National Coalition of STD Directors’ Meeting Highlights

Infertility Prevention Program MeetingNovember 1, 2006

Navigating Change

• CDC statement of vision – Dr. Fenton

• Integration of new & old tech for case management

• Attitudes toward adolescent sexual health

• Herpes simplex virus

• Human papillomavirus

Federal vision Drs. Fenton & Douglas

• Priority STD areas– STI-related HIV transmission– Impaired fertility– Adverse pregnancy outcomes– STI-related cancer

Federal vision Drs. Fenton & Douglas

• Reality: shrinking budgets, field staff attrition

• Response: includes creating synergies & economies of scale via integration across categories, and fostering sound, work-reducing legislation (EPT)

• Block granting for STD unlikely

• ? Will our federal grants permit us to do less with less ?

Bringing together old and new technologies

• Adoption of core health dept competencies

• Locally-developed PHA training and certification programs

• Getting hip to new technologies– Need to get staff access to/ conversant with:

• Internet cruising portals• Using cell phones, PDAs to learn about partners

*ISIS= Internet Sexuality Info Services

Bringing together old and new technologies

• Getting hip to new technologies (cont’d)– Locales need to develop methods to notify

partners on the internet• By patients

– In person– Anonymously – InSpot System by ISIS*

• By Health Dept

• Ensuring confidentiality: increased reliance on technology poses new vulnerabilities

Attitudes toward adol sexual health

• Comparison of Dutch and American parental attitudes– Normalization (i.e. readiness, self-regulation)– Dramatization (any sexuality prior to self-

sufficiency = bad; raging hormones out of control)

Attitudes toward adol sexual health• Abstinence only funding has resulted in an

erosion of comprehensive sexuality education……we need to learn to work better with abstinence only grantees.

• Examples of successful collaboration given. Included: – review of the laws for loopholes– Built coalition composed of divergent viewpoints

and a willingness to learn– Developed statements of agreement

Attitudes toward adol sexual health

• Great American Condom Campaign– Domestic college campus-focused condom

distribution campaign– Circumvent institutional politics by:

• Establishment as political campaign (vs. 501c3)• Using students/ dorm rooms as conveyance• Condomcampaign.org

Herpes simplex virus

• Important co-factor in HIV transmission

• Importance of type-specific serologic testing– Asymptomatics can be taught to recognize Sx

and take precautions at those times– Asymptomatics can be taught re: asymptomatic

shedding and need for vigilance– Discordant couples can be identified &

counseled

Human Papillomavirus

• Most infxns transient (incl oncogenic strains)

• Correct/ consistent condom use prevents transmission

• Gardisil quadrivalent vaccine prevents types 6/11 (cause of genital warts) and types 16/18 (oncogenic)

Human Papillomavirus- Vaccine

• Vax effective and safe

• Best if given before sexual debut, but useful even if already sexually active

• Recs:– Routinely for females 11-12 years– Catch-up vax for 13-26 years– NO CHANGE in Pap screening guidelines

• Male studies underway

Human Papillomavirus- Vaccine

• Need to get together leadership, coordination and support for HPV vax implementaiton– Immunization– STD Control– Cancer detection– Women’s health / Family Planning/ Maternal-Infant

health– HIV/AIDS

Thank You !