Presidents Corner for October 2015 by Dr. Freda Bush

STI Risk Taking and Screening:
Who’s Responsible?

MI Advisory President’s Corner, October 2015

Thank you to the Ware Foundation for funding the updating of the STD Wizard to the 2015 CDC Guidelines

One of the updates to the guidelines was in the area of chlamydia which is the focus of the Science Section of this Advisory

The previous CDC Guidelines in 2010 recommended screening yearly for sexually active females under age 25. However, the 2015 Guidelines recommended the screen for chlamydia be broadened to those over 25 with risk factors. One of the reasons for the new recommendation is the increase in infection rates in those over 25 with multiple partners or those with concurrent partners. In other words a young woman may only have one partner but when her partner has multiple partners then her risk is increased for being exposed to an STI from any one of his partners.

Another reason for the increase in chlamydia infections has been associated with the recommendation to post-pone initial  pap smear screenings in young women until age 21. Traditionally, clinicians do screening for both gonorrhea and chlamydia in sexually active patients along with a pap smear. With changes in the recommendations for pap smears, an unintended consequence has been a decrease in GC/Chlamydia screening.  Both gonorrhea and chlamydia  can cause pelvic pain, scaring of the reproductive tract and blocked fallopian tubes leading to infertility. However, clinicians are not the only ones with the responsibility to emphasize screening for STI’s in “at risk” young people (male and female).

My grandmother used to say, “Every tub gotta sit on its own bottom,” meaning we have to each take responsibility for our own actions. We certainly have to bear the consequences of our behavior. “Ignorance of the law is no excuse,” is a legal principle holding that a person who is unaware of a law may not escape liability for violating that law merely because he or she was unaware of its content.  This certainly applies here in the health risk to our young people, who are daily being exposed to STI/STDs, without being educated about the risk that can affect their whole lives.

If the school, clinic, educator or healthcare professional passes out condoms to “protect” the young person from STI’s and pregnancy, then they should bear the responsibility of telling the young person how much “protection” they can expect from the condom.  Without the knowledge that condoms only reduce the risk rather than  avoid the risks of pregnancy and STIs, the person is unaware of the risk they’re taking. In ignorance of the law, the principle of “disinhibition” takes root. This means the young person may take even more risks, thinking the condom is providing “protection” from consequences.

Who cares enough to tell them about the laws of nature? Who cares enough to inform them of the truth? Our young people deserve to receive information that will give them the best opportunity for a life of health and well-being without the consequences of sexually transmitted infections.

 

2 Comments

  1. Dear Dr. Bush: Thank you for your much needed comments here. As you know, the new CDC treatment guidelines for STDs includes abstinence as the most effective method of prevention. Catherine

    • Catherine, thank you for pointing out that the CDC has finally come around to admitting that condoms are not the answer to preventing STIs. MI has worked for years to get the true message out!

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