UNITED STATES: Budget Widens Teen Pregnancy Prevention Efforts

Thu, 07 May 2009 - http://public.wsj.com/home.html

In his proposed 2010 budget, President Obama seeks to eliminate most federal funding for abstinence-only sex education in favor of programs that have been proven “through rigorous evaluation,” according to an administration official. Abstinence-only education is currently funded through two streams, one that provides money directly to community-based programs and is subject to an annual appropriations process ($95 million this year), and one that gives funding to states on an automatic basis ($50 million this year). The Obama administration is seeking to cut both programs, proposing two new ones oriented toward the larger goal of reducing teenage pregnancy. The first program would cost $110 million, plus $4 million for program evaluation. Much like the program it is replacing, it would go through an annual appropriations process and require community-based programs to apply directly to the federal government for grants. Seventy-five percent of the money would go to programs proven to delay sexual activity, increase contraceptive use (without increasing sexual activity), or to reduce teen pregnancy. An administration official said no abstinence-only programs have met those standards through “rigorous evaluation.” The remaining money would be available to develop and test “innovative strategies” for preventing teen pregnancy. Abstinence-only programs could qualify for these funds, though they would have to compete with other initiatives, officials said. The second program would give an automatic $50 million to states and be subject to the same 75 percent-25 percent split. Supporters of comprehensive sex education lauded the proposal. “The Obama administration deserves praise for bringing science and evidence back to public health policy,” said James Wagoner, president of Advocates for Youth. Valerie Huber, executive director of the National Abstinence Education Association, said she is deeply disappointed and plans to fight the budget in Congress.

NORTH CAROLINA: When the Cell Phone Teaches Sex Education

Sun, 03 May 2009 - http://www.nytimes.com/

The Durham-based Adolescent Pregnancy Prevention Campaign of North Carolina recently launched the Birds and Bees Text Line, a cell phone line where youths ages 14-19 can anonymously text sexual health questions. Within 24 hours, one of nine APPNC staff members anonymously responds with text message answers, information, and referrals. The staffers have graduate degrees in public health, social work, or years of experience working with teens. The service reflects a trend in reaching out to teens by using technologies with which they are most familiar. Based partly on a similar service in Alexandria, Va., the Birds and Bees Text Line is supported with a $5,000 state Department of Health and Human Services grant. In programs in Washington, D.C., Chicago, Toronto, and San Francisco, teens can text a number and scroll through a menu of frequently asked questions and receive automated replies and referrals. Last month, California began “HookUp 365247,” a statewide service that refers people to local clinics and offers weekly health tips. “The technology can be used to connect young people to trusted, competent adults who have competent information,” said Sheana Bull, a professor at the University of Colorado School of Public Health and an expert on STDs and technology. APPNC staff follow a few ground rules: No medical advice - urge clients to visit a doctor; Do not advocate abortion; When necessary, refer questioners to local clinics, Web sites or hot lines; Give reasoned, kind advice; Read answers twice before sending; and No sarcasm. Sally Swanson, an APPNC staffer who answers text messages, never divulges her age or gender: “I’m a texter. I want them to find someone real to talk to.” Were parents to read some of the teens’ messages, she said, “it would highlight how much disconnected information kids are already getting at younger ages than we did.”

AUSTRALIA: Genital Wart Infections Plunge Following Vaccine Rollout

Fri, 08 May 2009 - http://aap.com.au/

Cases of genital warts at a large Australian health clinic have plunged in the 12 months since the introduction of the Gardasil vaccine. The three-shot series protects against human papillomavirus (HPV) strains that cause 90 percent of genital warts and 70 percent of cervical cancer cases. The Melbourne Sexual Health Center began to notice a decline in the number of cases of genital warts within six months of the vaccine’s introduction there in mid-2007, said Professor Christopher Fairley, the clinic’s director. The vaccine has also been distributed in Australia under the National Human Papillomavirus Vaccination Program since January 2008. The center reviewed about 36,000 new patient contacts dating back to 2004. The number of female center patients with genital warts under the age of 28 fell to about half, while the number of cases among heterosexual men has fallen about 20 percent, Fairley said. The decline among women is the direct result of the vaccine, while heterosexual men are seeing a drop in cases because they are not being infected by women, Fairley noted. The clinic has not seen a decline in the incidence of genital warts among gay men, suggesting that the observed drop can be attributed to the vaccination of women, Fairley said. Fairley said the drop in genital warts supports the idea that Gardasil eventually will bring about a reduction in cervical cancer cases. “The abnormalities that the vaccine protects against in the cervix take much longer to appear,” he said. Fairley predicted that if the number of cases continues to drop by half each year, genital warts could eventually become a “historic phenomenon.” “It won’t take long and it’s solely due to the vaccine,” he said.

UNITED KINGDOM: UK Young Lack Awareness on HIV

Thu, 07 May 2009 - http://www.bbc.co.uk/

A new UNICEF report warns that too many young people in the United Kingdom lack comprehensive and accurate information on HIV. Strategies to encourage safer sex and improve access to sexual health services are urgently needed, it says. People ages 16-24 comprise 10 percent of new HIV diagnoses in Britain, and immigrants from sub-Saharan Africa and young men who have sex with men are most at risk, according to the report. “More attention has to be given to preventing the spread of HIV by working alongside young people to make sure that prevention work is designed and delivered in a way that is ‘youth friendly’ and really meets their needs,” said Anita Tiessen, deputy executive director of UNICEF in the United Kingdom. “HIV can be best avoided through a three-pronged approach: by making sure people have the right information, can access health services, and get protection when they need it.” The report noted that recent research shows that some young people, especially young women, experience long wait times and difficulty in making appointments for sexual health services. “By next year there will be 100,000 people living with HIV in the UK, and one in four of those are undiagnosed, and we need to support those who are undiagnosed to get tested,” said Lisa Power, head of policy at the Terrence Higgins Trust (THT). A Department of Health spokesperson said HIV prevention is a priority. “That is why we continue to provide funding for [THT] and for the African HIV Policy Network for work with the groups most at risk of HIV in the UK - gay men and African communities,” the spokesperson noted. “This is additional to our Condom Essential Wear campaign and joint awareness campaigns with the Department for Children, Schools, and Families for young people, which target other sexually transmitted infections.”

UNITED KINGDOM: HIV Cases Rising in Wales at Fastest-Ever Rate

Sun, 26 Apr 2009 - http://www.walesonline.co.uk

HIV is on the rise in Wales, prompting health officials to call for more awareness and testing efforts. According to the Health Protection Agency, 193 new HIV cases were diagnosed in Wales in 2007. Around 35 percent of these cases were transmitted heterosexually, with more women diagnosed than men - a trend that has been steadily increasing since 1998. Within that timeframe, 256 new cases were diagnosed in women, compared with 164 in men. Fifty percent of the new cases in 2007 involved gay men. The 2007 data also show people ages 35-44 are the most affected, though new diagnoses among people ages 15-24 increased 13 percent. Wales has a total of 1,009 people living with HIV/AIDS, a 14 percent increase over the 884 in 2006. Cases are starting to shift from urban areas like Cardiff and Swansea to rural areas such as Powys, Denbigshire, and Gwynedd. Health experts are concerned the data indicate relaxing attitudes about safe sex, particularly among young people. “We now live in a society where it’s easier to have sex than to talk about it,” said Lisa Power, head of the Terrence Higgins Trust. “Whoever you are, if you have had unprotected sex, get a sexual health check-up. And use condoms - people feel awkward about asking their partner to wear one, but it will be more awkward if you catch something.” “It isn’t an issue that has been very high on Welsh policy because we have only had around 1,000 people at one time living with the virus,” said Dr. Olwen Williams, a sexual health consultant at North Wales National Health Service Trust. “There is a lot more acceptability for HIV testing now, but there is also a little bit of ‘it won’t happen to me’.”

AUSTRALIA: Screening Pregnant Women for Chlamydia: What Are the Predictors of Infection?”

Sun, 01 Feb 2009 - http://sti.bmj.com/

In the current study, the researchers set out to determine the risk factors associated with chlamydial infection in pregnancy, together with the sensitivity and specificity of these when used for selective screening. They conducted a prospective cross-sectional study of pregnant women ages 16 to 25 attending four major public antenatal services in Melbourne. The women were approached consecutively between October 2006 and July 2007; they were asked to complete a questionnaire and to provide a first-pass urine specimen for Chlamydia trachomatis testing using PCR. A total of 1,180 women were eligible; 1,087 were approached; and 1,044 (88 percent) agreed to take part. A questionnaire and a definitive diagnostic assay were available for 987 women, and among these chlamydia prevalence was 3.2 percent (95 percent CI 1.8 to 5.9). In a multiple logistic regression model, having more than one sex partner in the past year (AOR 11.5; 95 percent CI 7.1 to 18.5) was associated with chlamydia infection. The use of any antibiotic within three months (AOR 0.2; 95 percent CI 0.1 to 0.6) was associated with a decreased risk of infection. The researchers found that screening restricted to women who reported more than one sexual partner in the past year would have detected 44 percent of infections in women ages 16-25 and would have required that only 7 percent of women be screened. Adding women age 20 and younger would have required 27 percent of women to be screened and detected 72 percent of infections. “Selective chlamydia screening of pregnant women based on risk factors can improve the yield from screening,” the authors concluded. “However, the potential harm of missed infections among excluded women would need to be considered.”

UNITED STATES: What About the Partners of Women with Abnormal Pap or Positive HPV Tests?

Sun, 01 Mar 2009 - http://www.stdjournal.com

In detailing the background of the current study, the authors observed: “Because high-risk HPV [human papillomavirus] is highly prevalent in the general population, usually transient, and rarely causes clinical symptoms, and because diagnostic and treatment options for HPV in men are lacking, partner notification is not useful for preventing transmission or protecting the health of male partners.” The researchers conducted a nationally representative survey of clinicians in seven areas of specialty who perform screening for cervical cancer. The health care professionals were asked whether they recommend that women with an abnormal Pap test or positive HPV test results inform their sex partners of the infection or refer those partners to a clinician. In all seven specialties, a large proportion of providers, ranging from 48 to 73 percent, encourage women with either test result to tell their sex partners to see a clinician. Health care providers who perform reflex HPV testing were more likely to recommend that patients with an ASCUS Pap tell their partners of the test result if the HPV test was positive than if it was negative (66-83 percent vs. 29-50 percent). Clinicians who perform adjunct HPV testing were more likely to recommend that patients with a normal Pap inform their partners if an HPV test was positive than if it was negative (72-92 percent vs. 30-52 percent). “Most providers advise patients with cervical cancer screening tests suggestive of HPV infection to notify their sex partners and to refer them to a clinician,” the authors wrote in their conclusion to the study. “Guidelines are needed for providers to clarify any rationale for clinical evaluation of male partners, including that informing partners has a limited role in the control of HPV transmission or in preventing adverse health outcomes in the male partner.”

BOTSWANA: Botswana Plans to Circumcise Nearly Half a Million Men in AIDS Fight

Thu, 07 May 2009 - http://www.afp.com/english/home/

On Thursday, Botswana’s health ministry announced it has launched a five-year program to circumcise males as a way to prevent HIV. The country hopes to circumcise 460,000 men, since studies have found the procedure reduces the risk of female-to-male HIV transmission by up to 60 percent, said Janet Mwambona, the public health specialist in charge of the project. “For the public health benefits of the preventive effect of circumcision to be realized, the Ministry of Health is supposed to cover 80 percent of eligible males in Botswana,” she said. About 50 health care workers and doctors have been trained in the procedure, and the government is running a television and radio campaign about the availability of safe circumcisions.

CALIFORNIA: TB Tests Continue at Tulare Union After One Student Contracts Infection

Fri, 08 May 2009 - http://www.visaliatimesdelta.com

Tulare County Health and Human Service officials say they have detected no other active TB cases among the hundreds of people screened at Tulare Union High School in January and March. In early December, the school learned that a student had active TB and reported the case to the county health agency. Those who tested positive with latent TB were advised to take antibiotics, said Dr. Karen Haught, the county’s public health officer. “Positive TB tests have a 10 percent risk that they could become active later, and that’s why we advise medications to eliminate the risk in the future,” she explained. The department is conducting a third round of testing on those who had contact with the infected student, who is recovering and not attending school. Results from the latest round of testing should be available within a week, Haught said.