Question

Need help ASAP.

What can health educators do to decrease the prevalence of STD's among college students?

Answer 1

Answer:

Promote safer sex behaviour Governmental bodies and
nongovernmental organizations (NGOs) should develop and disseminate messages promoting safer sex and educating people about risk reduction. They should provide barrier contraceptives which protect against pregnancy and
infection, educating people about condoms and encouraging their use. Schools and community-based programmes should provide appropriate sex education to adolescents before sexual activity starts. Some studies have shown that such education tends to delay the onset or frequency of sexual intercourse, rather than increase promiscuity (see UNAIDS, Learning and Teaching about AIDS at School,
Technical Update, Geneva :
UNAIDS, 1997). Promote health-care-seeking behaviour Health authorities should develop and deliver messages through a variety of channels to encourage
people who either have STD symptoms, or suspect they may have contracted an STD, to seek health care early.
To reduce the obstacles faced by people seeking care, health
authorities should integrate STD care activities into other health-care facilities. Patients seeking STD care
should be received in a friendly setting where they can be interviewed and treated in privacy. Efforts should
be made to improve the attitudes of health-care workers who are sometimes hostile or judgemental towards patients with STDs. Young people, and men who have sex with other men, are among those in need of friendly and confidential services.
Integrate STD prevention and care into primary health care
Integrating STD prevention and care into primary health care facilities, maternal and child health centres, family planning clinics and private clinics --- one of the key elements in
the public health package --- makes STD services available and accessible to far more people than are currently being served, and especially to sexually activeadolescent females. It also has the great advantage that people seeking care can avoid the potential stigma of going to a dedicated STD clinic.
Comprehensive case management of STDs

Comprehensive case management of STDs --- another key element of the public health package --- comprises
the following.
Identification of the syndrome
This can be done through syndromic
diagnosis or laboratory tests. The
syndromic case management
approach, using flow charts, is well
suited to settings in which resources
for laboratory facilities are limited or
unavailable. A diagnosis can be
made within a short time without
expensive and complex laboratory
tests.
The public health package for STD prevention and care : the essential components
. promotion of safer sex behaviour
. condom programming --- encompassing a full range of activities from condom promotion to the planning
and management of supplies and distribution
. promotion of health-care-seeking behaviour
. integration of STD control into primary health care, reproductive health-care facilities, private clinics and
others
. specific services for populations with often high-risk behaviours --- such as female and male sex workers,
adolescents, long-distance truck drivers, military personnel, and prisoners
. comprehensive case management of STDs
. prevention and care of congenital syphilis and neonatal conjunctivitis
. early detection of symptomatic and asymptomatic infections.

Antibiotic treatment for the syndrome
Whichever means are used for
diagnosis- flow charts or laboratory
tests --- the availability and use of
effective antibiotics is an absolute
requirement. The drugs must be
available at the first point of contact
with a patient with an STD. Effective
treatment must also be available and
used in the private sector. The use of
ineffective or partially effective drugs
actually results in an escalation of
costs, as patients repeatedly seek
treatment forthe same condition orits
complications. Partially effective
treatments may also be responsible
for the rapid appearance of resistant
strains of organisms.
Educating the patient
The importance of taking the full
course of medication must be stressed
to all patients undergoing courses of
drug treatment that are longer than a
single dose. Patients should also
understand that during treatment
they are still infectious to others; for
this reason, and because intercourse
could prolong their own symptoms,
they should be advised to abstain
from sex during the course of
treatment.
Condom supply
With people being encouraged to
use condoms, health authorities
should ensure that there is an
adequate supply of good-quality
condoms at health facilities and at
various other distribution points in
the community. Social marketing of
condoms is another way of
increasing access to condoms.
Counselling
Counselling should be made
available for cases where it is needed
--- for example, in chronic cases of
genital herpes or warts --- either for
individuals or for couples in a sexual relationship. (The UNAIDS Technical

Update on Counselling and HIV/
AIDS deals with counselling in more
detail.)
Information on partner notification
and treatment
Contacting sex partners of clients
with STDs, persuading them to
present themselves to a site offering
STD services, and treating them ---
promptly and effectively --- are
essential elements of any STD control
programme. These actions, however,
should be carried out with sensitivity,
with social and cultural factors taken
into account. This will avoid ethical
problems, as well as practical pro-
blems such as rejection and violence,
particularly against women.
In communities where STDs are
particularly prevalent, health
workers, social workers and the
media should educate people about
the reasons for partner notification.
This will alert people to the possibility
that in the future they themselves may
be notified by their sex partner that
they may have been infected, and
that treatment is important.
Syndromic case-management flow
charts specify that partners of STD
patients must be treated. This is
particularly important in gonorrhoea
and chlamydial infections, which are
asymptomatic in most women.
Control congenital syphilis
and neonatal conjunctivitis
Congenital syphilis occurs in about a
third of newborn babies of women
with untreated syphilis. Syphilis
prevalence rates of up to 19% have
been reported from some developing
countries. Prenatal screening and
treatment of pregnant women for
syphilisis cost-effective, even in areas
of prevalence as low as 0.1%.
Women should be educated and
motivated to attend antenatal clinics,
early in pregnancy, where they will
be routinely tested and, where
necessary, treated for syphilis
promptly and appropriately (see
Dallabetta et al. 1996, pp. 173-177).
Because of the high prevalence in
developing countries of gonorrhoea
and chlamydial infections, and the
consequent risk of newborn children
developing gonococcal or
chlamydial ophthalmia, routine
prophylactic treatment for such
ophthalmia at birth is strongly
recommended.
Monitor drug sensitivity
It is essential that health authorities
regularly monitor and detect the
emergence of resistance to STD
drugs. This will enable programmes
to adapt their treatment protocols
accordingly.
Carry out further research
and evaluation
By definition, the syndromic
management of STDs cannot help
individuals with no symptoms of
STDs. Also, the vaginal discharge
algorithm has less than optimum
sensitivity and specificity for cervi-
cal gonococcal and chlamydial
infections. Risk factors that are used
to increase the validity of the vaginal
discharge flow chart need to be
modified in order to make them
applicable to the site. This is an area
for local research. It is especially
important that overall research
should be speeded up, so that
affordable, simple, and non-invasive
diagnostic testsforthe early detection
of STDs in both symptomatic and
asymptomatic women and men can
be developed.

It is very important to overcome these challenges:

There are several reasons why STDs
continue to spread, and why their
complications and long-term health
effects continue to be a burden on
individuals and communities. The
following are some of the factors
hindering the effective prevention
and care of STDs.
Many cases are
asymptomatic
As already stated, many cases of
STDs are asymptomatic, especially in
women. Asymptomatic individuals
will not know that they have an STD
and hence will not seek care. They
will continue to be infected and
infectious
to others.
Reluctance to seek
health care
Even with symptoms, some people
may be reluctant to seek STD care.
This can be out of ignorance,
embarrassment or guilt. They may
also be deterred by an unfriendly
attitude by staff, a lack of privacy or
confidentiality, or an intimidating
setting of the service.
In 1993 a study in men in Harare,
Zimbabwe, found that of those who
sought STD care at the primary
health- care clinics only 27% did so
within
4 days of first noticing symptoms,
37% between 4 and 7 days, 15%
between 8 and 14 days and 21%
took longer than two weeks. As this
was a clinic-based population it was
not possible to determine what
fraction this represented of the
population with a symptomatic STD.
Difficulty of notifying spouse
or sex partner(s)
Partner notification is important for
interrupting the transmission of STDs
and preventing possible eventual
reinfection, but in practice there are
obstacles. Patients may not inform
their sex partners out of fear,
embarrassment, or unawareness
of the importance of doing so. In
resource-poor settings, it is usually
impractical for notification to be
done by the health sector.
Unavailability or
unsuitability of STD services
STD services often do not exist in a
particular locality. Even where they
exist, they may be difficult to access,
especially for women and young
people --- or they may lack privacy or
confidentiality. Alternatively, clients
may be deterred from attending by
the stigma attached to dedicated STD
clinics. A final problem, for men who
have sex with men, is that the health-
care provider may not look for or be
able to recognize a rectal STD.
Ignorance of STDs, their
causes, symptoms, cures
and possible consequences
Ignorance or misinformation are
always powerful obstacles to
resolving problems, and this is
particularly true where STDs and
HIV/AIDS are concerned. While
ignorance of STDs and AIDS can
exist in all types of people and all
age groups, it is likely to be more
widespread among adolescents and
young people --- in fact, the very
people who are likely to be more
sexually active than others, unlikely
to be in stable sexual relationships,
and who have poor access to STD
care services.
The prescribed treatment
is substandard
Although treatment for STDs such as
syphilis, gonorrhoea, chlamydial
infection, chancroid and
trichomoniasis is effective when the
correct drugs are given, government
health departmentssometimes opt for
cheaper but substandard treatments
in an effort to save money. This
practice perpetuates infection and
may encourage the rapid emergence
of resistant organisms.