

A subobjective was added to the proportion of females aged 24 years and under with chlamydia enrolled in the National Job Training Program (25-1d). This subobjective was added to provide data for a high-risk population in a nonhealth care setting. With the 2002 baseline at 10.1 percent, the 2010 target for objective 25-1d was set at 6.8 percent.

The objective for gonorrhea infections (25-2) was divided into two subobjectives, with new cases of gonorrhea in the total population (25-2a) retaining a baseline of 122 cases per 100,000 persons. Subobjective 25-2b was established to measure new cases of gonorrhea among females aged 15 to 44 years, with a 2002 baseline of 279 cases per 100,000 women and a target of 42 cases per 100,000 women. This subobjective was added to provide data for women at greatest risk of complications from gonorrhea—women in their reproductive years. The developmental objective for human papillomavirus (HPV) infection (25-5) was revised to clarify that it will measure females and match the potential data source. The objective for heterosexually transmitted HIV/AIDS in women (25-8) was moved to HIV (Focus Area 13) as objective 13-18.

Responsible adolescent sexual behavior (25-11) was divided into three subobjectives:

• Never had sexual intercourse (25-11a), with a 1999 baseline of 50 percent and a target of 56 percent.
• If sexually experienced, were not currently sexually active (that is, did not have sexual intercourse within the past 3 months) (25-11b), with a 1999 baseline of 27 percent and a target of 30 percent.
• If currently sexually active, used a condom at last sexual intercourse (25-11c), with a 1999 baseline of 58 percent and a target of 65 percent.

These subobjectives distinguish between the proportion of students in grades 9 to 12 who are not sexually active and students who are currently sexually active and use condoms.

The developmental objective for annual screening for genital chlamydia (25-16) became measurable and was divided into two subobjectives. The added subobjectives track sexually active females aged 25 years and under enrolled in commercial managed care organizations (MCOs) (25-16a) or enrolled in Medicaid MCOs (25-16b).

As stated in Healthy People 2010: "Most developmental objectives have a potential data source with a reasonable expectation of data points by the year 2004 to facilitate setting 2010 targets in the mid-decade review. Developmental objectives with no baseline at the midcourse will be dropped." Accordingly, at the midcourse review these developmental objectives were deleted from this focus area because they lacked data sources: neonatal STDs (25-10), responsible sexual behavior messages on television (25-12), STD screening in youth detention facilities and jails (25-14), contracts to treat nonplan partners of STD patients (25-15), STD screening of pregnant women (25-17), and provider referral services for sex partners (25-19). One previously measurable objective, compliance with recognized STD treatment standards (25-18), was also deleted because it could not be tracked by the existing data source. The U.S. Department of Health and Human Services (HHS) will consider ways to ensure that these public health issues retain prominence despite their current lack of data.

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