Sexual Health PH 431 by Natalie Paler

Chlamydia Rates in SF Disproportionately Affects Black Women

alatpangan — 2024-03-12 19:42:45 UTC

In 2022, Black/African American Female Youth aged 15-19 years old in San Francisco were diagnosed with Chlamydia 10x more compared to White Female Youth of the same age. Black/African American Female Youth aged 20-24 years old are diagnosed 7x more than White Female Youth of the same age (Pipkin et al., 2023)

"Doxy-PEP: A Promising STI Prevention, But for Whom?"

palernatalie — 2024-03-14 20:06:35 UTC

Exciting news: This article highlights the effectiveness of a treatment called doxy-PEP for preventing sexually transmitted infections (STIs) in cisgender men and transgender women. While this approach has shown promise in reducing STI rates, it hasn't proven as effective for cisgender women. Further research is needed to understand why and to ensure that all individuals, regardless of gender identity, have access to effective STI prevention methods. Since STI rates are disproportionately high among Black communities, this setback could exacerbate existing health disparities, especially for young Cis-gender Black women.

(Stone, 2023)

Lack of STI Testing among College Aged Students

2024-03-14 20:13:18 UTC

70 percent of college students were sexually active in 2018, yet only 8% of 20% of college men, and 20% of college women were tested for STI's (Jennings, 2020). A lack of STI testing for women can lead to serious Chlamydia outcomes such as infertility and Pelvic Inflammatory Disease (PID) (SF City Clinic, 2014).

Chlamydia Shown to Affect Women More Than Men

alatpangan — 2024-03-14 20:25:15 UTC

Chlamydia, a sexually transmitted bacterial infection, results in worse health outcomes for women than in men. Research shows that if left untreated, women may develop Infertility, Pelvic Inflammatory Disease, or Ectopic Pregnancy (Centers for Disease Control, 2022). Based on 2020 statistics, Black and young adult women in California reported Chlamydia at 2.5 to 4.5 times higher compared to other population Chlamydia average rates (STD Surveillance Executive Summary, 2020).

San Francisco County Ranks High in Chlamydia Reported Cases

2024-03-14 20:27:32 UTC

In 2020, 14 counties surpassed the state's chlamydia rate (445.6 cases/100,000). San Francisco had one of the highest rate at 638.2. (California Department of Public Health, 2020).

Cost of Testing and Treatment

palernatalie — 2024-03-15 21:10:19 UTC

The cost of testing and treatment can be a barrier to accessing care, particularly for those without adequate healthcare coverage or financial resources. Increasing awareness, improving access to affordable testing and treatment, and addressing systemic healthcare disparities are crucial steps in combating the burden of chlamydia on young Black women's health.

Testing for chlamydia can vary in cost depending on the type of test needed and whether one has health insurance, ranging from $0 to $250(Planned Parenthood, n.d.). However, access to affordable testing and treatment can be limited, especially for young Black women. Programs like EPSDT and CHIP are meant to provide preventative services, but many states do not adequately promote or evaluate these programs, leaving them inaccessible to those who need them most.

(Loosier et al., 2014)

What happens if Chlamydia is left untreated?

2024-03-19 18:07:39 UTC

Pelvic Inflammatory Disease (PID) and Ectopic Pregnancy (EP)are complications often associated with Chlamydia. When PID IS diagnosed early, it can be treated but left undiagnosed, it leads to further complications like Ectopic pregnancy, Infertility and in some cases, lifelong pelvic and abdominal pain. Numerous studies has showed a clear association between EP,PID and prior Chlamydia infections, that Chlamydia significantly increases the risk of EP occurrence.

(Xia et al., 2020)

(Price et al., 2016)

(den Heijer et al., 2019)

Sources

palernatalie — 2024-03-19 20:20:01 UTC

CDPH. California Department of Public Health. (2020). https://www.cdph.ca.gov/Programs/CID/DCDC/CDPH%20Document%20Library/2020-STD-Surveillance-Executive-Summary.pdf

Centers for Disease Control and Prevention. (2022, April 12). https://www.cdc.gov/std/chlamydia/stdfact-chlamydia.htm#:~:text=Chlamydia%20is%20a%20common%20STD,that%20occurs%20outside%20the%20womb

“Chlamydia Infections | Chlamydia | Chlamydia Symptoms.” MedlinePlus, U.S. National Library of Medicine, 19 Mar. 2024, medlineplus.gov/chlamydiainfections.html.

Pipkin, S., Nguyen, T., Underwood, N., & Cohen , S. (2023, December 5). HIV/STI Update. San Francisco Department of Public Health. https://www.sf.gov/sites/default/files/2023-12/HC_HIVSTI%20update_2023.cleaned_0.pdf

Stone, W. (2023, December 20). https://www.npr.org/sections/health-shots/2023/12/20/1220691158/doxy-pep-sti-prevention-pill-women-after-sex

Alam, Najiha, and Pam Alldred. (16 Apr. 2021) https://doi.org/10.3390/ijerph18084257.

Leath, Seanna et al. (27 August, 2020) https://journals.sagepub.com/doi/10.1177/0361684320948539

Cohn, Tanya, and Carmen V. Harrison. “A systematic review exploring racial disparities, social determinants of health, and sexually transmitted infections in black women.” Nursing for Women’s Health, vol. 26, no. 2, Apr. 2022, pp. 128–142, https://doi.org/10.1016/j.nwh.2022.01.006.

Jennings, Sydney. (15 Oct. 2020) www.patientcareonline.com/view/study-most-college-students-don-t-get-sti-testing-but-self-tests-may-help.

Parenthood, P. (n.d.). STD testing in San Francisco, CA - herpes, chlamydia, gonorrhea tests. Planned Parenthood. https://www.plannedparenthood.org/health-center/california/san-francisco/94109/san-francisco-health-center-3997-90200/std-testing-treatment

(Loosier et al., 2014) Children’s Health Insurance Program (CHIP) programs are not guaranteed to cover EPSDT services

https://pubmed.ncbi.nlm.nih.gov/25118966/

(Xia et al., 2020)

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6946389/

Price et al.

https://www.ncbi.nlm.nih.gov/books/NBK350645/

Safe Sex Communication Struggles

2024-03-20 20:03:44 UTC

Communication between partners can determine whether a condom is worn during sex. "When communication was good, they were more likely to make informed decisions about condom use. When they judged that this conversation would be distressing, they chose not to voice their preference, usually resulting in unprotected sex" (Alldred, Najiha, 2021).

If there is discomfort when discussing practicing safe sex, parties are less likely to use a condom. This poses a risk to higher Chlamydia rates among women as transmission of STIs becomes more likely without condom use.

Family Stigma Can Lead to Lower Rates of Safe Sex Practices Among Young Black Women

2024-03-20 20:53:46 UTC

A study conducted among Undergraduate African American students found that "Exposure to parental abstinence messages predicted less sexual experience but also less consistent use of protection", as well as, "exposure to parental messages that highlighted sex as relational predicted greater sexual assertiveness and more comfort with one’s sexual experience level" (Leath et al., 2020). This poses a risk to young black women contracting Chlamydia as they are less likely to use protection during sex if exposed to abstinence messages from parents.

Systemic Racism and Structural Oppression Lead to Lack of Access

2024-03-20 21:38:14 UTC

Historically, U.S. policies and societal structures have perpetuated social, economic, and educational marginalization of Black individuals, most especially black women. The results of this treatment is shown in the prevalent lower income and educational achievement for this population, often resulting in a lack of access to health care and preventive measures (Cohn, Harrison, 2022). This causes a direct risk to worsening disease outcomes of black women who contract Chlamydia due to not having access to health care and preventative measures.

Long Term Outcomes

palernatalie — 2024-04-04 20:02:30 UTC

Decrease the rate of chlamydia diagnoses in Black Teens and young adult women in 2-3 years.
Decrease the rate of chlamydia related diseases and complications among Black Teens and Young Adult women in 2.5 years.

Medium Term Outcome

palernatalie — 2024-04-04 20:03:47 UTC

Increase in the number of black teens and young adults in San Francisco who use contraceptive barriers in 9 months.
Increase access to STI testing for black teen and young adult women in San Francisco in 12 months.
Increase in the number of black teens, young adults and their partner(s) who are confident and/or able to communicate with their partners about their sexual history & practicing safe sex within 9 months.

Short Term Outcomes

palernatalie — 2024-04-04 20:04:45 UTC

Increase in the number of black teens and young adult women in SF who know how chlamydia is spread, prevented, treated, and its effects on the body among black teen and young adult women by 6 months.
Increase in the number of black teen and young adult women in SF who believe that they are susceptible to chlamydia without safe sex practices in 3 months.
Increase in the number of black teen and young adult women in SF who believe that getting tested for STIs can reduce the risk of contracting chlamydia in 5 months.
Increase in the number of black teens and young adult women in San Francisco who believe it is important to share their sexual history and talk about safe sex with their partner to reduce the risk of contracting chlamydia in 5 months.

What is Chlamydia?

palernatalie — 2024-04-04 20:17:16 UTC

Chlamydia is a common sexually transmitted disease caused by a bacterial infection called Chlamydia trachomatis. Chlamydia can be spread through oral, vaginal, or anal sex if engaging with a partner who has the disease. Additionally, chlamydia can be spread to infants during childbirth.

Symptoms of chlamydia in women include abnormal vaginal discharge, a burning sensation while urinating, or painful vaginal sex. Though some may have no symptoms of chlamydia, despite being infected (Medline, 2024).

Anybody can get chlamydia, and it can be cured by antibiotics, but if left untreated it can cause serious health problems.

Program Name

palernatalie — 2024-04-23 19:47:04 UTC

SF Young Adult STI Prevention Program

Program Participants

2024-04-23 19:47:19 UTC

Black teens and young adult women aged 15-25 in San Francisco
All teens and young adults in SF

Building on cultural wealth of Black teen and young adults

2024-04-23 19:52:52 UTC

With our population focusing on black teens and young adult women within San Francisco being the most affected by rates of chlamydia, it is important for us to utilize their existing skills in modern technology and the internet. This program will include a social media campaign component to build on the cultural wealth that our population of teens and young adults ages 15-25 years old have on their knowledge and skills with using social media and internet searches.

Program Activities Phase 1: Program Development (mos.1-3)

2024-04-23 19:53:31 UTC

Hire staff (mostly BIPOC identifying)
Recruit 3 student interns (mostly BIPOC identifying)
Find brick and mortar location to serve as headquarters in where program planning will be conducted
Reach out to high schools in SF who are willing to have us hold workshops in their classrooms
Reach out to healthcare professionals who are willing to partner with our program to provide low-cost or free testing and follow-up care
Develop a curriculum for training student interns
Develop curriculum for chlamydia and safe sex workshops

Program Activities Phase 2: Program Implementation (mos. 4-21)

alatpangan — 2024-04-24 21:07:38 UTC

Conduct Social Media Campaign
- create social media accounts (Instagram, TikTok, Twitter)
- 50 Instagram posts every two weeks
- 20 TikTok videos 1-2 every month
- 150 Twitter posts once a week for 2 years
- create informational posts for socials (how chlamydia is spread, how it’s treated, how it affects the body, current chlamydia rates in the US, prevention, how and where to be tested, and conversation starters for how to talk to partners about STIs)
Bye Bye STI Young Adult Workshop
- High Schools: 1 Staff and 3 Student Interns will conduct 7 workshop sessions (90 minutes each) per high school in 10 total SF High Schools in 1 academic year. In the Fall Semester, there will be 3 sessions. In the Spring Semester, there will be 4 sessions. Each session shall have 50 participants each.
- College: 2 Staff will conduct 2 sessions (90 minutes each) in 1 academic year with up to 50 participants per session
- Topics:
  - What is Chlamydia
  - What Chlamydia Does to the Human Body
  - Who is vulnerable to Chlamydia
  - Current Chlamydia Prevalence Rate in 15-25 year olds
  - How Chlamydia is Spread
  - Chlamydia Prevention Efforts
  - How to Talk to Your Partner about STIs (Conversation Starters)
  - How and Where to get STI Testing + What our Program Can Do For You + Our Social Media Pages
- Approaches:
  - Slideshow Presentation
  - "How Infectious Diseases Spread" Interactive Game
  - Kahoot Game at the end of the presentation with prizes
  - Condom & Dental Dams Distribution
Contraceptives and Preventative Care referrals
- Partner with local clinics to get referrals for testing and follow-ups.
- Partnership with planned parenthood for STI testing and follow-ups.
- Partnerships with private healthcare professionals to provide STI testing as well as one-on-one follow-ups.
- Acquire condoms and contraceptives.
- Distribute condoms and contraceptives to participants.

GANNT CHART

palernatalie — 2024-04-24 23:17:34 UTC

Program Outputs

palernatalie — 2024-04-24 23:35:24 UTC

1 curriculum for educational place-based workshops
1 training curriculum for student interns to teach workshops
7 workshops in 10 high schools 3,600 total participants
4 workshops in 2 colleges 300 total participants
4 paid staff
3 student interns
distribute 2000 condoms & 500 dental dams
50 Instagram posts, 20 TikTok videos, 150 Twitter posts
45 posters displayed throughout the high school and college campuses we are visiting

Program Closing Phase 3:(last 3 months)

2024-04-24 23:36:32 UTC

Kahoot game at the end of the workshop, to review materials and reward with food
Evaluation in the form of a survey given to each school and college campus participant to assess knowledge retention.

SF Young Adult STI Prevention Program Budget

palernatalie — 2024-05-02 23:20:11 UTC

SF Young Adult STI Prevention Program Staffing

2024-05-02 23:21:44 UTC

Project Director (Full Time)
Project Coordinator (Part Time)
2 Health Educators (Part Time)
3 Student Interns (less than Part Time)