Home' Trinidad and Tobago Guardian : September 26th 2014 Contents providing education about condom use, and teaching ways to communicate
with partners about safe sex.
Previous research has shown that when adults or adolescents spend
at least two hours talking about these issues with a counsellor, including
hands-on practice with condoms, condom use increases and STD cases
Less-intensive counselling did not affect outcomes, however.
"These types of interventions are generally not feasible in a typical
primary care visit, but they could be feasible in an integrated care setting
that included a behaviour specialist who was trained to provide sexual
risk-reduction counselling," the authors write. (Reuters Health)
body & soul
Guardian www.guardian.co.tt Friday, September 26, 2014
Sexually active women under age 24 and older
women at risk, like those who are pregnant, should
be tested for the sexually transmitted diseases (STDs)
Chlamydia and gonorrhea, according to new recom-
mendations from the US Preventive Services Task
Those are the most common STDs in the country,
with more than 1.4 million reported cases of Chlamydia
in 2012 alone, the government-backed Task Force wrote
in a guideline published online in Annals of Internal
It is important to screen for these infections because
they usually don t cause symptoms for women, but
can be dangerous if left untreated, the authors wrote.
"Chlamydia is the most common reportable disease
in the United States and gonorrhea is the second most
common," said Hayley Mark of the Johns Hopkins
School of Nursing in Baltimore, Maryland, who isn t
a member of the Task Force.
"Both are a major cause of genital tract infections
and untreated have substantial implications for women
including ectopic pregnancy, infertility and chronic
pelvic pain," she told Reuters Health by e-mail.
The Centers for Disease Control and Prevention
(CDC) estimate that more than 800,000 people contract
gonorrhoea in the US each year, and less than half of
these infections are diagnosed and reported.
The USPSTF recommendation does not include men
because there was not enough evidence to recommend
for or against screening, the authors said.
"Sexually transmitted infections in men are usually
symptomatic, which generally leads to earlier diagnosis
and treatment, and these infections are less likely to
result in long term health complications for men," said
Dr Kirsten Bibbins-Domingo, Task Force co-vice chair
and a general internist at San Francisco General Hos-
Most new Chlamydia and gonorrhea infections hap-
pen among women aged 20 to 24. People with new
or multiple sex partners, who use condoms inconsis-
tently or who exchange sex for money or drugs are
also at high risk.
The USPSTF recommends screening for the infec-
tions with nucleic acid amplification tests (NAATs) at
primary care visits for young women and older women
with extra risk factors at least once, and then again
if a woman s sexual history changes to include risk
These tests, which are very sensitive and specific,
require a urine sample for men and a vaginal swab for
women, Mark said.
Antibiotics can treat the infections, but gonorrhea
is resistant to all but one class of antibiotics --
cephalosporins -- and even the effectiveness of that
drug is dwindling, she said.
"There are antibiotic treatments that are safe to use
in pregnant women, and it is important for pregnant
women to get treated, to prevent passing an infection
on to her baby before and during the baby s birth,"
said Dr Rachel Gorwitz, medical epidemiologist in the
Division of STD Prevention in the CDC.
Prompt treatment is important for infected women
and also for their sex partners, she told Reuters Health
In the same issue of Annals of Internal Medicine,
the USPSTF also published a recommendation that
doctors should offer or refer patients to high-intensity
behavioural counselling if they have a current or recur-
ring STD or engage in risky sexual practices, and for
all sexually active adolescents.
Counselling involves providing basic information
about the infections and how they re passed from
person to person, assessing an individual patient s risk,
Experts: Test young women
for gonorrhoea, Chlamydia
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