information on specific populations & other resourcesinformation on specific populations &...

Information on Specific Populations & Other

Resources

STD Overview for Non-Clinicians

Information on Specific Populations & Other Resources

Table of Contents

Title

1. Resource Page for Specific Populations……………...…………………………………..1

2. STD/HIV Hotlines & Websites………………………………...........................................6

3. STD 101 & MTC Lesson Plans Flyer………………………………………….…………..13

4. Organisms that share our world……..……………………………………………………..14

5. Science & Success: Programs that work……………………………………….…………15

6. When mandated reporters in CA must report sexual intercourse…………….………..31

7. CA minor consent laws………………………………………..…………………………….32

8. CA HIV Laws…………………………………………………………………………………36

9. Family PACT brochure………………………………………………………………….....37

10. CDC Fact Sheet on the male condom……………………………………………………39

11. CA Morbidity Form…………………………………………………………..……………...42

12. CA Department of Public Health STD home page......................................................44

13. CA STD Data Summaries for 2008.............................................................................46

Information on Specific Populations Youth and Young Adults

HIV/AIDS among Youth-Revised June 2006 http://www.cdc.gov/hiv/resources/factsheets/PDF/youth.pdf Teen Sexual Activity, Pregnancy, and Childbearing among Non-Hispanic White Teens in the United States-October 2006 http://www.teenpregnancy.org/resources/reading/pdf/TSA_whites_Oct2006.pdf

Kaiser Family Foundation: Substance Use and Sexual Health Among Teens and Young Adults in the U.S. February 2002 http://www.kff.org/youthhivstds/loader.cfm?url=/commonspot/security/getfile.cfm&PageID=14905

Public Health Institute: Center for Research on Adolescent Health and Development Teen Births in California May 2008; Youth STDs in California Counties October 2007; Sex Education the Parent’s Perspective May 2007; Parent Support for HPV Vaccination December 2006 http://teenbirths.phi.org/ Love is Respect: An organization that focuses on teen dating violence. Lots of information & free resources available. http://www.loveisrespect.org/ ACT for Youth Center of Excellence: Adolescent Romantic Relationships July 2007 http://www.actforyouth.net/documents/AdolescentRomanticRelationships_July07.pdf

Latinos

HIV/AIDS among Hispanics/Latinos-Revised August 2007 http://www.cdc.gov/hiv/resources/factsheets/PDF/hispanic.pdf Fact Sheet of Latino Youth STIs & HIV/AIDS- November 2002 http://reprohealth.ucsf.edu/publications/files/Latino.sti.pdf Fact Sheet on Latino Youth: Sexual Behavior-November 2002 http://reprohealth.ucsf.edu/publications/files/Latino.sex.pdf Teen Sexual Activity, Pregnancy, and Childbearing among Latino Teens in the

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United States-October 2006 http://www.teenpregnancy.org/resources/reading/pdf/TSA_hispanic_Oct2006.pdf Fact Sheet: Latinos and HIV/AIDS-July 2007 http://www.kff.org/hivaids/upload/6007-04.pdf

African-Americans

HIV/AIDS among African Americans-Revised June 2007 http://www.cdc.gov/hiv/topics/aa/resources/factsheets/pdf/aa.pdf Teen Sexual Activity, Pregnancy, and Childbearing among Black Teens in the United States-October 2006 http://www.teenpregnancy.org/resources/reading/pdf/TSA_black_Oct2006.pdf Fact Sheet: Black Americans and HIV/AIDS- July 2007 http://www.kff.org/hivaids/upload/6089-04.pdf

Asian/Southeast Asian/Pacific Islander Americans

HIV/AIDS among Asians and Pacific Islanders-Revised June 2007 http://www.cdc.gov/hiv/resources/factsheets/PDF/API.pdf Teen Sexual Activity, Pregnancy, and Childbearing among Asians and Pacific Islanders in the United States- October 2006 http://www.teenpregnancy.org/resources/reading/pdf/TSA_asian_pac_Oct2006.pdf The South and Southeast Asia Research Center on Sexuality: Sexuality Matters: A Report of a Regional Consultation on Sexuality in South and Southeast Asia Bali, Indonesia, 28-30 September 2004 http://www.asiasrc.org/reports/reports.asp Advocates For Youth: The Sexual Health of Asian-American/Pacific Islander Young Women-Focus on Assets http://www.advocatesforyouth.org/PUBLICATIONS/frtp/api.pdf Predictors of STDs Among Asian and Pacific Islander Young Adults http://www.guttmacher.org/pubs/journals/3923107.html

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Native Americans/Alaskan Natives

HIV/AIDS among American Indians and Alaska Natives-Revised June 2007 http://www.cdc.gov/hiv/resources/factsheets/PDF/aian.pdf Teen Sexual Activity, Pregnancy, and Childbearing among Native Americans Teens in the United States-October 2006 http://www.teenpregnancy.org/resources/reading/pdf/TSA_natamer_Oct2006.pdf

Lesbian, Gay, Bisexual, Transgender, Questioning Individuals (LGBTQ)

Advocates For Youth: The Impact of Homophobia and Racism on LGBTQ Youth of Color June 2007 http://www.advocatesforyouth.org/PUBLICATIONS/factsheet/fsglbtq_yoc.pdf

FOCUS A Guide to AIDS Research and Counseling. Transgender Identity and HIV: Resilience in the Face of Stigma. V. 32 No. 2 Spring 2008. http://www.ucsf-ahp.org/HTML2/services_providers_publications_focus.html “Barriers to Infectious Disease Care Among Lesbians.” Emerging Infectious Diseases. Vol. 10 No.11, November, 2004, p. 1974. http://www.cdc.gov/ncidod/EID/vol10no11/pdfs/EID_V10N11.pdf

The Intersex Society of North America (ISNA) is devoted to systemic change to end shame, secrecy, and unwanted genital surgeries for people born with an anatomy that someone decided is not standard for male or female. http://www.isna.org

Center of Excellence for Transgender HIV Prevention. The CoE's mission is to provide leadership, capacity building, professional training, policy advocacy, research development, and resources to increase access to culturally competent HIV prevention services for transgender people in California. http://transhealth.ucsf.edu

Women

HIV/AIDS among Women-Revised June 2007 http://www.cdc.gov/hiv/topics/women/resources/factsheets/pdf/women.pdf HIV/AIDS and Women Who Have Sex with Women-Revised June 2006 http://www.cdc.gov/hiv/topics/women/resources/factsheets/pdf/wsw.pdf

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Men

HIV/AIDS among Men who have Sex with Men-Revised June 2007 http://www.cdc.gov/hiv/topics/msm/resources/factsheets/pdf/msm.pdf

General

A Glance at the HIV/AIDS Epidemic-Revised June 2007 http://www.cdc.gov/hiv/resources/factsheets/PDF/At-A-Glance.pdf

Fact Sheet: The Global HIV/AIDS Epidemic-June 2007 http://www.kff.org/hivaids/upload/3030_09.pdf Fact Sheet: HIV Testing in the United States-June 2007 http://www.kff.org/hivaids/upload/6094-06.pdf

Special Education/Physically Disabled Students

Advocates for Youth: Sex Education for Physically, Emotionally and Mentally Challenged Youth http://www.advocatesforyouth.org/PUBLICATIONS/frtp/challengedyouth.pdf

James Stanfield: www.stanfield.com We offer the most respected library of educational materials available today in the areas of conflict management for the general school population and for students with cognitive challenges. The quality and excellence of our programs reflect the best possible educational research and experience available today. SIECUS: has a list of available special education resources http://www.siecus.org/pubs/biblio/bibs0009.html California Department of Education, Special Education Information and resources to serve the unique needs of persons with disabilities so that each person will meet or exceed high standards of achievement in academic and nonacademic skills. http://www.cde.ca.gov/sp/se/

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The Great Body Shop Our nationally recognized comprehensive health and substance abuse prevention program used by preschool, elementary and middle schools throughout the US. The program meets all state and national standards, is affordable, easy to teach, and provides an educational environment in which it is enjoyable to learn. Lesson plans are adaptable to special education and developmentally disabled students. http://www.thegreatbodyshop.net

Other Resources

Bixby Center for Global Reproductive Health: Unintended Pregnancy, Abortion and Post Abortion Care http://reprohealth.ucsf.edu/research/researchareas/abortion.html CA Chlamydia Action Coalition: Multilingual STD and HIV/AIDS Education Resources http://igh.ucsf.edu/castd/toolbox/22v2-MultiLingual_Resources.pdf

Center for Disease Control Fact Sheets- Population and Surveillance www.cdc.gov

Center for Reproductive Health and Research Policy University of California, San Francisco http://bixbycenter.ucsf.edu National Campaign to Prevent Teen Pregnancy www.Teenpregnancy.org The Henry J. Kaiser Family Foundation www.kff.org The Public Health Institute www.phi.org

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STD/HIV HOTLINES & WEBSITES (and other related resources)

℡ HOTLINES Centers for Disease Control and Prevention’s National HIV/STD Hotline 1-800-CDC-INFO (232-4636) Spanish: same as above Hearing Impaired: 1-800-232-6348 This hotline will answer general questions about HIV and STDs, their symptoms,

transmission, treatment, testing, prevention and can also provide referrals to clinics and other hotlines.

California STD/AIDS/Hepatitis Hotline 1-800-367-AIDS (2437) TDD/TYY: 1-888-225-AIDS (2437) (M-F, 9am-9pm, S/S 10am-6pm) Trained counselors speak English, Spanish, and Tagolog. California Youth Crisis Line 1-800-843-5200 (24 hours) The California Youth Crisis Line (CYCL) is a statewide, toll free, 24-hour,

confidential phone line available to young people, primarily between the ages of 12-24, and those who are concerned about them. They offer support, encouragement, and help to youth who have run away or are in other high-risk situations. This hotline utilizes a translation service for non-English speaking individuals.

Domestic Violence Hotline 1-800-799-SAFE (7233) (24 hours) Offers support for people living in violent situation and gives referrals for

additional services. Information is available in Spanish.

National Teen Dating Abuse Helpline 1-866-331-9474; 1-866-331-8453 TTY National Teen Dating Abuse Helpline is a national resource that can be accessed by phone or the internet. The Helpline and loveisrespect.org offer real-time one-on-one support from trained Peer Advocates. The National Domestic Violence Hotline operates loveisrespect, National Teen Dating Abuse Helpline from their call center in Austin, TX. Peer Advocates are trained to offer support, information and advocacy to those involved in dating abuse relationships as well as concerned parents, teachers, clergy, law enforcement, and service providers.

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Emergency Contraception Hotline 1-888-NOT2LATE (668-2-5283)

Run by the Reproductive Health Technologies Project, this hotline provides pre-recorded information about emergency contraception, and gives the names and phone numbers of places where you can get emergency contraception. Information is available in Spanish.

National Child Abuse Hotline 1-800-4-A-CHILD (422-4453) (24 hours) Answers questions from youth and adults related to child abuse and refers to

appropriate local resources. Utilize language line for non-English speakers. National Gay and Lesbian Hotline 1-888-843-4564 (M-F, 4pm-midnight; Sat. 12pm-5pm EST) Offers support to youth who have questions about sexuality and gender. National Hotline for Gay, Lesbian, Bisexual, and Transgender Youth 1-800-246-PRIDE (M-F, 5pm-9pm, PST) Offers support to youth who have questions about sexuality and gender. National Runaway Switchboard 1-800-786-2929 (24 hours)

This is a confidential nationwide hotline providing crisis intervention and referrals on a range of issues. Translation service available.

Planned Parenthood National Hotline 1-800-230-PLAN (7526)

This hotline will automatically connect you to the Planned Parenthood Provider nearest you. Planned Parenthood is a source for contraception, testing for sexually transmitted infections including HIV, pre-natal and post-natal care, pregnancy options counseling, and adoption referrals.

WEBSITES

= Teen-friendly website

Advocates for Youth Advocates for Youth is dedicated to creating programs and advocating for

policies that help young people make informed and responsible decisions about their reproductive and sexual health. This site has many resources for educators, including a comprehensive family life education program.

http://www.advocatesforyouth.org

Advocates for Youth’s teen site http://www.advocatesforyouth.org/teens/

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AfraidToAsk.com Information on average penis & erection size, breast sizes & shapes, vaginal anatomy, and sexually transmitted disease (STD) photos. Info on Lyme disease, skin cancer, etc.

http://www.afraidtoask.com

Love is Respect: National Teen Dating Abuse Helpline & Website National Teen Dating Abuse Helpline is a national resource that can be accessed by phone or the internet. The Helpline and loveisrespect.org offer real-time one-on-one support from trained Peer Advocates. The National Domestic Violence Hotline operates loveisrespect, National Teen Dating Abuse Helpline from their call center in Austin, TX. Peer Advocates are trained to offer support, information and advocacy to those involved in dating abuse relationships as well as concerned parents, teachers, clergy, law enforcement, and service providers. http://www.loveisrespect.org

Alan Guttmacher Institute Alan Guttmacher Institute website provides information on reproductive health

research, policy analysis, and public education. http://www.guttmacher.org American Social Health Association ASHA is dedicated to the prevention and control of all sexually transmitted

diseases. ASHA's STI Resource Center Hotline:1-800-227-8922 http://www.ashastd.org

ASHA’s teen site: iwannaknow.org http://www.iwannaknow.org

(AmFAR) American Foundation for AIDS Research

This site is dedicated to the support of AIDS research (both basic biomedical and clinical research), AIDS prevention, and the advocacy of sound AIDS-related public policy.

http://www.amfar.org

Boston Women's Health Book Collective Authors of Our Bodies, Ourselves for the New Century http://www.ourbodiesourselves.org

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Sexually Transmitted Disease Control Branch The CA STD Control Branch provides statewide consultation, surveillance,

educational, screening, and mobile clinic programs on the prevention, treatment, and interruption of sexually transmitted diseases. Go to “Local Health Jurisdiction Summaries” for current STD statistics in your area of the State.

http://www.std.ca.gov California STD/HIV Prevention Training Center The CA PTC is one of 10 national sites funded by the CDC that offers training for

health care providers in the diagnosis, treatment, and management of sexually transmitted diseases (STDs), including Human Immunodeficiency Virus (HIV).

http://www.stdhivtraining.org Campaign for Our Children, Inc. CFOC is a national non-profit organization dedicated to creating educational

media campaigns which are designed to promote adolescent preventive health issues, including pregnancy and STD prevention. The website includes educator resource center.

http://www.cfoc.org Center for AIDS Prevention Studies University of San Francisco is committed to maintaining a focus on prevention of

HIV disease, using the expertise of multiple disciplines and an applied and community-based perspective within a university setting.

http://www.caps.ucsf.edu Centers for Disease Control (CDC): National Prevention Information

Network NPIN is the U.S. national reference, referral and distribution service for

information on HIV/AIDS, STDs, and TB, sponsored by the Centers for Disease Control and Prevention (CDC). All of NPIN’s services are designed to facilitate the sharing of information and resources among people working in HIV, STD, and TB prevention, treatment, and support services.

http://www.cdcnpin.org Education Training Research (ETR) Access ETR’s Catalog and Ordering Online for a variety of health education

materials, including STD education. http://www.etr.org

Go Ask Alice! http://www.goaskalice.columbia.edu/index.html

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Healthy Kids Resource Center

The California Healthy Kids Resource Center (CHKRC) maintains a comprehensive collection of health education materials, including STD curricula, for use by teachers, administrators, other professionals, parents, and community personnel who work with students in preschool through grade 12. The CHKRC is an easily accessible source of comprehensive information about health related issues for teachers, administrators, and other professionals who work with students.

http://www.californiahealthykids.org Henry J. Kaiser Family Foundation The Foundation’s work is focused on four main areas: health policy, reproductive

health, HIV policy, and health and development in South Africa. http://www.kff.org HRSA: Health Resources & Services Administration, U.S. Department of

Health and Human Services HIV/AIDS Bureau, health data, Education, training, and grant opportunities http://www.hrsa.gov HIV InSite Gateway to AIDS Knowledge. http://hivinsite.ucsf.edu HIV Test Sites: Centers for Disease Control and Prevention (CDC) The Centers for Disease Control and Prevention's website connects you with

HIV testing resources in your local community. http://www.hivtest.org

It’s Your Sex Life http://www.itsyoursexlife.com

Medline Plus: Sexually Transmitted Diseases MEDLINE Plus has extensive information from the National Institutes of Health

and other trusted sources on over 500 diseases and conditions, including sexually transmitted diseases. There are also lists of hospitals and physicians, a medical encyclopedia and dictionaries, health information in Spanish, extensive information on prescription and nonprescription drugs, health information from the media, and links to thousands of clinical trials.

http://www.medlineplus.gov MMWR Morbidity and Mortality Weekly Report Medical Literature On-line access to the MMWR reporting on prevalence and incidence of all

reportable diseases, including STDs.

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http://www.cdc.gov/mmwr/ NACCHO: National Association of County and City Health Officials

(HIV and STI Prevention Project) NACCHO is the national organization representing local health departments.

NACCHO supports efforts that protect and improve the health of all people and all communities by promoting national policy, developing resources and programs, seeking health equity, and supporting effective local public health practice and systems. The goal of NACCHO’s HIV and STI Prevention project is to strengthen NACCHO’s role as an advocate for progressive HIV policy and adequate resources to sustain and enhance HIV prevention, research, and care services.

http://www.naccho.org; http://www.naccho.org/topics/infectious/hiv.cfm NCTPTP: National Campaign to Prevent Teen Pregnancy Provides resources and information on teen pregnancy trends and resources to

assist providers in the development of effective teen pregnancy prevention programs. Also has a new teen website: http://www.stayteen.org

http://www.teenpregnancy.org

National Center for HIV, STD, and TB Prevention of the Centers for Disease Control (CDC)

(NCHSTP) is responsible for public health surveillance, prevention research, and programs to prevent and control human immunodeficiency virus (HIV) infection and acquired immunodeficiency syndrome (AIDS), other sexually transmitted diseases (STDs), and tuberculosis (TB).

http://www.cdc.gov/nchhstp National Institute of Health Many links and references to other resources. http://www.health.nih.gov NIAID Pages National Institute of Allergy and Infectious Diseases http://www3.niaid.nih.gov

Planned Parenthood Federation of America Planned Parenthood is the world’s largest and oldest voluntary family planning

organization. PP is dedicated to the principles that every individual has a fundamental right to decide when or whether to have a child, and that every child should be wanted and loved.

http://www.plannedparenthood.org

Teenwire http://www.teenwire.com

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ReCAPP ReCAPP provides practical tools and information to effectively reduce sexual

risk-taking behaviors. Teachers and Health Educators will find up-to-date, evaluated programming materials to help with their work with teens.

http://www.etr.org/recapp

Scarleteen http://www.scarleteen.com

Teensource http://www.teensource.org

SIECUS SIECUS is a national, nonprofit organization which affirms that sexuality is a

natural and healthy part of living. Incorporated in 1964, SIECUS develops, collects, and disseminates information, promotes comprehensive education about sexuality, and advocates the right of individuals to make responsible sexual choices.

http://www.siecus.org STD Clinical Slides The STD Clinical slides depict symptoms for 9 sexually transmitted diseases.

The slides are available in ready-to-use Microsoft PowerPoint slide shows or as individual graphic files for inclusion in slide shows or documents. To access the STD clinical slides, please request a user id and password. Please indicate how you plan to use the slides. Request a password by clicking the available link.

http://www.cdc.gov/std/ UNAIDS Joint United Nations Programme on HIV/AIDS Mission: Main advocate for global action on HIV/AIDS - leads, strengthens and

supports an expanded response aimed at preventing the transmission of HIV, providing care and support, reducing the vulnerability of individuals and communities to HIV/AIDS and alleviating the impact of the epidemic.

http://www.unaids.org World Health Organization http://www.who.int/en/

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Are you looking for STD prevention activities you can use to educate youth?

Go to www.stdhivtraining.org

Browse over Resources, and then click on Educational and Program Resources, search documents by title and download

these free tools: 1) “Making the Connection Between HIV and STDs” is an 8-lesson

plan STD resource guide to supplement HIV and other sexual health curricula. Interactive activities focus on STD data, transmission, consequences and increasing youth perceptions of risk for STDs.

2) “STD 101” is a 50-min interactive STD 101 power point slide

presentation for youth with accompanying Educator Guide, including facilitator tips. Version A has clinical photos, and Version B does not.

“STD 101” NOW AVAILABLE IN SPANISH For more information, call 510-625-6000 or email [email protected]

STD Community Interventions Program (SCIP), CA STD Control Branch, Dept. of Public Health 13

Organisms That Share Our World

Bacteria A microorganism that comes in three different shapes (round, rod-shaped, and spiral). Most bacteria have the ability to move independently. Some bacteria have mucous surrounding each cell and this makes the bacteria stronger and more infectious. It is estimated that each person carries 100 trillion bacteria on and in our bodies. Some bacteria create disease in people and can be harmful. However, there are also bacteria that co-exist with the human body without causing disease. Bacteria that cause disease are usually treated with antibiotics. Most bacteria grow best at moderate temperatures.

Protozoa These are the simplest form of animals. Most protozoa are single-celled and have mobility, using tail-like structures called flagella. Protozoa are larger than both viral and bacterial organisms. There are medicines that kill protozoa and are used in treatment of infected people (Ex: Flagyl for treatment of Trichomoniasis).

Virus A virus is a parasitic organism because it totally depends upon the human cell for nutrients to survive. There have been over 300 types of viruses isolated from animals, but not all of these are harmful to humans. Infection with a virus stimulates an antibody response from the body. This means that special proteins are formed in people to defend itself against the virus. There are viruses that cause everything from the common cold to HIV infection. There are treatments for viral infections, but viral treatments only help with symptoms and do not get rid of the virus. Many viral infections will resolve on their own. Some viruses you have for life (i.e. Herpes, HIV).

Adapted from: Taber’s Cyclopedic Medical Dictionary, Edited by Clayton L. Thomas, MD, MPH 1989.

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Science and Success, Second Edition: Sex Education and Other Programs that Work to Prevent Teen Pregnancy, HIV & Sexually Transmitted Infections

Until recently, teen pregnancy and birth rates had declined in the United States. Despite these declines, US teen birth and sexually transmitted infection (STI) rates remain among the highest in the industrialized world. Given the need to focus limited prevention resources on effective programs, Advocates for Youth undertook exhaustive reviews of existing research to compile a list of those programs proven effective by rigorous evaluation. Nineteen programs appeared in Science and Success when it was fi rst published in 2003; seven additional programs are included in Science and Success, Second Edition.

Criteria for Inclusion—The programs included in this document all had evaluations that:• Were published in peer-reviewed journals (a proxy for the quality of the evaluation

design and analysis);• Used an experimental or quasi-experimental evaluation design, with treatment and

control / comparison conditions;• Included at least 100 young people in treatment and control / comparison groups.

Further, the evaluations either:• Continued to collect data from both groups at three months or later after

interventionAnd

• Demonstrated that the program led to at least two positive behavior changes among program youth, relative to controls:ο Postponement or delay of sexual initiation;ο Reduction in the frequency of sexual intercourse;ο Reduction in the number of sexual partners / increase in monogamy;ο Increase in the use, or consistency of use, of effective methods of contraception

and/or condoms;ο Reduction in the incidence of unprotected sex.

Or:• Showed effectiveness in reducing rates of pregnancy, STIs, or HIV in intervention

youth, relative to controls.

Program Effects—Twenty-six programs met the criteria described above. These 26 programs were able to affect the behaviors and/or sexual health outcomes of youth exposed to the program.

Exec

utive

Sum

mar

y

15

Risk Avoidance Through Abstinence—Fourteen programs demonstrated a statistically signifi cant delay in the timing of fi rst sex among program youth, relative to comparison / control youth. One of these programs is an intervention for elementary school children and their parents. The other 13 programs target middle and high school youth and all include information about both abstinence and contraception, among other topics and/or services. (See Table A, Page 3-4)

Risk Reduction for Sexually Active Youth—Many of the programs also demonstrated reductions in other sexual risk-taking behaviors among participants relative to comparison / control youth. (See Table A, Page3-4)

• 14 programs helped sexually active youth to increase their use of condoms.• 9 programs demonstrated success at increasing use of contraception other than condoms.• 13 programs showed reductions in the number of sex partners and/or increased monogamy among program

participants.• 7 programs assisted sexually active youth to reduce the frequency of sexual intercourse.• 10 programs helped sexually active youth to reduce the incidence of unprotected sex.

Reduced Rates of Teenage Pregnancy or Sexually Transmitted Infections—Thirteen programs showed statistically signifi cant declines in teen pregnancy, HIV or other STIs. Nine demonstrated a statistically signifi cant impact on teenage pregnancy among program participants and four, a reduced trend in STIs among participants when measured against comparison / control youth. (See Table A, Page 3-4)

Increased Receipt of Health Care or Increased Compliance with Treatment Protocols—Six programs achieved improvements in youth’s receipt of health care, and/or compliance with treatment protocols. (See Table A, Page 3-4)

Program Content—Of the 26 effective programs described here, 23 included information about abstinence and contraception within the context of sexual health education. Of the three that did not include sexual health education, two were early childhood interventions and one was a service-learning program.

Following is a brief description of each of the 26 programs. For more detailed descriptions, please see Science and Success, Second Edition, Advocates for Youth, 2008, or visit www.advocatesforyouth.org/programsthatwork/.

2 Science & Success, Second Edition: Executive Summarywww.advocatesforyouth.org 16

3 Science & Success, Second Edition: Executive Summarywww.advocatesforyouth.org

Delayed Initiation of

Sex

Reduced Frequency

of Sex

Reduced Number of

Sex Partners

Increased Monogamy

Reduced Incidence of Unprotected

Sex

Increased Use of

Condoms

Increased Use of

Contra-ception

Increased Use of Sexual

Health Care/ Treatment

Compliance

Reduced Incidence of

STIs

Decreased Number or

Rate of Teen Pregnancy /

Birth

1. AIDS Prevention for Adolescents in School

2. Get Real about AIDS

3. Postponing Sexual Involvement (Augmenting a Five-Session Human Sexuality Curriculum)4. Postponing Sexual Involvement: Human Sexuality & Health Screening5. Reach for Health Community Youth Service

6. Reducing the Risk

7. Safer Choices

8. School / Community Program for Sexual Risk Reduction among Teens

9. Seattle Social Development Project10. Self Center (School-Linked Reproductive Health Care)

11. Teen Outreach Program

12. Abecedarian Project

13.Adolescents Living Safely: AIDS Awareness, Attitudes & Actions

Note: Blank boxes indicate either 1) that the program did not measure nor aim at this particular outcome/impact or 2) that the program did not achieve a signifi cant positive outcome in regard to the particular behavior or impact.

Table A. Effective Programs: Impact on Adolescents’ Risk for Pregnancy, HIV & STIs School-Based Programs Community-Based Based Programs Clinic-Based Programs

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Delayed Initiation of

Sex

Reduced Frequency

of Sex

Reduced Number of

Sex Partners

Increased Monogamy

Reduced Incidence of Unprotected

Sex

Increased Use of

Condoms

Increased Use of

Contra-ception

Increased Use of Sexual

Health Care/ Treatment

Compliance

Reduced Incidence of

STIs

Decreased Number or

Rate of Teen Pregnancy /

Birth

14. Be Proud! Be Responsible!

15. Becoming a Responsible Teen

16. California’s Adolescent Sibling Pregnancy Prevention Project 17. Children’s Aid Society – Carrera Program18. Community-level HIV Prevention for Adolescents in Low-Income Developments

19. ¡Cuidate!

20. Making Proud Choices!21. Poder Latino: Community AIDS Prevention Program for Inner-City Latino Youth22. HIV Risk Reduction for African American & Latina Adolescent Women23. Project SAFE: Sexual Awareness for Everyone

24. SiHLE

25. Tailoring Family Planning Services to the Special Needs of Adolescents

26. TLC: Together Learning Choices

Note: Blank boxes indicate either 1) that the program did not measure nor aim at this particular outcome/impact or 2) that the program did not achieve a signifi cant positive outcome in regard to the particular behavior or impact.

Table A. Effective Programs: Impact on Adolescents’ Risk for Pregnancy, HIV & STIs School-Based Programs Community-Based Based Programs Clinic-Based Programs

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I. School Based Programs

1. AIDS Prevention for Adolescents in SchoolThis HIV/STI prevention curriculum comprises six sessions, delivered on consecutive days, and includes experiential activities to build skills in refusal, risk assessment, and risk reduction. It is recommended for use with African American, Hispanic, white, and Asian high school students in urban settings. Evaluation found that this program assisted sexually experienced participants to increase monogamy, reduce the number of their drug-using sexual partners, and increase condom use. The program had no signifi cant effect on delaying the initiation of sex. Evaluation found the program to be associated with a favorable trend in the incidence of STIs among participants, relative to controls.1

For More Information or to Order, Contact• Sociometrics, Program Archive on Sexuality, Health & Adolescence: Phone, 1.800.846.3475; Fax,

1.650.949.3299; E-mail, [email protected]; Web, http://www.socio.com

2. Get Real about AIDSThis HIV risk reduction curriculum comprises 15 sessions delivered over consecutive days. It includes experiential activities to build skills in refusal, communication, and condom use. Other components include activities, such as public service announcements, to reach more youth and reinforce educational messages. It is recommended for use with sexually active, white and Hispanic, urban, suburban, and rural, high school students. Evaluation found that the program assisted sexually active participants to reduce the number of their sexual partners, increase condom use, and increase condom purchase. The program did not affect the timing of sexual initiation. It did not reduce the frequency of sex among sexually active youth nor their use of drugs and alcohol prior to having sex.2



3. Postponing Sexual Involvement (Augmenting a Five-Session Human Sexuality Curriculum)This fi ve-session, peer-led curriculum is designed to augment a fi ve-session human sexuality curriculum led by health professionals, who also refer sexually active youth for nearby reproductive health care. It is recommended for use with eighth grade, black urban youth, especially those at socioeconomic disadvantage. Evaluation showed delayed initiation of sexual intercourse and, among sexually experienced participants, reduced frequency of sex and increased use of contraception. When replicated without fi delity (including omission of the fi ve-session human sexuality curriculum), the program led to no changes in sexual behavior among participants relative to comparison youth.3,4,5

For More Information or to Order Postponing Sexual Involvement to Augment Human Sexuality Education, Contact• Marian Apomah, Coordinator, Jane Fonda Center; Emory Unversity School of Medicine: Building A

Briarcliff Campus, 1256 Briarcliff Road, Atlanta, GA, 30306; Phone, 404.712.4710; Fax, 404.712.8739

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4. Postponing Sexual Involvement, Human Sexuality & Health ScreeningThis pregnancy prevention program combines the fi ve-session, peer-led Postponing Sexual Involvement curriculum with elements drawn from the Self Center (described below), and includes: three classroom sessions on reproductive health, delivered to seventh graders by health professionals and, again the next year, to eighth graders; group discussions; and a full-time health professional from outside the school and working in the school. Other components of the program include individual health risk screening and an eighth grade assembly and contest. The program is recommended for seventh and eighth grade, urban, African American, economically disadvantaged females. Evaluation found that the program assisted female participants to delay initiation of sexual intercourse and increased the use of contraception by sexually active female participants. Evaluation found no statistically signifi cant impact on the sexual behaviors of male participants.6

For More Information or to Order, Contact• Renee R. Jenkins, MD, Dept. of Pediatrics and Child Health, Howard University Hospital: 2041

Georgia Avenue NW, Washington, DC 20060 • For Postponing Sexual Involvement— Marian Apomah, Coordinator, Jane Fonda Center; Emory Unversity

School of Medicine: Building A Briarcliff Campus, 1256 Briarcliff Road, Atlanta, GA, 30306; Phone, 404.712.4710; Fax, 404.712.8739

• For the Self Center—Sociometrics, Program Archive on Sexuality, Health & Adolescence: Phone, 1.800.846.3475; Fax, 1.650.949.3299; E-mail, [email protected]; Web, http://www.socio.com

5. Reach for Health Community Youth ServiceThis program combines a health promotion curriculum (40 lessons per year in each of two years), including sexual health information, with three hours per week of community service. Activities help students refl ect on and learn from their community experience. The program is recommended for use with seventh and eighth grade, urban, black, and Hispanic youth, especially those who are economically disadvantaged. Evaluation showed delayed initiation of sexual intercourse, an effect that continued even through 10th grade. The program also assisted sexually active participants in reducing the frequency of sex and increasing use of condoms and contraception.7,8



6. Reducing the Risk (RTR)Reducing the Risk is a sex education curriculum, including information on abstinence and contraception. In 16, 45-minute sessions, it offers experiential activities to build skills in refusal, negotiation, and communication, including that between parents and their children. Designed for use with high school students, especially those in grades nine and 10, it is recommended for use with sexually inexperienced, urban, suburban, and rural youth—white, Latino, Asian, and black. Evaluation showed that it was more effective with lower risk, than with higher risk, youth. Evaluations—of the original program and of a replication of the program—each found: increased parent-child communication about abstinence and contraception; delayed initiation of sexual intercourse; and reduced incidence of unprotected sex / increased use of contraception among participants as well.9,10


1.650.949.3299; E-mail, [email protected]; Web, http://www.socio.com• ETR Associates: Phone, 1.800.321.4407; Fax, 1.800.435.8433; Web, http://www.etr.org/

20


7. Safer ChoicesThis is an HIV/STI and teen pregnancy prevention curriculum, given in 20 sessions, evenly divided over two years and designed for use with grades nine through 12. The program includes experiential activities to: build skills in communication; delay the initiation of sex; and promote condom use by sexually active participants. Other elements include a school health protection council, a peer team or club to host school-wide activities, educational activities for parents, and HIV-positive speakers. The program is recommended for use with Hispanic, white, African American, and Asian, urban and suburban high school students. A new evaluation showed that Safer Choices effectively assisted sexually inexperienced youth, especially Hispanics, to delay the initiation of sexual intercourse. It assisted sexually experienced youth to reduce the number of new sex partners, reduce the incidence of unprotected sex, and increase use of condoms and other contraception. Earlier evaluation showed that Safer Choices assisted sexually experienced youth to increase condom and contraceptive use. Earlier evaluation also showed that hearing an HIV-positive speaker was associated with participants’ greater likelihood of receiving HIV testing, relative to control youth.11,12,13,14


1.650.949.3299; E-mail, [email protected]; Web, http://www.socio.com• ETR Associates: Phone, 1.800.321.4407; Fax, 1.800.435.8433; Web, http://www.etr.org

8. School/Community Program for Sexual Risk Reduction among TeensThis intensive, school-based intervention integrates sex education into a broad spectrum of courses throughout public education (kindergarten through 12th grade). It includes teacher training, peer education, school-based health clinic services (including contraceptive provision), referral and transportation to community-based reproductive health care, workshops to develop the role modeling skills of parents and community leaders, and media coverage of a spectrum of health topics. The program is recommended for use with black and white rural students (kindergarten through 12th grade). Evaluation found that this program reduced teen pregnancy rates in the participating community relative to comparison counties. Replication in two counties in another state found that it assisted youth in one county to delay the initiation of sexual intercourse and assisted males in another county to increase their use of condoms, relative to youth in comparison counties.15,16,17



9. Seattle Social Development ProjectThis is a school-based program to provide developmentally appropriate, social competence training to elementary school children. Components include educator training each year and voluntary parenting classes on encouraging children’s developmentally appropriate social skills. The program is recommended for use with urban, socio-economically disadvantaged children—white, Asian, and Native American, but especially African American—in grades one through six. Evaluation when study participants were age 18, and again when they reached 21, found that the program assisted youth who participated in the program as children to signifi cantly delay the initiation of sexual intercourse and, among sexually experienced youth, to reduce the number of sexual partners and increase condom use, relative to comparison youth. By age 21, the program also showed reduced rates of teenage pregnancy and birth in participants, relative to comparison youth. Other long-term positive outcomes for participating youth, relative to comparisons, included increased academic achievement and reduced incidence of delinquency, violence, school misbehavior, and heavy drinking.18,19

21


For More Information, Contact• Social Development Research Group, University of Washington: 9725 Third Avenue NE, Suite 401,

Seattle, Washington, 98115

(This program is not available for purchase)

10. Self-Center (School-Linked Reproductive Health Center)This model of the school-linked health center (SLHC) offers free reproductive and contraceptive health care to participating youth from nearby junior and senior high schools. SLHC staff works daily in participating schools, providing sex education lessons once or twice a year in each homeroom and offering daily individual and group counseling in the school health suite. Staff is also available daily in the SLHC to provide students with education and counseling and, for those youth registered with the clinic, reproductive and sexual health care. The program is recommended for use with urban, black, and economically disadvantaged, junior and senior high school students. Evaluation found that the program assisted participants to delay the initiation of sexual intercourse and to use reproductive health services prior to initiating sex. It also assisted sexually active participants to reduce the incidence of unprotected sex and increase their use of contraception. The program resulted in a reduction in teen pregnancy rates among participants, relative to comparison youth.20,21

For More Information or to order, Contact• Sociometrics, Program Archive on Sexuality, Health & Adolescence: Phone, 1.800.846.3475; Fax,


11. Teen Outreach Project (TOP)This school-based, teen pregnancy and dropout prevention program involves weekly school classes, lasting one hour, that integrate the developmental tasks of adolescence with lessons learned from community service (lasting at least 30 minutes each week). The curriculum focuses on values, human growth and development, relationships, dealing with family stress, and issues related to the social and emotional transition from adolescence to adulthood. The program is recommended for high school youth at risk of teen pregnancy, academic problems, and school dropout, and is most effective with ethnic minority youth, adolescent mothers, and students with academic diffi culties, including previous school suspension. Evaluation of the original program and evaluations of two replications all found that the program reduced rates of pregnancy, school suspension, and class failure among participants, relative to control/comparison youth.222324

For More Information or to Order, Contact• Wyman Teen Outreach Program: 600 Kiwanis Drive, Eureka, MO 63025; Phone, 636-938-5245;

E-mail, [email protected]; Web, http://www.wymanteens.org.

Section II. Community-Based Programs

12. Abecedarian ProjectThis full-time educational program consists of high quality childcare from infancy through age fi ve, including individualized games that focus on social, emotional, and cognitive development, with a particular emphasis on language. During the early elementary school years, the program works to involve parents in their children’s education, using a Home School Resource Teacher to serve as a liaison between school and families. The program

22


is recommended for use with healthy, African American infants from families that meet federal poverty guidelines. Evaluation found long-term impacts, including a reduced number of adolescent births and delayed fi rst births as well as increased rates of skilled employment and college education and reduced rates of marijuana use among former participants, relative to controls.25

For More Information, Contact• FPG Child Development Institute, University of North Carolina at Chapel Hill: www.fpg.unc.

edu/~abc/

This program is not available for purchase.

13. Adolescents Living Safely: AIDS Awareness, Attitudes & ActionsThis HIV prevention program is designed to augment traditional services available at shelters for runaway youth. The program involves 30 discussion sessions for small groups, each lasting one-and-a-half to two hours and including experiential activities to build cognitive and coping skills. Intensive training of shelter staff and access to health care, including mental health services, are also important components of the program. It is recommended for use with black and Hispanic runaway youth, ages 11 through 18, living in city shelters. Evaluation found that the program assisted youth to reduce the frequency of sex and numbers of sexual partners, and to increase condom use. The program did not affect the timing of sexual initiation.26



14. Be Proud! Be Responsible! A Safer Sex CurriculumThis HIV prevention curriculum comprises six sessions, each lasting 50 minutes, and includes experiential activities to build skills in negotiation, refusal, and condom use. It is recommended for use with urban, black, male youth, ages 13 through 18. Evaluation found that it assisted young men to reduce their frequency of sex, reduce the number of their sexual partners (especially female partners who were also involved with other men), increase condom use, and reduce the incidence of heterosexual anal intercourse.27,28

For More Information or to Order, Contact• Select Media: Phone, 1.800.707.6334; Web, http://www.selectmedia.org • For educator training, contact ETR Associates: Phone, 1.800.321.4407; Fax, 1.800.435.8433; Web, http://

www.etr.org

15. Becoming a Responsible TeenThis HIV prevention, sex education, and skills training curriculum comprises eight one-and-a-half- to two-hour sessions. It includes experiential activities to build skills in assertion, refusal, problem solving, risk recognition, and condom use and is designed for use in single-sex groups, each facilitated by both a male and a female leader. It is recommended for use with African American youth, ages 14 through 18. Evaluation found the program assisted participants to delay the initiation of sex and assisted sexually active participants to reduce the frequency of sex, decrease the incidence of unprotected sex (including anal sex), and increase condom use.29

For More Information or to Order, Contact• ETR Associates: Phone, 1.800.321.4407; Fax, 1.800.435.8433; Web, http://www.etr.org/

23


16. California’s Adolescent Sibling Pregnancy Prevention ProjectThis teen pregnancy prevention program provides individualized case management and care as well as sex education, including information on abstinence and contraception, to the adolescent siblings of pregnant and parenting teens. The program is recommended for economically disadvantaged, Hispanic youth, ages 11 to 17. Evaluation found that the program assisted female youth to delay the initiation of sexual intercourse and assisted male youth to increase the consistent use of contraception. The program resulted in reductions in teen pregnancy rates among program youth, relative to comparison youth.30

For More Information, Contact• California Department of Health Services, Maternal & Child Health Branch: 714 P Street, Room

750, Sacramento, CA 95814; Phone: 1.866. 241.0395

This program is not available for purchase.

17. Children’s Aid Society—Carrera ProgramThis multi-component youth development program provides daily after-school activities—including a job club and career exploration, academic tutoring and assistance, sex education that includes information about abstinence and contraception, arts workshops, and individual sports activities. A summer program offers enrichment activities, employment assistance, and tutoring. The program provides year-round, comprehensive health care, including primary, mental, dental, and reproductive health services. The program involves youth’s families and provides interpersonal skills development and access to a wide range of social services. The program is recommended for use with urban, black and Hispanic, socio-economically disadvantaged youth, ages 13 through 15. Evaluation found that the program assisted female participants to delay the initiation of sexual intercourse and resist sexual pressure. It also assisted sexually experienced female participants to increase their use of dual methods of contraception. The program assisted both male and female participants to increase their receipt of health care. Otherwise, evaluation showed no positive, signifi cant behavioral changes in participating males relative to comparison males. The program resulted in reduced rates of teen pregnancy among participants, relative to comparison youth.31

For More Information, Contact• Children’s Aid Society: 105 East 22nd Street, New York, NY 10010; Phone, 212.949.4800; Web, http://

www.childrensaidsociety.org

18. Community Level HIV Prevention Intervention for Adolescents in Low-Income DevelopmentsThis HIV prevention program includes training in refusal, condom negotiation, communication, and condom use for adolescents in low-income housing developments. Workshops are followed by a multi-component community intervention including follow-up sessions; a Teen Health Project Leadership Council; media projects, social events, talent shows, musical performances, and festivals; and HIV/AIDS workshops for parents. The program is recommended for low-income adolescents living in housing projects, urban youth, and multi-ethnic youth ages 12-17. Evaluation found that the program assisted participants to delay initiation of sex and assisted sexually active participants to increase condom use.32

For More Information, Contact• Kathleen Sikkema, PhD, Department of Epidemiology and Public Health, Yale University, 60 College

Street, P.O. Box 208034, New Haven CT 06520-8034; e-mail: [email protected] program is not available for purchase.

24


19. ¡Cuidate!This HIV prevention curriculum is tailored for use with Latino adolescents. Its goals are to 1) infl uence attitudes, beliefs, and self-effi cacy regarding HIV risk reduction, especially abstinence and condom use; 2) highlight cultural values that support safer sex practices; 3) reframe cultural values that might be perceived as barriers to safer sex; and 4) emphasize how cultural values infl uence attitudes and beliefs in ways that affect sexual risk behaviors. It consists of six one-hour modules delivered over consecutive days. The program is recommended for urban Latino youth ages 13-18. Evaluation found that the program assisted participants to reduce frequency of sex, reduce number of sex partners, reduce incidence of unprotected sex, and increase condom use. 33,34

For More Information, Contact• Susan S. Witte, Columbia University, Room 813, 1255 Amsterdam Avenue, New York, New York 10027;

Phone 202-851-2394; e-mail [email protected]

20. Making Proud Choices!This HIV prevention curriculum emphasizes safer sex and includes information about both abstinence and condoms. It comprises eight, culturally appropriate sessions, each lasting 60 minutes and includes experiential activities to build skills in delaying the initiation of sex, communicating with partners, and among sexually active youth, using condoms. It is recommended for use with urban, African American youth, ages 11 through 13. Evaluation found the program assisted participants to delay initiation of sex and assisted sexually active participants to reduce the frequency of sex, reduce the incidence of unprotected sex, and increase condom use.35

For More Information or to Order, Contact• Select Media: Phone, 1.800.707.6334; Web, http://www.selectmedia.org • For information regarding training, contact ETR Associates: Phone, 1.800.321.4407; Fax, 1.800.435.8433;

Web, http://www.etr.org

21. Poder Latino: A Community AIDS Prevention Program for Inner-City Latino YouthThis community-wide, 18-month program provides peer education workshops on HIV awareness and prevention and peer-led group discussions in various community settings. Peer educators also lead efforts to make condoms available via door-to-door and street canvassing and make presentations at major community events. Radio and television public service announcements, posters in local businesses and public transit, and a newsletter augment the work of the peer educators. The program is designed for use in urban, Latino communities in order to reach the community’s adolescents ages 14 through 19. Evaluation showed that the program assisted the community’s male teens to delay the initiation of sexual intercourse and assisted the community’s sexually active female teens to reduce the number of their sexual partners. The program did not affect sexually active participants’ frequency of sex.36,37

For More Information or to Order, Contact• Sociometrics Program Archive on Sexuality, Health & Adolescence: Phone, 1.800.846.3475; Fax,


25


Section III. Clinic-Based Programs

22. HIV Risk Reduction for African American & Latina Adolescent WomenThis skills-based HIV risk reduction intervention is designed for use in health clinics. Intended for use with African American and Latina young women, ages up to 19, who are at high risk of HIV because they have prior STI infections, the program provides young clients with confi dential and free family planning services, teaches them how to use condoms, and provides skill building in relation to partner negotiation and condom use. Evaluation found that young women who participated in the intervention had a lower incidence of STIs versus comparisons; they also reduced the number of their sexual partners and their incidence of unprotected sex.38

For More Information or to Order, Contact:• Loretta Sweet Jemmott, PhD, FAAN, RN, School of Nursing, University of Pennsylvania, Room

239 Fagin Hall, 418 Curie Blvd., Philadelphia, Pennsylvania 19104-6096; Phone, 215.898.8287; E-mail, [email protected]

There is little replication information available for this program.

23. Project SAFE (Sexual Awareness for Everyone)This gender- and culture-specifi c behavioral intervention consists of three sessions, each lasting three to four hours. Designed specifi cally for young African American and Latina women ages 15 through 24, it actively involves participants in lively and open discussion and games, videos, role plays, and behavior modeling. Discussions cover abstinence, mutual monogamy, correct and consistent condom use, compliance with STI treatment protocols, and reducing the number of one’s sex partners. Each participant is encouraged to identify realistic risk reduction strategies that she can use in the context of her own life and values. Evaluation found that participants increased their adherence to monogamy, reduced the number of their sexual partners and the incidence of unprotected sex, reduced the incidence of STIs, and increased their compliance with STI treatment protocols.39,40,41,42

For More Information or to Order, Contact:• Sociometrics, Program Archive on Sexuality, Health & Adolescence: Phone, 1.800.846.3475; Fax,


24. SiHLESiHLE is an HIV prevention program especially designed for sexually active African American teenage women. Consisting of four sessions, each lasting four hours, the program is facilitated by trained, African American females—one health educator and two peer educators. Sihle means beautiful or strong young woman, and the program encourages participants to develop ethnic and gender pride as well as self-confi dence. It also builds their skills and awareness for sexual risk reduction. Evaluation found increased condom use and reduced number of new sex partners as well as reduced incidence of: unprotected sex; STIs, and pregnancy.43

For More Information or to order, Contact• Sociometrics, Program Archive on Sexuality, Health & Adolescence: Phone, 1.800.846.3475; Fax,


26


25. Tailoring Family Planning Services to the Special Needs of AdolescentsThis effective, clinic-based, pregnancy prevention protocol is designed for use in family planning and other reproductive and sexual health clinics. It is particularly designed to meet the special needs of youth under the age of 18. As such, it provides education geared to the adolescent’s cognitive development and offers reassurance of confi dentiality, extra time for counseling, information and reassurance regarding medical exams, and carefully timed medical services. Evaluation found that teens that had these specially tailored services were signifi cantly more likely than other teens to increase their use of effective contraception and had a decreased pregnancy rate.44

For More Information or to Order, Contact• Sociometrics, Program Archive on Sexuality, Health & Adolescence: Phone 1.800.846.3475; Fax,

1.650.949.3299; E-mail, [email protected]; Web, http://www.socio.com.


This curriculum is aimed at HIV positive youth in a clinic setting. It consists of 16 sessions of a small group intervention led by trained facilitators. Participants learn skills in solving problems, setting goals, communicating effectively, being assertive, and negotiating safer sex practices. They also improve their self-awareness regarding their feelings, thoughts, and beliefs, especially related to health promotion and positive social interactions. The program can be used with urban, African American or Latino, HIV-positive youth ages 13 through twenty-four. Evaluation found that the program assisted participants to reduce numbers of sexual partners, reduce incidence of unprotected sex, increase positive lifestyle changes (females only), and increase positive coping actions.45,46

For More Information, Contact• A detailed manual for the two sessions is available online at http://chipts.ucla.edu • In addition, this program is a part of CDC’s Diffusion of Effective Behavioral Interventions (DEBI) project.

For additional information and training visit http://www.effectiveinterventions.org/go/interventions/together-learning-choices

27


Urban Suburban Rural Elementary School

Middle School

Sr. High 18-24 White Black Hispanic/

Latino Asian Sex

1. AIDS Prevention for Adolescents in School

Both Sexes

2. Get Real about AIDS Both Sexes

3. Postponing Sexual Involvement (Augmenting a Five-Session Human Sexuality Curriculum)

Both Sexes

4. Postponing Sexual Involvement: Human Sexuality & Health Screening

Females

5. Reach for Health Community Youth Service

Both Sexes

6. Reducing the Risk Both Sexes

7. Safer Choices Both Sexes

8. School / Community Program for Sexual Risk Reduction among Teens

Both Sexes

9. Seattle Social Development Project §

Both Sexes

10. Self Center (School-Linked Reproductive Health Care)

Females

11. Teen Outreach Program Both Sexes

12. Abecedarian Project Both Sexes

13. Adolescents Living Safely: AIDS Awareness Attitudes & Actions

Both Sexes

Table B. Effective Programs: Settings & Populations Served School-Based Programs Community-Based Based Programs Clinic-Based Programs

§ This program is also effective with Native American youth.

28


Urban Suburban Rural Elementary School

Middle School

Sr. High 18-24 White Black Hispanic/

Latino Asian Sex

14. Be Proud! Be Responsible!: A Safer Sex Curriculum

Males

15. Becoming a Responsible Teen

Both Sexes

16. California’s Adolescent Sibling Pregnancy Prevention Project

Both Sexes

17. Children’s Aid Society—Carrera Program Females

18. Community-level HIV Prevention for Adolescents in Low-Income Developments

Both Sexes

19. ¡Cuidate! Both Sexes

20. Making Proud Choices Both Sexes

21. Poder Latino: A Community AIDS Prevention Program for Inner-City Latino Youth

Both Sexes

22. HIV Risk Reduction for African American and Latina Adolescent Women

Females

23. Project Safe – Sexual Awareness for Everyone Females

24. SiHLE Females

25. Tailoring Family Planning Services to the Special Needs of Adolescents

Females


Both Sexes

Table B. Effective Programs: Settings & Populations Served School-Based Programs Community-Based Based Programs Clinic-Based Programs

29

2000 M Street, NW, Suite 750 • Washington, DC 20036 USA • Phone: 202.419.3420 • Fax: 202.419.1448 • www.advocatesforyouth.org

References1. Walter HJ, Vaughan RD. AIDS risk reduction among a multiethnic sample of urban high school students. JAMA 1993; 270:725-730.2. Main DS, Iverson DC, McGloin J et al. Preventing HIV infection among adolescents: evaluation of a school-based education program. Preventive Medicine 1994; 23:409-417.3. Howard M, McCabe JB. Helping teenagers postpone sexual involvement. Family Planning Perspectives 1990; 22:21-26.4. Kirby D, Korpi M, Barth RP et al. The impact of the Postponing Sexual Involvement curriculum among youths in California. Family Planning Perspectives 1997; 29:100-108.5. Cagampang HH, Barth RP, Korpi M et al. Education Now and Babies Later (ENABL): life history of a campaign to postpone sexual involvement. Family Planning Perspectives

1997; 29:109-114.6. Aarons SJ, Jenkins RR, Raine TR et al. Postponing sexual intercourse among urban junior high school students—a randomized controlled evaluation. Journal of Adolescent Health

2000; 27:236-247.7. O’Donnell L, Stueve A, San Doval, A et al. The effectiveness of the Reach for Health Community Youth Service learning program in reducing early and unprotected sex among urban

middle school students. American Journal of Public Health 1999; 89:176-181.8. O’Donnell L, Stueve A, O’Donnell C et al. Long-term reductions in sexual initiation and sexual activity among urban middle schoolers in the Reach for Health service learning

program. Journal of Adolescent Health 2002; 31:93-100.9. Kirby D, Barth RP, Leland N et al. Reducing the Risk: impact of a new curriculum on sexual risk-taking. Family Planning Perspectives 1991; 23:253-263.10. Hubbard BM, Giese ML, Rainey J. A replication study of Reducing the Risk, a theory-based sexuality curriculum for adolescents. Journal of School Health 1998; 68:243-247.11. Coyle K, Basen-Engquist K, Kirby D et al. Short-term impact of Safer Choices: a multicomponent, school-based HIV, other STD, and pregnancy prevention program. Journal of

School Health 1999; 69:181-188.12. Coyle K, Basen-Engquist K, Kirby D et al. Safer Choices: reducing teen pregnancy. HIV, and STDs. Public Health Reports 2001; 116 (Supplement 1):82-93.13. Kirby D, Baumler E, Coyle K et al. The Safer Choices intervention: its impact on the sexual behaviors of different subgroups of high school students. Journal of Adolescent Health

2004; 35:442-452.14. Markham C, Baumler E, Richesson R et al. Impact of HIV-positive speakers in a multicomponent, school-based HIV / STD prevention program for inner-city adolescents. AIDS

Education & Prevention 2000; 12:442-454.15. Vincent ML, Clearie AF, Schluchter MD. Reducing adolescent pregnancy through school and community-based education. JAMA 1987; 257:3382-3386.16. Koo HP, Dunteman GH, George C et al. Reducing adolescent pregnancy through a school- and community-based intervention: Denmark, South Carolina, revisited. Family Planning

Perspectives 1994; 26:206-211.17. Paine-Andrews A, Harris KJ, Fisher JL et al. Effects of a replication of a multicomponent model for preventing adolescent pregnancy in three Kansas communities. Family Planning

Perspectives 1999; 31:182-189.18. Lonczak HS, Abbott RD, Hawkins JD et al. Effects of the Seattle Social Development Project on sexual behavior, pregnancy, on sexual behavior, pregnancy, birth, and sexually

transmitted disease outcomes by age 21 years. Archives of Pediatrics & Adolescent Medicine 2002; 156:438-447.19. Hawkins JD, Catalano RF, Kosterman R et al. Preventing adolescent health-risk behaviors by strengthening protection during childhood. Archives of Pediatrics & Adolescent

Medicine 1999; 153:226-234.20. Zabin LS, Hirsch MB, Smith EA et al. Evaluation of a pregnancy prevention program for urban teenagers. Family Planning Perspectives 1986; 18:119-126.21. Frost JJ, Forrest JD. Understanding the impact of effective teenage pregnancy prevention programs. Family Planning Perspectives 1995; 27:188-195.22. Allen JP, Philliber S, Hoggson N. School-based prevention of teen-age pregnancy and school dropout: process evaluation of the national replication of the Teen Outreach Program.

American Journal of Community Psychology 1990; 18:505-523.23. Allen JP, Philliber S, Herrling S et al. Preventing teen pregnancy and academic failure: experimental evaluation of a developmentally-based approach. Child Development 1997;

64:729-742.24. Allen JP, Philliber S. Who benefi ts most from a broadly targeted prevention program? Differential effi cacy across populations in the Teen Outreach Program. Journal of Community

Psychology 2001; 29:637-655.25. Campbell FA, Ramey CT, Pungello E et al. Early childhood education: young adult outcomes from the Abecedarian Project. Applied Developmental Science 2002; 6(1):42-57.26. Rotheram-Borus MJ, Koopman C, Haignere C et al. Reducing HIV sexual risk behaviors among runaway adolescents. JAMA 1991; 266:1237-1241.27. Jemmott JB, Jemmott LS, Fong GT. Reductions in HIV risk-associated sexual behaviors among black male adolescents: effects of an AIDS prevention intervention. American Journal

of Public Health 1992; 82:372-377.28. ETR Associates. Be Proud! Be Responsible! Programs that Work. http://www.etr.org/recapp/programs/proud.htm.29. St. Lawrence JS, Brasfi eld TL, Jefferson KW et al. Cognitive-behavioral intervention to reduce African American adolescents’ risk for HIV infection. Journal of Consulting and

Clinical Psychology 1995; 63:221-23730. East P, Kiernan E, Chavez G. An evaluation of California’s Adolescent Sibling Pregnancy Prevention Program. Perspectives on Sexual & Reproductive Health 2003; 35:62-70.31. Philliber S, Williams Kaye J, Herrling S et al. Preventing pregnancy and improving health care access among teenagers: an evaluation of the Children’s Aid Society—Carrera

Program. Perspectives on Sexual & Reproductive Health 2002; 34:244-251.32. Sikkema KJ, Anderson ES, Kelly JA et al. Outcomes of a randomized, controlled community-level HIV prevention intervention for adolescents in low-income housing developments.

AIDS 2005; 19:1509-1516.33. Villarruel AN, Jemmott JB, Jemmott LS. A randomized controlled trial testing an HIV prevention intervention for Latino youth. Archives of Pediatrics & Adolescent Medicine 1006;

160:772-777.34. Centers for Disease Control & Prevention. Cuidate! A Culturally-based Program to Reduce HIV Sexual Risk Behavior among Latino Youth; http://www.cdc.gov/hiv/topics/prev_

prog/rep/packages/!cuidate!.htm; accessed 11/16/2007.35. Jemmott JB, Jemmott LS, Fong GT. Abstinence and safer sex HIV risk-reduction interventions for African American adolescents: a randomized controlled trial. JAMA 1998;

279:1529-1536.36. Sellers DE, McGraw SA, McKinlay JB. Does the promotion and distribution of condoms increase teen sexual activity? Evidence from an HIV prevention program for Latino youth.

American Journal of Public Health 1994; 84:1952-1959.37. Smith KW, McGraw SA, Crawford SL et al. HIV risk among Latino adolescents in two New England cities. American Journal of Public Health 1993; 83:1395-1399.38. Jemmott JB, Jemmott LS, Braverman PK et al. HIV/STD risk reduction interventions for African American and Latino adolescent girls at an adolescent medicine clinic. Archives of

Pediatrics & Adolescent Medicine 2005; 159:440-449.39. Shain RN, Piper JM, Newton ER et al. A randomized controlled trial of a behavioral intervention to prevent sexually transmitted diseases among minority women. New England

Journal of Medicine 1999; 340(2):93-100.40. Shain RN, Piper JM, Holden AEC et al. Prevention of gonorrhea and chlamydia through behavioral intervention: results of a two-year controlled randomized trial in minority women.

Sexually Transmitted Diseases 2004; 31(7):401-408.41. Shain RN, Perdue ST, Piper JM et al. Behaviors changed by intervention are associated with reduced STD recurrence: the importance of context in measurement. Sexually Transmitted

Diseases 2002; 29:520-529.42. Korte JE, Shain RN, Holden AEC et al. Reduction in sexual risk behaviors and infection rates among African Americans and Mexican Americans. Sexually Transmitted Diseases

2004; 31:166-173.43. DiClemente RJ, Wingood GM, Harrington KF et al. Effi cacy of an HIV prevention intervention for African American adolescent girls: a randomized controlled trial. JAMA 2004;

292:171-179.44. Winter L, Breckenmaker LC. Tailoring family planning services to the special needs of adolescents. Family Planning Perspectives 1991; 23:24-30.45. Rotheram-Borus MJ, Lee MB, Murphy DA et al. Effi cacy of a preventive intervention for youths living with HIV. American Journal of Public Health 2001; 91:400-405.46. Centers for Disease Control & Prevention. TLC: Together Learning Choices: A Small Group Level Intervention with Young People Living with HIV/AIDS; http://www.cdc.gov/hiv/

topics/prev_prog/rep/packages/TLC.htm; accessed 11/16/2007.

Written by Sue Alford, MLS Advocates for Youth © 2008

30

(1) If a minor has consensual sexual intercourse with an older (or younger)partner, is a report mandated?*

Age ofPartner

12 13 14 15 16 17 18 19 20 21 22

Age of

Patient 11 N N Y Y Y Y Y Y Y Y Y12 N N Y Y Y Y Y Y Y Y Y13 N N Y Y Y Y Y Y Y Y Y14 Y Y N N N N N N N Y Y15 Y Y N N N N N N N Y Y16 Y Y N N N N N N N N N17 Y Y N N N N N N N N N18 Y Y N N N N N N N N N

Chart by David Knopf, LCSW, UCSF.

(2) If a minor engages in “lewd and lascivious acts” with an older or youngerpartner, is a report required?

“Lewd and lascivious acts” are acts performed with the intent of arousing, appealing to, or gratifyingthe lust, passions, or sexual desires of the minor or partner. Mandated reporters must report “lewd andlascivious acts” when a minor is 14 or 15 and the partner is 10 or more years older, (14 year old with anadult 24 years or older/ 15 year old with an adult 25 years or older), or when a minor is under 14 andthe partner is 14 or older, regardless of claimed consent by the minor.

(3) Are there other situations in which sexual intercourse must be reported?**

Mandated reporters must report sexual intercourse or other sexual activity with a minor under 18 yearsold when the activity appears coerced, exploitative, based on intimidation, or in any other wayresembles abuse -- regardless of claimed consent by the minor and regardless of partner age.

*The law does not require providers to ask about partner age. **This worksheet is not a complete review of all California sexual abuse reporting requirements.

© National Center for Youth Law. Jul. 2004. This chart may be reprinted providing any reprinting be accompanied by an acknowledgement. Chart available atwww.youthlaw.org.

When Mandated Reporters in California Must ReportConsensual Disparate Age Sexual Intercourse to ChildAbuse Authorities

31

©NATIONAL CENTER FOR YOUTH LAW, www.youthlaw.org, revised: Sep. 2003 1-4

CALIFORNIA MINOR CONSENT LAWS:

Which minors can consent for what services and providers’ confidentiality obligations

MINORS OF ANY AGE MAY CONSENT LAWCONFIDENTIALITY AND/OR INFORMING

OBLIGATION OF THE HEALTH CAREPROVIDER

PREGNANCY“A minor may consent to medical care related to

the prevention or treatment of pregnancy,”except sterilization. (Cal. Family Code § 6925).

The health care provider is not permitted to inform aparent or legal guardian without minor’s consent. Theprovider can only share the minor’s medical records withthe signed consent of the minor. (Cal. Health & SafetyCode §§ 123110(a), 123115(a); Cal. Civ. 56.10, 56.11).

CONTRACEPTION A minor may receive birth control withoutparental consent. (Cal. Family Code § 6925).


ABORTIONA minor may consent to an abortion without

parental consent and without court permission.(American Academy of Pediatrics v. Lungren, 16

Cal.4th 307 (1997)).


EMERGENCY MEDICALSERVICES*

*An emergency is “a situation . . . requiring immediateservices for alleviation of severe pain or immediate

diagnosis of unforeseeable medical conditions, which, if notimmediately diagnosed and treated, would lead to seriousdisability or death” (Cal. Code Bus. & Prof. 2397 (c)(2)).

A minor who has a condition or injury which isconsidered an emergency but whose parent or

guardian is unavailable to give consent ispermitted to give consent for medical services.

(Cal. Bus. and Prof. Code § 2397).

The health care provider shall inform the minor’s parentor guardian. (Cal. Bus. and Prof. Code § 2397).

SEXUAL ASSAULT* SERVICES

* For the purposes of minor consent alone, sexual assaultincludes acts of oral copulation, sodomy, and other violent

crimes of a sexual nature.

A minor who may have been sexually assaultedmay consent to medical care related to thediagnosis, treatment and the collection of

medical evidence related to the assault. (Cal.Family Code § 6928).

The health care provider must attempt to contact theminor’s parent/guardian and note in the minor’s record theday and time of the attempted contact and whether it wassuccessful. This provision does not apply if the treatingprofessional reasonably believes that the parent/guardiancommitted the assault. (Cal. Family Code § 6928).

RAPE* SERVICES FOR MINORSUNDER 12 YRS**

*Rape requires an act of non-consensual sexual intercourse.** See also “Rape Services for Minors 12 and Over” at page

4-4 of this chart

A minor under 12 years of age who may havebeen raped may consent to medical care relatedto the diagnosis, treatment and the collection of

medical evidence related to the rape. (Cal.Family Code § 6928).

The health care provider must attempt to contact the minor’sparent/guardian and must note in the minor’s record the day andtime of the attempted contact and whether it was successful.This provision does not apply if the treating professionalreasonably believes that the parent/guardian committed the rapeor assault. (Cal. Family Code § 6928).

32


MINORS OF ANY AGE MAY CONSENT LAWCONFIDENTIALITY AND/OR INFORMING


*SKELETAL X-RAY TODIAGNOSE CHILD ABUSE OR

NEGLECT* The provider does not need the minor’s or her parent’s

consent to perform a procedure under this section.

“A physician and surgeon or dentist or theiragents . . . may take skeletal X-rays of the child

without the consent of the child's parent orguardian, but only for purposes of diagnosing

the case as one of possible child abuse or neglectand determining the extent of.” (Cal Penal Code

§ 11171).

Neither the physician-patient privilege nor thepsychotherapist-patient privilege applies to informationreported pursuant to this law in any court proceeding.

MINORS 12 YEARS OF AGE OR OLDERMAY CONSENT

LAWCONFIDENTIALITY AND/OR INFORMING


OUTPATIENT MENTALHEALTH SERVICES*

* This section does not authorize a minor to receiveconvulsive therapy, psychosurgery or psychotropic drugs

without the consent of a parent or guardian.

“A minor who is 12 years of age or older mayconsent to mental health treatment or counseling

on an outpatient basis, or to residential shelterservices, if both of the following requirementsare satisfied: (1) The minor, in the opinion ofthe attending professional person, is mature

enough to participate intelligently in theoutpatient services or residential shelter services.

(2) The minor (A) would present a danger ofserious physical or mental harm to self or toothers without the mental health treatment or

counseling or residential shelter services, or (B)is the alleged victim of incest or child abuse.”

(Cal. Family Code § 6924).

MENTAL HEALTH TREATMENT:The health care provider is required to involve a parent orguardian unless the health care provider decides thatinvolvement is inappropriate. This decision must bedocumented in the minor’s record.

SHELTER:Although minor may consent to service, the shelter mustuse its best efforts based on information provided by theminor to notify parent/guardian of shelter services.(Note: The parent/guardian of a minor shall not beentitled to inspect or obtain copies of the minor’spatient records where the health care providerdetermines that access to the patient records requestedby the parent/guardian would have a detrimentaleffect on the provider's professional relationship withthe minor patient or the minor's physical safety orpsychological well-being. The decision of the healthcare provider as to whether or not a minor's recordsare available for inspection under this section shall notattach any liability to the provider, unless the decisionis found to be in bad faith. (Cal. Health & Safety Code§ 123115(a)(2))).

DIAGNOSIS AND/ORTREATMENT FOR INFECTIOUS,CONTAGIOUS COMMUNICABLE

DISEASES

“A minor who is 12 years of age or older and whomay have come into contact with an infectious,

contagious, or communicable disease may consentto medical care related to the diagnosis or

treatment of the disease, if the disease… is one thatis required by law…to be reported….” (Cal.

Family Code § 6926).


33


MINORS 12 YEARS OF AGE OR OLDERMAY CONSENT LAW

CONFIDENTIALITY AND/OR INFORMINGOBLIGATION OF THE HEALTH CARE PROVIDER

DIAGNOSIS AND/ORTREATMENT FOR SEXUALLY

TRANSMITTED DISEASES

A minor 12 years of age or older who mayhave come into contact with a sexually

transmitted disease may consent to medicalcare related to the diagnosis or treatment of

the disease. (Cal. Family Code § 6926).

The health care provider is not permitted to inform a parent orlegal guardian without minor’s consent. The provider canonly share the minor’s medical records with the signedconsent of the minor. (Cal. Health & Safety Code §§123110(a), 123115(a); Cal. Civ. 56.10, 56.11).

AIDS/HIV TESTING ANDTREATMENT

A minor 12 and older is competent to givewritten consent for an HIV test. (Cal. Healthand Safety Code § 121020). A minor 12 and

older may consent to the diagnosis andtreatment of HIV/AIDS. (Cal. Family Code

§ 6926).

The health care provider is not permitted to inform a parent orlegal guardian without minor’s consent. The provider canonly share the minor’s medical records with the signedconsent of the minor. (Cal. Health & Safety Code §§123110(a), 123115(a); Cal. Civ. 56.10, 56.11).

DRUG AND ALCOHOLABUSE TREATMENT*

• This section does not authorize a minor to receivereplacement narcotic abuse treatment without theconsent of the minor's parent or guardian.

• This section does not grant a minor the right torefuse medical care and counseling for a drug oralcohol related problem when the minor’s parentor guardian consents for that treatment. (Cal.Family Code § 6929(f)).

“A minor who is 12 years of age or oldermay consent to medical care and counselingrelating to the diagnosis and treatment of a

drug or alcohol related problem.”(Cal.Family Code §6929(b)).

There are different confidentiality rules under federal and state law.Providers meeting the criteria listed under ‘federal’ below must follow thefederal rule. Providers that don’t meet these criteria follow state law.FEDERAL: Federal confidentiality law applies to any individual, program,or facility that meets the following two criteria:1. The individual, program, or facility is federally assisted. (Federally

assisted means authorized, certified, licensed or funded in whole or inpart by any department of the federal government. Examples includeprograms that are: tax exempt; receiving tax-deductible donations;receiving any federal operating funds; or registered with Medicare.)(42C.F.R. §2.12); AND

2. The individual or program:1) Is an individual or program that holds itself out as providing

alcohol or drug abuse diagnosis, treatment, or referral; OR2) Is a staff member at a general medical facility whose primary

function is, and who is identified as, a provider of alcohol or drugabuse diagnosis, treatment or referral; OR

3) Is a unit at a general medical facility that holds itself out asproviding alcohol or drug abuse diagnosis, treatment or referral.(42 C.F.R. §2.11; 42 C.F.R. §2.12).

For individuals or programs meeting these criteria, federal law prohibitsdisclosing any information to parents without a minor’s written consent.One exception, however, is that an individual or program may share withparents if the individual or program director determines the following threeconditions are met: (1) that the minor’s situation poses a substantial threat tothe life or physical well-being of the minor or another; (2) that this threatmay be reduced by communicating relevant facts to the minor’s parents; and(3) that the minor lacks the capacity because of extreme youth or a mental orphysical condition to make a rational decision on whether to disclose to herparents. (42 C.F.R. §2.14).STATE: For programs that don’t meet the above criteria, state law applies.State law allows health care providers to determine whether involving aparent or guardian in the minor’s treatment would be appropriate. Thisdecision must be documented in the minor’s record. (Cal. Family Code§6929(c)). A provider shall not be liable for any good faith decisionsconcerning access to a minor's records. (Cal. H & S Code §123115(a)(2)).

34


MINOR 12 YEARS OF AGE OR OLDERMAY CONSENT

LAWCONFIDENTIALITY AND/OR INFORMING


RAPE SERVICES FOR MINORS12 and OVER

“A minor who is 12 years of age or older andwho is alleged to have been raped may consent

to medical care related to the diagnosis ortreatment of the condition and the collection of

medical evidence with regard to the allegedrape.” (Cal. Family Code 6927).

The health care provider is not permitted to inform a parentor legal guardian without minor’s consent. The providercan only share the minor’s medical records with the signedconsent of the minor. (Cal. Health & Safety Code §§123110(a), 123115(a); Cal. Civ. 56.10, 56.11).

MINOR 15 YEARS OF AGE OR OLDER LAWCONFIDENTIALITY AND/OR INFORMING


GENERAL MEDICAL CARE

“A minor may consent to the minor's medicalcare or dental care if all of the following

conditions are satisfied: (1) The minor is 15years of age or older. (2) The minor is living

separate and apart from the minor's parents orguardian, whether with or without the consent of

a parent or guardian and regardless of theduration of the separate residence. (3) The

minor is managing the minor's own financialaffairs, regardless of the source of the minor's

income.” (Cal. Family Code § 6922(a)).

“A physician and surgeon or dentist MAY, with or withoutthe consent of the minor patient, advise the minor's parentor guardian of the treatment given or needed if thephysician and surgeon or dentist has reason to know, onthe basis of the information given by the minor, thewhereabouts of the parent or guardian.” (Cal. FamilyCode § 6922(c)).

MINOR MUST BE EMANCIPATED(GENERALLY 14 YEARS OF AGE OR

OLDER)LAW

CONFIDENTIALITY AND/OR INFORMINGOBLIGATION OF THE HEALTH CARE

PROVIDER

GENERAL MEDICAL CARE

An emancipated minor may consent to medical,dental and psychiatric care. (Cal. Family Code §

7050(e)).“A person under the age of 18 years is anemancipated minor if any of the followingconditions is satisfied: (a) The person has

entered into a valid marriage, whether or not themarriage has been dissolved. (b) The person is

on active duty with the armed forces of theUnited States. (c) The person has received adeclaration of emancipation” from the court.

(Cal. Family Code § 7002).


This chart may be adapted or reprinted providing any adaptation or reprinting be accompanied by an acknowledgement of its source.

35

Legal Issues Relevant to Disclosure of HIV Status

There are several California laws* that may be relevant to disclosure of HIV status. There are two broad categories of legislation: laws specific to people living with HIV and laws specific to providers working with HIV+ clients. Laws specific to people living with HIV: California Health and Safety Code 120291(a) - Willful Exposure: “Any person who exposes another to the human immunodeficiency virus (HIV) by engaging in unprotected sexual activity when the infected person knows at the time of the unprotected sex that he or she is infected with HIV, has not disclosed his or her HIV positive status, and acts with the specific intent to infect the other person with HIV, is guilty of a felony punishable by imprisonment in the state prison for three, five or eight years. Evidence that the person had knowledge of his or her HIV positive status, without additional evidence, shall not be sufficient to prove specific intent.” California Penal Code 647, 1202.1 and 1202.6: Testing Sexual Offenders for HIV: A law passed in 1998 (Senate bill 1007) amends the penal code to authorize HIV testing of those convicted of sexual offenses, including sex work. If someone who is convicted tests positive for HIV and is re-arrested for a sexual offense, it is an automatic felony. Laws specific to providers: California Health and Safety Code 120975 - Confidentiality Protections Regarding Subjects of HIV Tests: “To protect the privacy of individuals who are the subject of blood testing for the antibodies to the probably causative agent of acquired immune deficiency syndrome (AIDS) the following shall apply: Except as provided in Section 1603.1 or 1603.3, as amended by Chapter 23 of the Statutes of 1985, no person shall be compelled in any state, county, city, or other local civil, criminal, administrative, legislative, or other proceedings to identify or provide identifying characteristics that would identify any individual who is the subject of a blood test to detect antibodies to the probably causative agent of AIDS.” California Health and Safety Code 120908 - Disclosure Laws, Including Parameters and Penalties: (a) “Any person who negligently discloses results of a HIV test, as defined in Section 120775, to any third party, in a manner that identifies or provides identifying characteristics of the person to whom the test results apply, except to a written authorization, as described on subdivision (g) or except as provided in Section 1603.1 or 1603.3 or any other statute that expressly provides an exemption to this section, shall be assessed a civic penalty in an amount not to exceed $1,000 plus court costs, as determined by the court, which penalty and costs shall be paid to the subject of the test.” For more information, see sections (b) through (i) of this statute. For more information on California laws, visit http://www.leginfo.ca.gov/. For information on HIV laws in other states, see http://www.lambdalegal.org/. *The above information was taken from the: Supporting Self Disclosure of HIV Status course from the CA STD/HIV Prevention Training Center, Oakland, CA.

36

for your future

for yourself

for your family

C a l l 1 - 8 0 0 - 9 4 2 - 1 0 5 4

Do it...

What is Family PACT?Family PACT provides no-cost familyplanning services to low-income men andwomen, including teens.

Why should I enroll?Family PACT provides access to familyplanning services for men and women, as well as education, counseling and treatment to protect your reproductive health. If you are concerned about unplannedpregnancies, call 1-800-942-1054 for aFamily PACT provider near you.

Who is eligible?Both men and women are eligible if theyare low-income California residents and:

• Do not have insurance that covers family planning

OR• Have insurance, but need to keep family

planning services confidential.

What services are provided?• Personal and confidential health care• Prevention of unplanned pregnancy• Basic reproductive health assessments• Prevention, screening and treatment of

STIs (sexually transmitted infections)• Pregnancy testing and counseling• Hepatitis B immunizations• HIV testing and counseling• Limited male and female cancer screening

What birth control methodsdoes Family PACT provide?

• Birth control pills• Emergency contraception• Contraceptive implants• Intra-Uterine Contraceptives (IUC)• Birth control shots• Diaphragm• Cervical cap• Spermicides• Female and male condoms• Fertility Awareness Methods (FAM)• Lactation Amenorrhea Method (LAM)• Female and male sterilization

Fin

d o

ut

wh

at

Fa

mil

y P

AC

T c

an

do

fo

r y

ou

.

Brochure.qxp 10/4/02 9:01 AM Page 4

38

DEPARTMENT OF HEALTH AND HUMAN SERVICES | Centers for Disease Control and Prevention Page 1CS124752

Consistent and correct use of male latex condoms can reduce (though not eliminate) the risk of STD transmission. To achieve the maximum protective effect, condoms must be used both consistently and correctly. Inconsistent use can lead to STD acquisition because transmission can occur with a single act of intercourse with an infected partner. Similarly, if condoms are not used correctly, the protective effect may be diminished even when they are used consistently. The most reliable ways to avoid transmission of sexually transmitted diseases (STDs), including human immunodeficiency virus (HIV), are to abstain from sexual activity or to be in a long-term mutually monogamous relationship with an uninfected partner. However, many infected persons may be unaware of their infections because STDs are often asymptomatic or unrecognized.This fact sheet presents evidence concerning the male latex condom and the prevention of STDs, including HIV, based on information about how different STDs are transmitted, the physical properties of condoms, the anatomic coverage or protection that condoms provide, and epidemiologic studies assessing condom use and STD risk. This fact sheet updates previous CDC fact sheets on male condom effectiveness for STD prevention by incorporating additional evidence-based findings from published epidemiologic studies.

Condoms and STDs: Fact Sheet for Public Health Personnel

Sexually Transmitted Diseases, Including HIV InfectionLatex condoms, when used consistently and correctly, are highly effective in preventing the sexual transmission of HIV, the virus that causes AIDS. In ad-dition, consistent and correct use of latex condoms reduces the risk of other sexually transmitted diseases (STDs), including diseases transmitted by genital secretions, and to a lesser degree, genital ulcer diseases. Condom use may reduce the risk for genital human papillomavirus (HPV) infection and HPV-associated diseases, e.g., genital warts and cervical cancer. There are two primary ways that STDs are transmitted. Some diseases, such as HIV infection, gonorrhea, chlamydia, and trichomoniasis, are transmitted when infected urethral or vaginal secretions contact mucosal surfaces (such as the male urethra, the vagina, or cervix). In contrast, genital ulcer diseases (such as genital herpes, syphilis, and chancroid) and human papillomavirus (HPV) infection are primarily transmitted through contact with infected skin or mucosal surfaces.Laboratory studies have demonstrated that latex condoms provide an essentially impermeable barrier to particles the size of STD pathogens.Theoretical and empirical basis for protection. Condoms can be expected to provide different levels of protection for various STDs, depending on differences in how the diseases are transmitted. Condoms block transmission and acquisition of STDs by preventing contact between the condom wearer’s penis and a sex partner’s skin, mucosa, and genital secretions. A greater level of protection is provided for the diseases transmitted by genital secretions. A lesser degree of protection is provided for genital ulcer diseases or HPV because these infections also may be transmitted by exposure to areas (e.g., infected skin or mucosal surfaces) that are not covered or protected by the condom.

Epidemiologic studies seek to measure the protective effect of condoms by comparing risk of STD transmission among condom users with nonusers who are engaging in sexual intercourse. Accurately estimating the effectiveness of condoms for prevention of STDs,

39


however, is methodologically challenging. Well-designed studies address key factors such as the extent to which condom use has been consistent and correct and whether infection identified is incident (i.e., new) or prevalent (i.e. pre-existing). Of particular importance, the study design should assure that the population being evaluated has documented exposure to the STD of interest during the period that condom use is being assessed. Although consistent and correct use of condoms is inherently difficult to measure, because such studies would involve observations of private behaviors, several published studies have demonstrated that failure to measure these factors properly tends to result in underestimation of condom effectiveness.Epidemiologic studies provide useful information regarding the magnitude of STD risk reduction associated with condom use. Extensive literature review confirms that the best epidemiologic studies of condom effectiveness address HIV infection. Numerous studies of discordant couples (where only one partner is infected) have shown consistent use of latex condoms to be highly effective for preventing sexually acquired HIV infection. Similarly, studies have shown that

condom use reduces the risk of other STDs. However, the overall strength of the evidence regarding the effectiveness of condoms in reducing the risk of other STDs is not at the level of that for HIV, primarily because fewer methodologically sound and well-designed studies have been completed that address other STDs. Critical reviews of all studies, with both positive and negative findings (referenced here) point to the limitations in study design in some studies which result in underestimation of condom effectiveness; therefore, the true protective effect is likely to be greater than the effect observed. Overall, the preponderance of available epidemiologic studies have found that when used consistently and correctly, condoms are highly effective in preventing the sexual transmission of HIV infection and reduce the risk of other STDs. The following includes specific information for HIV infection, diseases transmitted by genital secretions, genital ulcer diseases, and HPV infection, including information on laboratory studies, the theoretical basis for protection and epidemiologic studies.

HIV, the virus that causes AIDSLatex condoms, when used consistently and correctly, are highly effective in preventing the sexual transmission of HIV, the virus that causes AIDSHIV infection is, by far, the most deadly STD, and considerably more scientific evidence exists regarding condom effectiveness for prevention of HIV infection than for other STDs. The body of research on the effectiveness of latex condoms in preventing sexual transmission of HIV is both comprehensive and conclusive. The ability of latex condoms to prevent transmission of HIV has been scientifically established in “real-life” studies of sexually active couples as well as in laboratory studies.Laboratory studies have demonstrated that latex condoms provide an essentially impermeable barrier to particles the size of HIV.Theoretical basis for protection. Latex condoms cover the penis and provide an effective barrier to exposure to secretions such as urethral and vaginal secretions, blocking the pathway of sexual transmission of HIV infection.Epidemiologic studies that are conducted in real-life settings, where one partner is infected with HIV and the other partner is not, demonstrate that the consistent use of latex condoms provides a high degree of protection.

40


Other Diseases transmitted by genital secretions, including Gonorrhea, Chlamydia, and TrichomoniasisLatex condoms, when used consistently and correctly, reduce the risk of transmission of STDs such as gonorrhea, chlamydia, and trichomoniasis. STDs such as gonorrhea, chlamydia, and trichomoniasis are sexually transmitted by genital secretions, such as urethral or vaginal secretions.Laboratory studies have demonstrated that latex condoms provide an essentially impermeable barrier to particles the size of STD pathogens. Theoretical basis for protection. The physical properties of latex condoms protect against diseases such as gonorrhea, chlamydia, and trichomoniasis by providing a barrier to the genital secretions that transmit STD-causing organisms. Epidemiologic studies that compare infection rates among condom users and nonusers provide evidence that latex condoms can protect against the transmission of STDs such as chlamydia, gonorrhea and trichomoniasis.

Genital ulcer diseases include genital herpes, syphilis, and chancroid. These diseases are transmitted primarily through “skin-to-skin” contact from sores/ulcers or infected skin that looks normal. HPV infections are transmitted through contact with infected genital skin or mucosal surfaces/secre-tions. Genital ulcer diseases and HPV infection can occur in male or female genital areas that are covered (protected by the condom) as well as those areas that are not.Laboratory studies have demonstrated that latex condoms provide an essentially impermeable barrier to particles the size of STD pathogens. Theoretical basis for protection. Protection against genital ulcer diseases and HPV depends on the site of the sore/ulcer or infection. Latex condoms can only protect against trans-mission when the ulcers or infections are in genital areas that are covered or protected by the condom. Thus, consistent and correct use of latex condoms would be expected to protect against transmission of genital ulcer diseases and HPV in some, but not all, instances.

Genital ulcer diseases and HPV infectionsGenital ulcer diseases and HPV infections can occur in both male and female genital areas that are covered or protected by a latex condom, as well as in areas that are not covered. Consistent and correct use of latex con-doms reduces the risk of genital herpes, syphilis, and chancroid only when the infected area or site of potential exposure is protected. Condom use may reduce the risk for HPV infection and HPV-associated diseases (e.g., genital warts and cervical cancer).

Epidemiologic studies that compare infection rates among condom users and nonusers provide evidence that latex condoms provide limited protection against syphilis and herpes simplex virus-2 transmission. No conclusive studies have specifically addressed the transmission of chancroid and condom use, although several studies have documented a reduced risk of genital ulcers associated with increased condom use in settings where chancroid is a leading cause of genital ulcers. Condom use may reduce the risk for HPV-associated diseases (e.g., genital warts and cervical cancer) and may mitigate the other adverse consequences of infection with HPV; condom use has been associated with higher rates of regression of cervical intraepithelial neoplasia (CIN) and clearance of HPV infection in women, and with regression of HPV-associated penile lesions in men. A limited num-ber of prospective studies have demonstrated a protective effect of condoms on the acquisition of genital HPV. While condom use has been associated with a lower risk of cervical cancer, the use of condoms should not be a substitute for routine screening with Pap smears to detect and prevent cervical cancer, nor should it be a substitute for HPV vaccination among those eligible for the vaccineSelected References are available at: www.cdc.gov/condomeffectiveness/references.html

41

____________________________

____________________________

State of California—Health and Human Services Agency California Department of Public Health

CONFIDENTIAL MORBIDITY REPORT NOTE: For STD, Hepatitis, or TB, complete appropriate section below. Special reporting requirements and reportable diseases on back.

DISEASE BEING REPORTED: ___________________________________________________________________________________

Patient’s Last Name Social Security Number

– – Birth Date

First Name/Middle Name (or initial) Month Day Year Age

Address: Number, Street Apt./Unit Number

Ethnicity (✓ one)

❒ Hispanic/Latino

❒ Non-Hispanic/Non-Latino

Race (✓ one)

❒ African-American/Black

❒ Asian/Pacific Islander (✓ one):

❒ Asian-Indian ❒ Japanese

❒ Cambodian ❒ Korean

City/Town State ZIP Code

Area Code Home Telephone Gender Pregnant? Estimated Delivery Date

Month Day Year

– – Area Code Work Telephone Patient’s Occupation/Setting

M F Y UnkN

❒ Chinese ❒ Laotian

❒ Filipino ❒ Samoan

❒ Guamanian ❒ Vietnamese

❒ Hawaiian

❒ Other:________________________

❒ Native American/Alaskan Native

❒ White: __________________________

❒ Other: __________________________

REPORT TO

–DATE OF ONSET

Month Day Year

DATE DIAGNOSED

Month Day Year

DATE OF DEATH

Month Day Year

❒ Food service ❒ Day care ❒ Correctional facility– ❒ Health care ❒ School ❒ Other _________________________

Reporting Health Care Provider

Reporting Health Care Facility

Address

City State ZIP Code

Telephone Number Fax

( ) ( ) Submitted by Date Submitted

(Month/Day/Year)

❒ Secondary ❒ Late (tertiary) ❒ VDRL Titer:__________

❒ Primary (lesion present) ❒ Late latent > 1 year ❒ RPR Titer:__________

SEXUALLY TRANSMITTED DISEASES (STD)Syphilis Syphilis Test Results

❒ Neurosyphilis ❒ Other:_________________

❒ Early latent < 1 year ❒ Congenital ❒ FTA/MHA: ❒ Pos ❒ Neg ❒ Latent (unknown duration) ❒ CSF-VDRL: ❒ Pos ❒ Neg

Gonorrhea Chlamydia ❒ PID (Unknown Etiology) ❒ Urethral/Cervical ❒ Urethral/Cervical ❒ Chancroid ❒ PID ❒ PID

❒ Non-Gonococcal Urethritis ❒ Other: ____________________ ❒ Other: _____________

STD TREATMENT INFORMATION ❒ Untreated ❒ Treated (Drugs, Dosage, Route): Date Treatment Initiated ❒ Will treat

Month Day Year ❒ Unable to contact patient ❒ Refused treatment

❒ Referred to: _________________

(Obtain additional forms from your local health department.)

VIRAL HEPATITIS Not Pos Neg Pend Done

❒ Hep A anti-HAV IgM ❒ ❒ ❒ ❒

❒ Hep B HBsAg ❒ ❒ ❒ ❒ ❒ Acute anti-HBc ❒ ❒ ❒ ❒

❒ Chronic anti-HBc IgM ❒ ❒ ❒ ❒

anti-HBs ❒ ❒ ❒ ❒

❒ Hep C anti-HCV ❒ ❒ ❒ ❒ ❒ Acute PCR-HCV ❒ ❒ ❒ ❒

❒ Hep D (Delta) anti-Delta ❒ ❒ ❒ ❒

❒ Chronic

❒ Other: ______________ ❒ ❒ ❒ ❒

Suspected Exposure Type

❒ Blood ❒ Other needle ❒ Sexual ❒ Household transfusion exposure contact contact

❒ Child care ❒ Other: ________________________________

TUBERCULOSIS (TB) Status Mantoux TB Skin Test Bacteriology

❒ Active Disease Month Day Year Month Day Year

❒ Confirmed ❒ Suspected Date Performed Date Specimen Collected

❒ Infected, No Disease ❒ Pending ❒ Convertor Results:______________ mm ❒ Not Done Source _______________________________________

❒ Reactor Smear: ❒ Pos ❒ Neg ❒ Pending ❒ Not done Chest X-Ray Month Day Year Culture: ❒ Pos ❒ Neg ❒ Pending ❒ Not done

Site(s)

❒ Pulmonary Date Performed Other test(s) ___________________________________

❒ Extra-Pulmonary ❒ Normal ❒ Pending ❒ Not done ❒ Both ❒ Cavitary ❒ Abnormal/Noncavitary _______________________________________

TB TREATMENT INFORMATION ❒ Current Treatment

❒ INH ❒ RIF ❒ PZA ❒ EMB ❒ Other:____________

Month Day Year

Date Treatment

Initiated

❒ Untreated ❒ Will treat

❒ Refused treatment ❒ Unable to contact patient

❒ Referred to: _____________________

REMARKS

PM 110 (revised 10/30/08) 42

State of California - Health and Human Services Agency California Department of Public Health

Title 17, California Code of Regulations (CCR) §2500, §2593, §2641.5-2643.20, and §2800-2812 Reportable Diseases and Conditions*§ 2500. REPORTING TO THE LOCAL HEALTH AUTHORITY.● § 2500(b) It shall be the duty of every health care provider, knowing of or in attendance on a case or suspected case of any of the diseases or conditions listed

below, to report to the local health officer for the jurisdiction where the patient resides. Where no health care provider is in attendance, any individual having knowledgeof a person who is suspected to be suffering from one of the diseases or conditions listed below may make such a report to the local health officer for the jurisdictionwhere the patient resides.

● § 2500(c) The administrator of each health facility, clinic, or other setting where more than one health care provider may know of a case, a suspected case or an outbreak of disease within the facility shall establish and be responsible for administrative procedures to assure that reports are made to the local officer.

● § 2500(a)(14) "Health care provider" means a physician and surgeon, a veterinarian, a podiatrist, a nurse practitioner, a physician assistant, a registered nurse, a nursemidwife, a school nurse, an infection control practitioner, a medical examiner, a coroner, or a dentist.

URGENCY REPORTING REQUIREMENTS [17 CCR §2500(h)(i)]☎ =Report immediately by telephone (designated by a ◆ in regulations). † =Report immediately by telephone when two or more cases or suspected cases of foodborne disease from separate households are suspected to have the same source

of illness (designated by a ● in regulations.)FAX ✆✉ =Report by FAX, telephone, or mail within one working day of identification (designated by a + in regulations).

=All other diseases/conditions should be reported by FAX, telephone, or mail within seven calendar days of identification.

REPORTABLE COMMUNICABLE DISEASES §2500(j)(1) Acquired Immune Deficiency Syndrome (AIDS) FAX ✆ ✉ Poliomyelitis, Paralytic (Human Immunodeficiency Virus infection only - see lower right) FAX ✆ ✉ Psittacosis

FAX ✆✉ Amebiasis FAX ✆ ✉ Q Fever☎ Anthrax ☎ Rabies, Human or Animal☎ Avian Influenza (human) FAX ✆ ✉ Relapsing Fever

FAX ✆✉ Babesiosis Rheumatic Fever, Acute☎ Botulism (Infant, Foodborne, Wound) Rocky Mountain Spotted Fever☎ Brucellosis Rubella (German Measles)

FAX ✆✉ Campylobacteriosis Rubella Syndrome, CongenitalChancroid FAX ✆ ✉ Salmonellosis (Other than Typhoid Fever)

FAX ✆✉ Chickenpox (only hospitalizations and deaths) ☎ Scombroid Fish PoisoningChlamydial Infections, including Lymphogranulom Venereum (LGV) ☎ Severe Acute Respiratory Syndrome (SARS)

☎ Cholera ☎ Shiga toxin (detected in feces)☎ Ciguatera Fish Poisoning FAX ✆ ✉ Shigellosis

Coccidioidomycosis ☎ Smallpox (Variola)FAX ✆✉ Colorado Tick Fever ☎ Staphylococcus aureus infection (only a case resulting in death or admission to anFAX ✆✉ Conjunctivitis, Acute Infectious of the Newborn, Specify Etiology intensive care unit of a person who has not been hospitalized or had surgery, dialysis,

Creutzfeldt-Jakob Disease (CJD) and other Transmissible Spongiform or residency in a long-term care facility in the past year, and did not have an indwelling Encephalopathies (TSE) catheter or percutaneous medical device at the time of culture)

FAX ✆✉ Cryptosporidiosis FAX ✆ ✉ Streptococcal Infections (Outbreaks of Any Type and Individual Cases in FoodCysticercosis or Taeniasis Handlers and Dairy Workers Only)

☎ Dengue FAX ✆ ✉ Syphilis☎ Diarrhea of the Newborn, Outbreak Tetanus☎ Diphtheria Toxic Shock Syndrome☎ Domoic Acid Poisoning (Amnesic Shellfish Poisoning) Toxoplasmosis

Ehrlichiosis FAX ✆ ✉ Trichinosis FAX ✆✉ Encephalitis, Specify Etiology: Viral, Bacterial, Fungal, Parasitic FAX ✆ ✉ Tuberculosis

☎ Escherichia coli : shiga toxin producing (STEC) including E. coli O157 ☎ Tularemia† FAX ✆✉ Foodborne Disease FAX ✆ ✉ Typhoid Fever, Cases and Carriers

Giardiasis Typhus FeverGonococcal Infections FAX ✆ ✉ Vibrio Infections

FAX ✆✉ Haemophilus influenzae invasive disease (report an incident ☎ Viral Hemorrhagic Fevers (e.g., Crimean-Congo, Ebola, Lassa, and Marburg viruses) less than 15 years of age) FAX ✆ ✉ Water-Associated Disease (e.g., Swimmer's Itch or Hot Tub Rash)

☎ Hantavirus Infections FAX ✆ ✉ West Nile Virus (WNV) Infection☎ Hemolytic Uremic Syndrome ☎ Yellow Fever

Hepatitis, Viral FAX ✆ ✉ Yersiniosis FAX ✆✉ Hepatitis A ☎ OCCURRENCE of ANY UNUSUAL DISEASE

Hepatitis B (specify acute case or chronic) ☎ OUTBREAKS of ANY DISEASE (Including diseases not listed in §2500). Specify ifHepatitis C (specify acute case or chronic) institutional and/or open community. Hepatitis D (Delta) Hepatitis, other, acute HIV REPORTING BY HEALTH CARE PROVIDERS §2641.5-2643.20

Influenza deaths (report an incident of less than 18 years of age) Human Immunodeficiency Virus (HIV) infection is reportable by traceable mail or person-to-personKawasaki Syndrome (Mucocutaneous Lymph Node Syndrome) transfer within seven calendar days by completion of the HIV/AIDS Case Report form (CDPH 8641A)

Legionellosis available from the local health department. For completing HIV-specific reporting requirements, see Leprosy (Hansen Disease) Title 17, CCR, §2641.5-2643.20 and http://www.cdph.ca.gov/programs/AIDS/Pages/OAHIVReporting.aspx .Leptospirosis

FAX ✆✉ Listeriosis REPORTABLE NONCOMMUNICABLE DISEASES AND CONDITIONS §2800-2812 AND §2593(b)Lyme Disease Disorders Characterized by Lapses of Consciousness (§2800-2812)

FAX ✆✉ Malaria Pesticide-related illness or injury (known or suspected cases)** ☎ Measles (Rubeola) Cancer, including benign and borderline brain tumors (except (1) basal and squamous skin cancer FAX ✆✉ Meningitis, Specify Etiology: Viral, Bacterial, Fungal, Parasitic unless occurring on genitalia, and (2) carcinoma in-situ and CIN III of the cervix) ( §2593)***

☎ Meningococcal InfectionsMumps LOCALLY REPORTABLE DISEASES (If Applicable):

☎ Paralytic Shellfish PoisoningPelvic Inflammatory Disease (PID)

FAX ✆✉ Pertussis (Whooping Cough)☎ Plague, Human or Animal

* This form is designed for health care providers to report those diseases mandated by Title 17, California Code of Regulations (CCR). Failure to report is a misdemeanor (Heatlh and Safety Code §120295) and is a citable offense under the Medical Board of California Citation and Fine Program (Title 16, CCR, §1364.10 and 1364.11).** Failure to report is a citable offense and subject to civil penalty ($250) (Health and Safety Code §105200).*** The Confidential Physician Cancer Reporting Form may also be used. See Physician Reporting Requirements for Cancer Reporting in CA at: www.ccrcal.org.

PM110 (revised 10/30/08) page 2 of 2

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Home > Data > Statistics > STD Local Health Jurisdiction Data

Sexually Transmitted Diseases

Local Health Jurisdiction (LHJ) Data Summaries, 2006This section contains STD data summaries by local health jurisdiction (LHJ), as well as by the entire state. Data are broken down by: 1) disease, gender, and age group; 2) disease, gender, and race/ethnicity; and 3) disease and gender over time. Click here to return to the main STD data page.

Prior versions of these STD data summaries can be requested from the STD Control Branch Epidemiology Unit at [email protected] or 510-620-3400. For more information about STDs, please visit the STD Control Branch program page.

● California Local Health Jurisdiction STD Data Summaries - entire report (PDF, 1.5 MB) This report includes tables and graphs for all 61 local health jurisdictions as well as the entire state. To download individual jurisdiction PDF files, select from the LHJ table below.

● Data Sources (PDF)

● Data Limitations (PDF)

● State Summary Graphs and Tables (PDF)

LHJs: Alameda - Los Angeles LHJs: Madera - San Francisco LHJs: San Joaquin - Yuba

Alameda (PDF) Madera (PDF) San Joaquin (PDF)

Alpine (PDF) Marin (PDF) San Luis Obispo (PDF)

Amador (PDF) Marisposa (PDF) San Mateo (PDF)

Berkeley City (PDF) Mendocino (PDF) Santa Barbara (PDF)

Butte (PDF) Merced (PDF) Santa Clara (PDF)

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http://www.cdph.ca.gov/data/statistics/Documents/STD-Data-LHJ-Alameda.pdf

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http://www.cdph.ca.gov/data/statistics/Documents/STD-Data-LHJ-SanJoaquin.pdf

http://www.cdph.ca.gov/data/statistics/Documents/STD-Data-LHJ-Alpine.pdf

http://www.cdph.ca.gov/data/statistics/Documents/STD-Data-LHJ-Marin.pdf

http://www.cdph.ca.gov/data/statistics/Documents/STD-Data-LHJ-SanLuisObispo.pdf

http://www.cdph.ca.gov/data/statistics/Documents/STD-Data-LHJ-Amador.pdf

http://www.cdph.ca.gov/data/statistics/Documents/STD-Data-LHJ-Mariposa.pdf

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STD Local Health Jurisdiction Data

Calaveras (PDF) Modoc (PDF) Santa Cruz (PDF)

Colusa (PDF) Mono (PDF) Shasta (PDF)

Contra Costa (PDF) Monterey (PDF) Sierra (PDF)

Del Norte (PDF) Napa (PDF) Siskiyou (PDF)

El Dorado (PDF) Nevada (PDF) Solano (PDF)

Fresno (PDF) Orange (PDF) Sonoma (PDF)

Glenn (PDF) Pasadena City (PDF) Stanislaus (PDF)

Humboldt (PDF) Placer (PDF) Sutter (PDF)

Imperial (PDF) Plumas (PDF) Tehama (PDF)

Inyo (PDF) Riverside (PDF) Trinity (PDF)

Kern (PDF) Sacramento (PDF) Tulare (PDF)

Kings (PDF) San Benito (PDF) Tuolumne (PDF)

Lake (PDF) San Bernardino (PDF) Ventura (PDF)

Lassen (PDF) San Diego (PDF) Yolo (PDF)

Long Beach City (PDF) San Francisco (PDF) Yuba (PDF)

Los Angeles (PDF)

Birth Tables for Teens and Young AdultsBirth rates for teens and young adults, by local health jurisdiction and race/ethnicity:

● 2000-2006 Birth Rates for Females Ages 15-19 by LHJ and Race/Ethnicity (PDF)

● 2000-2006 Birth Rates for Females Ages 20-24 by LHJ and Race/Ethnicity (PDF)

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http://www.cdph.ca.gov/data/statistics/Documents/STD-Data-LHJ-Colusa.pdf

http://www.cdph.ca.gov/data/statistics/Documents/STD-Data-LHJ-Mono.pdf

http://www.cdph.ca.gov/data/statistics/Documents/STD-Data-LHJ-Shasta.pdf

http://www.cdph.ca.gov/data/statistics/Documents/STD-Data-LHJ-ContraCosta.pdf

http://www.cdph.ca.gov/data/statistics/Documents/STD-Data-LHJ-Monterey.pdf

http://www.cdph.ca.gov/data/statistics/Documents/STD-Data-LHJ-Sierra.pdf

http://www.cdph.ca.gov/data/statistics/Documents/STD-Data-LHJ-DelNorte.pdf

http://www.cdph.ca.gov/data/statistics/Documents/STD-Data-LHJ-Napa.pdf

http://www.cdph.ca.gov/data/statistics/Documents/STD-Data-LHJ-Siskiyou.pdf

http://www.cdph.ca.gov/data/statistics/Documents/STD-Data-LHJ-ElDorado.pdf

http://www.cdph.ca.gov/data/statistics/Documents/STD-Data-LHJ-Nevada.pdf

http://www.cdph.ca.gov/data/statistics/Documents/STD-Data-LHJ-Solano.pdf

http://www.cdph.ca.gov/data/statistics/Documents/STD-Data-LHJ-Fresno.pdf

http://www.cdph.ca.gov/data/statistics/Documents/STD-Data-LHJ-Orange.pdf

http://www.cdph.ca.gov/data/statistics/Documents/STD-Data-LHJ-Sonoma.pdf

http://www.cdph.ca.gov/data/statistics/Documents/STD-Data-LHJ-Glenn.pdf

http://www.cdph.ca.gov/data/statistics/Documents/STD-Data-LHJ-Pasadena.pdf

http://www.cdph.ca.gov/data/statistics/Documents/STD-Data-LHJ-Stanislaus.pdf

http://www.cdph.ca.gov/data/statistics/Documents/STD-Data-LHJ-Humboldt.pdf

http://www.cdph.ca.gov/data/statistics/Documents/STD-Data-LHJ-Placer.pdf

http://www.cdph.ca.gov/data/statistics/Documents/STD-Data-LHJ-Sutter.pdf

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http://www.cdph.ca.gov/data/statistics/Documents/STD-Data-LHJ-Tehama.pdf

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http://www.cdph.ca.gov/data/statistics/Documents/STD-Data-LHJ-Yolo.pdf

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http://www.cdph.ca.gov/data/statistics/Documents/STD-Data-LHJ-Yuba.pdf

http://www.cdph.ca.gov/data/statistics/Documents/STD-Data-LHJ-LosAngeles.pdf

http://www.cdph.ca.gov/data/statistics/Documents/STD-Data-BirthRates-Females-1519.pdf




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California – Chlamydia, Gonorrhea, and P&S SyphilisRates by County, 2008

Chlamydia

Gonorrhea

P&S Syphilis

Note: Rates are per 100,000 population.Source: California Department of Public Health, STD Control Branch

Rate per 100,0000 cases reported< 100100 to 199200 to 299300 +

Rate per 100,0000 cases reported< 2525 to 4950 to 99100 +

Rate per 100,0000 cases reported<= 0.50.6 to 2> 2

California Local Health Jurisdiction STD Data Summaries, 2008 Provisional Data (July 2009)

46

1:100

California – Chlamydia, Gonorrhea, and P&S SyphilisRates by Age Group (2008), Race/Ethnicity (2008), and Year

0−9 10−14 15−19 20−24 25−29 30−34 35−44 45+

Age Group

0

500

1000

1500

2000

2500

3000

Chlamydia

Nat. Am. A/PI Black Latino White

Race/Ethnicity*

0

500

1000

1500 Chlamydia

1999 2000 2001 2002 2003 2004 2005 2006 2007 2008

0

100

200

300

400

500

600

Year

Chlamydia

0−9 10−14 15−19 20−24 25−29 30−34 35−44 45+

Age Group

0

50

100

150

200

250

300

Gonorrhea


Race/Ethnicity*

0

100

200

300

Gonorrhea

1999 2000 2001 2002 2003 2004 2005 2006 2007 2008

0

20

40

60

80

100

120

Year

Gonorrhea

0−9 10−14 15−19 20−24 25−29 30−34 35−44 45+

Age Group

0

5

10

15

20

25

P&S Syphilis


Race/Ethnicity*

0

5

10

15

20

25

30

P&S Syphilis

1999 2000 2001 2002 2003 2004 2005 2006 2007 2008

0

2

4

6

8

10

12

Year

P&S Syphilis

Female Male Female Male

* Race data may be missing for a substantial number of cases. See the Data Limitations page for further information.Note: Rates are per 100,000 population.

Source: California Department of Public Health, STD Control Branch


47

1 Gender specific age groups and race/ethnicity percent calculations exclude "Not Specified" from the denominator. 2 Overall state rates were calculated using the July 1 county population estimates from the Department of Finance. (For California, the July 1, 2008 estimate is 38,148,493). Note: Rates are per 100,000 population. Source: California Department of Public Health, STD Control Branch

California State – Chlamydia, Gonorrhea, and Early Syphilis Cases and Rates Tables for 2008

Chlamydia Gonorrhea P&S Syphilis Early Latent Syphilis Population Gender & Age Group

Cases Percent1 Rate Cases Percent1 Rate Cases Percent1 Rate Cases Percent1 Rate Number Percent1

STATE TOTAL 149,070 100.0% 390.8 25,445 100.0% 66.7 2,180 100.0% 5.7 1,641 100.0% 4.3 38,246,598 100.0%

Female Total 104,400 70.0% 544.9 11,460 45.0% 59.8 108 5.0% 0.6 165 10.1% 0.9 19,159,540 50.1% Ages 00 – 09 25 0.0% 0.9 6 0.1% 0.2 0 0.0% 0.0 0 0.0% 0.0 2,642,084 13.8% 10 – 14 1,141 1.1% 83.7 201 1.8% 14.7 0 0.0% 0.0 0 0.0% 0.0 1,363,925 7.1% 15 – 19 34,616 33.3% 2,354.4 3,837 33.6% 261.0 13 12.0% 0.9 25 15.2% 1.7 1,470,271 7.7% 20 – 24 38,351 36.8% 2,907.3 3,606 31.6% 273.4 20 18.5% 1.5 29 17.6% 2.2 1,319,107 6.9% 25 – 29 16,527 15.9% 1,349.5 1,787 15.6% 145.9 21 19.4% 1.7 31 18.8% 2.5 1,224,642 6.4% 30 – 34 6,810 6.5% 561.4 851 7.4% 70.1 15 13.9% 1.2 30 18.2% 2.5 1,213,119 6.3% 35 – 44 5,046 4.8% 182.3 798 7.0% 28.8 30 27.8% 1.1 27 16.4% 1.0 2,767,810 14.4% 45 + 1,573 1.5% 22.0 339 3.0% 4.7 9 8.3% 0.1 23 13.9% 0.3 7,158,582 37.4% Not Specified 311 0.3% - 35 0.3% - 0 0.0% - 0 0.0% -

Male Total 44,130 29.6% 231.2 13,852 54.4% 72.6 2,071 95.0% 10.9 1,474 89.8% 7.7 19,087,058 49.9% Ages 00 – 09 13 0.0% 0.5 6 0.0% 0.2 0 0.0% 0.0 0 0.0% 0.0 2,754,497 14.4% 10 – 14 179 0.4% 12.6 41 0.3% 2.9 0 0.0% 0.0 1 0.1% 0.1 1,424,192 7.5% 15 – 19 8,643 19.7% 558.0 1,956 14.2% 126.3 61 2.9% 3.9 34 2.3% 2.2 1,548,834 8.1% 20 – 24 14,909 33.9% 1,047.0 3,600 26.1% 252.8 256 12.4% 18.0 135 9.2% 9.5 1,424,041 7.5% 25 – 29 9,201 20.9% 690.5 2,576 18.7% 193.3 294 14.2% 22.1 213 14.5% 16.0 1,332,591 7.0% 30 – 34 4,308 9.8% 339.6 1,644 11.9% 129.6 305 14.7% 24.0 175 11.9% 13.8 1,268,480 6.6% 35 – 44 4,546 10.3% 158.5 2,490 18.0% 86.8 662 32.0% 23.1 519 35.3% 18.1 2,867,338 15.0% 45 + 2,160 4.9% 33.4 1,489 10.8% 23.0 493 23.8% 7.6 394 26.8% 6.1 6,467,085 33.9% Not Specified 171 0.4% - 50 0.4% - 0 0.0% - 3 0.2% -

Chlamydia Gonorrhea P&S Syphilis Early Latent Syphilis Population Gender & Race/Ethnicity

Cases Percent1 Rate Cases Percent1 Rate Cases Percent1 Rate Cases Percent1 Rate Number Percent1

STATE TOTAL 149,070 100.0% 390.8 25,445 100.0% 66.7 2,180 100.0% 5.7 1,641 100.0% 4.3 38,246,598 100.0%

Female Total 104,400 70.0% 544.9 11,460 45.0% 59.8 108 5.0% 0.6 165 10.1% 0.9 19,159,540 50.1%American Indian/Alaska Native 361 0.5% 308.5 48 0.6% 41.0 0 0.0% 0.0 0 0.0% 0.0 117,022 0.6%Asian/Pacific Islander 4,169 6.1% 172.3 294 3.9% 12.1 6 5.8% 0.2 7 4.3% 0.3 2,419,866 12.6%Black/African-American 15,127 22.3% 1,303.1 3,721 48.8% 320.6 33 32.0% 2.8 43 26.4% 3.7 1,160,808 6.1%Latina/Hispanic 35,083 51.7% 517.6 2,165 28.4% 31.9 36 35.0% 0.5 82 50.3% 1.2 6,778,033 35.4%White 13,065 19.3% 157.8 1,394 18.3% 16.8 28 27.2% 0.3 31 19.0% 0.4 8,278,196 43.2%Other/Multi/Not Specified 36,595 35.1% - 3,838 33.5% - 5 4.6% - 2 1.2% - 405,615 2.1%Male Total 44,130 29.6% 231.2 13,852 54.4% 72.6 2,071 95.0% 10.9 1,474 89.8% 7.7 19,087,058 49.9%American Indian/Alaska Native 103 0.4% 91.0 35 0.4% 30.9 7 0.4% 6.2 8 0.6% 7.1 113,176 0.6%Asian/Pacific Islander 1,470 5.1% 65.7 392 4.2% 17.5 97 4.9% 4.3 53 3.7% 2.4 2,236,757 11.7%Black/African-American 7,888 27.4% 710.3 3,655 39.0% 329.1 307 15.6% 27.6 207 14.5% 18.6 1,110,450 5.8%Latina/Hispanic 12,953 45.0% 182.9 2,573 27.5% 36.3 661 33.5% 9.3 582 40.7% 8.2 7,080,421 37.1%White 6,388 22.2% 78.4 2,709 28.9% 33.2 902 45.7% 11.1 581 40.6% 7.1 8,150,042 42.7%Other/Multi/Not Specified 15,328 34.7% - 4,488 32.4% - 97 4.7% - 43 2.9% - 396,212 2.1%


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* Confidence intervals were calculated using Poisson exact method; not shown for counties with zero cases.Note: Rates are per 100,000 population.

Source: California Department of Public Health, STD Control Branch

California – Chlamydia, Gonorrhea, and P&S SyphilisRanking of County Rates for 2008

(with 95% Confidence Intervals*)


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