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| Coming Events! |
Back by popular demand- Online Medical Accuracy training!
Newly updated to reflect recent changes to PubMed!
Time is running out- register now for 2009 pricing!
It is time to learn how to find the most current credible sexual health information on the Internet. This innovative online training demonstrates how to search PubMed databases and the Internet to find medically accurate health information. It also introduces strategies for evaluating the medical accuracy of information found in the media, medical journals, and Internet.
The training program is spread over two sessions and all participants who complete both training sessions receive a Medical Accuracy Training certificate. You will only need a computer with Internet connection and a phone to attend the training. You can get trained without any travel -- sitting right at your desk at home or in your office.
The dates of the next training are:
Session 1: December 3, 2009 -- 11:30 AM - 1:30 PM Central Time
Session 2: December 10, 2009 -- 11:30 AM - 1:30 PM Central Time
All are welcome to register, but space is limited! To register, go to www.medinstitute.org or click here.
Coming August 2010: Clinical Intervention Seminar
Plans are underway for an August 2010 Clinical Intervention Seminar in Austin, TX. For further details and registration information, please call Austin LifeGuard at 512.374.0074.
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| New STD Statistics Released by the CDC |
Recently the Centers for Disease Control and Prevention (CDC) released the report Sexually Transmitted Diseases Surveillance, 2008,1 an annual update of sexually transmitted infection (STI) statistics and trends in the US. This report includes national STI data from 1941-2008, enabling the CDC to describe the trends as well as the current state of sexual health in the US. The annual report includes information submitted from all 50 states and many other sources. So, how did the US population fare in 2008 as it pertains to STIs?
Chlamydia continues to be the most commonly reported bacterial STI in the US, topping 1.2 million cases for the first time. Chlamydia infection rates have risen almost 400% in the last 20 years. Improved screening and diagnostic tests are responsible for much of the increase in infection rates over the last 2 decades. Because chlamydia infection does not cause symptoms in most people, many infections are never diagnosed or reported. However, a true increase in infection prevalence is probably responsible for part of the rise as well. Females aged 15-19 years continue to have the highest rate of this infection, followed closely by females aged 20-24 years. Certain racial/ethnic groups continue to be disproportionately affected by this infection, with rates among blacks and Hispanics that are about 8 times and 3 times the rate of chlamydia infection in whites, respectively.
Gonorrhea, the second most commonly reported bacterial STI in the US, experienced a small decline in rates in 2008. Gonorrhea rates fell 74% from 1975 through 1997, after which the rates seemed to stabilize. Despite the overall decrease in gonorrhea infection rates in the US over the last two decades, certain racial and ethnic groups continue to suffer disproportionately. Gonorrhea infection rates are 20 times higher in blacks and 2 times higher in Hispanics than among whites. As in previous years, females aged 15-19 years have the highest infection rates, followed closely by females aged 20-24 years.
Syphilis, a bacterial STI that was once considered a candidate for elimination, continues its rise in the US. Between 1990 and 2000, rates of early stage syphilis fell by almost 90%. However, since 2000, syphilis infection rates have increased every year. Between 2007 and 2008, syphilis rates increased over 13%. Unlike the other bacterial STIs mentioned above, the recent resurgence in syphilis is concentrated in men who have sex with men. The highest rates of new infection occurred among males aged 20-24 years and 25-29 years. Similar to other bacterial STIs, though, racial disparities persist in reported syphilis cases. Compared to whites, blacks and Hispanics have about 8 times and 2 times the rate of new infections, respectively.
Because this CDC publication only calculates infection rates for notifiable diseases, i.e., diseases that must be reported to local or state authorities when a diagnosis is made, many STIs are not included. HPV, genital herpes, and trichomoniasis are among the important STIs that are not notifiable. Also, surveillance information about HIV, which is a notifiable disease, is published in a separate report. Therefore, the 2008 STD surveillance report is not an exhaustive account of the status of STIs in the US. However, the information that is conveyed in the recent surveillance report does point to the continued and, in some cases, increased transmission of several STIs. As always, adolescents and young adults bear the brunt of the STI epidemic.
The widespread prevalence of STIs among American youth will undoubtedly result in serious long term health consequences and heavy costs to society. In light of this, MI continues to advocate risk avoidance and remains devoted to the prevention of these infections. By doing so, we hope to foster an environment that allows youth everywhere the opportunity to achieve their full potential and maintain the greatest measure of health.
References:
1. Centers for Disease Control and Prevention. Sexually Transmitted Diseases, 2008. Atlanta, GA: U.S. Department of Health and Human Services; November 2009. Available at: http://cdc.gov/std/stats08/main.htm. Accessed: 2009 November 24.
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| Job Opportnity at MI! |
The Medical Institute is looking for a Research Specialist. For more information, please click here or visit our website at www.medinstitute.org.
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| Fast Fact of the Month |
In 2008, girls aged 10-19 years accounted for about 30% of all chlamydia infections reported in the United States.
Reference: Centers for Disease Control and Prevention. Sexually Transmitted Diseases, 2008. Atlanta, GA: U.S. Department of Health and Human Services; November 2009. Available at: http://cdc.gov/std/stats08/main.htm. Accessed: 2009 November 24. (Calculation based on data in Table 10.)
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| Message from the President/CEO |
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As an old accounting major, I learned years ago that "figures can lie, and liars can figure." Case in point:
The Task Force on Community Preventive Services ("the Task Force") is an independent, nonfederal volunteer body of public health and prevention experts appointed by the Director of the CDC that recently prepared and released its findings of a meta-analysis of Abstinence Education ("AE") and Comprehensive Risk Reduction ("CRR") studies. These findings recommended group-based CRR "to promote behaviors that prevent or reduce the risk of pregnancy, HIV, and other sexually transmitted infections (STIs)", despite finding that "[t]here is limited direct evidence of effectiveness, however, for reducing pregnancy and HIV." As to AE, the Task Force concluded that there was "insufficient evidence to determine the effectiveness of group based abstinence education ... due to inconsistent results across the studies." The Task Force elsewhere specifically notes, however, that when concluding there is "insufficient evidence," all that means is: "The available studies do not provide sufficient evidence to determine if the intervention is, or is not, effective. This does NOT mean that the intervention does not work. It means that additional research is needed to determine whether or not the intervention is effective."
Serious objection has been made as to both the study methodology and the validity of the conclusions of the Task Force. However, regardless of the merits of this criticism, we need to consider whether this meta-analysis is useful. A "meta-analysis" is defined by Webster as "a quantitative statistical analysis of several separate but similar experiments or studies in order to test the pooled data for statistical significance." Its desired effect is to produce a larger sample size. Let's assume as hypothetical facts that there were five AE and five CRR programs included in the study. Of these, let's assume the AE programs, each different from the other, produced results of 0, 0, 0, 0, and 50% effectiveness in reducing pregnancies and STIs and the CRR programs similarly unlike each other produced results of 13, 14, 15, 16 and 17% effectiveness. It would be mathematically accurate to say that 100% of the CRR programs "worked" and only 20% of the AE programs worked and to say that the CRR programs averaged 15% effectiveness compared to 10% for the AE programs. But does that really mean we should pursue only CRR programs? Of course not. The obvious answer is to try to replicate the effective components of the "50% program" regardless of its type.
So then of what value was the meta-analysis, if any? Something to think about.
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