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Menlo Park, California, Henry J. Kaiser Family Foundation, 2003 Jun. 4 p. (Facts. Fact Sheet)Each year, there are approximately fifteen million new cases of sexually transmitted diseases (STDs) in the U.S., and this country has the highest rate of STD infection in the industrialized world. By age 24, at least one out of every four Americans is believed to have contracted an STD, and an estimated 65 million Americans are now living with an incurable STD. Research suggests that women are biologically more susceptible to STD exposure than men. While STDs, including HIV, affect every age group, people under 25 account for roughly two-thirds of all new STD infections: 42 percent occur among those aged 20-24 and 25 percent occur among 15-to-19-year-olds. CDC data also show higher reported rates of STDs among some racial and ethnic minority groups, compared with rates among whites – possibly reflecting overall health disparities as well as greater use of public health clinics by minority populations. (excerpt)
NURSING TIMES.. 1998 Oct 28-Nov 3; 94(43):52-3.While references to sexually transmitted infections (STIs) can be found back as far as biblical times, women have traditionally taken most of the blame for the spread of such diseases. There is no evidence to suggest that men were blamed or stigmatized in the same way as women until the panic over AIDS in the 1980s shifted some of the blame to groups such as gay and bisexual men, IV drug users, and Africans. Throughout history, heterosexual men have escaped blame for STIs. Maybe it is this latter population subgroup which should be targeted in future sexual health promotion programs. This paper reviews the history of blame for STIs dating from the book of Leviticus, in which men with urethral discharge are urged to wash after copulation, to female prostitutes during the past 400 years, and recent groups with the advent of HIV/AIDS.
TRANSITIONS. 1999 Mar; 10(3):12-3.US adults are generally uncomfortable with the subject of adolescent sexuality. As such, they either pretend that teenagers do not have sex or try to control and limit the information which young people receive about sex and contraception. Sexual abstinence until marriage is the US Congressionally mandated message to students. In contrast, adults, and society in general, in the Netherlands, France, and Germany are comfortable with adolescent sexuality, and understand that teens have sex as a natural part of growing into sexually healthy adults. Perhaps paradoxically, adolescents in these 3 countries have first intercourse 1-2 years later than do US teens. The US also has a higher teen birth rate than the Netherlands, France, and Germany, as well as Morocco, Albania, Brazil, and more than 50 other developing countries. The teen birth rate in the Netherlands is almost 8 times lower than that of the US. Adolescent HIV and STD rates are also higher in the Netherlands, France, and Germany than in the US. At the heart of these 3 European countries' success in achieving low teen pregnancy and HIV/STD rates is a cultural openness and acceptance of adolescent sexuality which respects young people's rights and responsibilities as sexually maturing members of society. Rather than following the American model of trying to prevent young people from having sex, the Dutch, Germans, and French teach and empower their youths to behave responsibly when they decide to have sex. The US could learn from the Dutch, French, and German experiences with adolescent sexuality in developing and implementing a more balanced approach to adolescent sexuality.
WORLDAIDS. 1992 Jan; (19):10.White, U.S. homosexual males were primarily affected in the early stages of the AIDS pandemic. Some Western researchers argued, however, that the syndrome originated in Africa. Strong political and social response to this notion resulted in only an anemic response to the growing AIDS epidemic in Nigeria. Nonetheless, the Stop AIDS Organization finally launched the Motor Park AIDS Education Program (MPAEP) in 1988, for health and education outreach to populations at risk of STDs and HIV infection. Specifically targeted are long-distance truck drivers, their young male assistants known as motor boys, and the barmaids, prostitutes, and homeless juveniles who frequent motor parks where these drivers rest while on the road. Many of these long-haul drivers have unprotected casual and commercial sex, both homosexual and heterosexual, take drugs, and suffer high rates of STDs. Marginalized, 75% illiterate, and speaking a variety of languages, these populations tend to be largely ignorant of the incurable nature of AIDS. Over 45% of motor park populations are estimated to be infected with an STD, or to have a future re-infection. These drivers are optimal vectors for the spread of HIV both internationally and within Nigeria. MPAEP workers work 6 days/week in the larger interstate motor parks to reach out to their predominantly male customers. They meet a host of primary health needs, and refer STD clients for testing and treatment. Drug use and homosexuality are 2 topics of discussion especially taboo in African society which have nonetheless been vigorously researched by MPAEP. Many drivers are unacknowledged bisexuals who have sex with their motor boys. Workers therefore explain the need to use condoms in same-sex activity without specifically mentioning homosexuality. Many Nigerians deny the existence of HIV and AIDS, are reluctant to speak about sex, and consider MPAEP workers to be intruders. Despite opposition in Muslim- dominated Northern Nigeria, however, program efforts continue.
HEALTH FOR THE MILLIONS. 1991 Aug; 17(4):20-3.Until recently, the only sustained AIDS activity in India has been alarmist media attention complemented by occasional messages calling for comfort and dignity. Public perception of the AIDS epidemic in India has been effectively shaped by mass media. Press reports have, however, bolstered awareness of the problem among literate elements of urban populations. In the absence of sustained guidance in the campaign against AIDS, responsibility has fallen to voluntary health activists who have become catalysts for community awareness and participation. This voluntary initiative, in effect, seems to be the only immediate avenue for constructive public action, and signals the gradual development of an AIDS network in India. Proceedings from a seminar in Ahmedabad are discussed, and include plans for an information and education program targeting sex workers, health and communication programs for 150 commercial blood donors and their agents, surveillance and awareness programs for safer blood and blood products, and dialogue with the business community and trade unions. Despite the lack of coordination among volunteers and activists, every major city in India now has an AIDS group. A controversial bill on AIDS has ben circulating through government ministries and committees since mid-1989, a national AIDS committee exists with the Secretary of Health as its director, and a 3-year medium-term national plan exists for the reduction of AIDS and HIV infection and morbidity. UNICEF programs target mothers and children for AIDS awareness, and blood testing facilities are expected to be expanded. The article considers the present chaos effectively productive in forcing the Indian population to face up to previously taboo issued of sexuality, sex education, and sexually transmitted disease.
In: International Health in the 1990s: Directions in Research and Development, NCIH Southern Regional Conference, Chapel Hill, North Carolina, October 29-31, 1987, selected proceedings, coordinated by Maureen Heffernan. Washington, D.C., National Council for International Health, 1988 Spring. 123-6.The issue of AIDS and all Sexually Transmitted Diseases (STDs) is now caught in the middle of a struggle to shape public opinion, and future funding of education services and research depends, to a large degree, on the outcome of that struggle. The issue is very sensitive, being involved with sex and fear. It has been highly politicized in the US because of several factors. 1) The public's education on the issue came mainly through the press, often making it unbalanced and sensational. 2) The public gets mixed signals: they are told that there is nothing to fear from a person with AIDS at work place or at school, but also read that many doctors and dentists avoid AIDS patients. 3) Federal government policy decisions on the issue often seem to be political, not coming from its medical experts. 4) The typical victim is among the disenfranchised of our society, and blaming the victim is a common reaction. Society has been unwilling to accept the reality of sexually transmitted diseases, as is clearly reflected in the way the government has allocated government funds. The challenge to America is to create an atmosphere that allows rational policy. 1) More and better information dissemination is critical; other countries are way ahead of the US in this matter. 2) The issue of heterosexual transmission should be put in proper perspective. 3) Professional training in all aspects of STDs and AIDS research, care and prevention needs to be vastly expanded. 4) The AIDS issue should be placed in the broader context of STDs and other public health problems to avoid all types of unhealthy competition among special interests.