Teenagers and the risks of sexually transmitted diseases: a need for the provision of balanced information.

Mellanby, Alex; Phelps, F. A.; Lawrence, C. J.; Tripp, J. H.

doi:10.1136/sti.68.4.241

Cited by 17 publications

(12 citation statements)

References 13 publications

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“…Early intercourse plus pattern of sexual activity and behaviour puts teenagers at signi® cant risk of sexually transmitted infections and unintended pregnancies for reasons including poor contraceptive use, multiple sexual partners, inadequate perception of risk and lack of information 4 . Underage conception rates in Britain are the highest in Western Europe and approximately 40% result in live births 5 .…”

Section: Introductionmentioning

confidence: 99%

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Sexual health needs of the under-16s attending an STI clinic: what are they and are they being addressed?

2003

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A retrospective analysis was performed on case notes of patients aged less than 16 years who attended a Department of Genito-Urinary Medicine as a new case in 1998. Seventy-four case notes were reviewed. There was a high rate of sexually transmitted infection (STI) (gonorrhoea six [8%], chlamydia 23 [31%], genital warts nine [12%], trichomonas seven [10%]) and low condom (30, 41%) and other contraceptive use (21 females [35%], six males [60%]). Many female attendees were victims of current or previous sexual abuse (eight, 8%) and/or exploitation, and for a further eight (8%) abuse/exploitation was considered possible; little reference was made to this in the notes. Thirty-three (45%) attendees were seen by junior members of staff, and only 49 (60%) were seen by a health adviser (42 females, seven males [60%]). Young attendees have a high STI rate, low contraceptive use and a significant minority are victims of abuse. Genitourinary medicine clinics need to provide a full sexual health service to this vulnerable group and have guidelines in place to assess for sexual abuse. Recommendations on how to achieve this are given.

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Section: Introductionmentioning

confidence: 99%

“…It has been recommended that the possibility of child abuse should be considered in any child in whom an STI is diagnosed 4 . This leads to con¯ict between the duty of con® dentiality to the young person who may disclose sexual abuse or sexual coercion with the duty to protect the child as laid down in The Children Act of 1989.…”

Section: Introductionmentioning

confidence: 99%

Sexual health needs of the under-16s attending an STI clinic: what are they and are they being addressed?

2003

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“…[7][8][9][10] The sense of invulnerability to STIs that many young people display may be explained by a media focus on HIV/AIDS to the exclusion of other STIs, creating a perception among young people that HIV/ AIDS is the most common STI. 4 Studies have found alarmingly low levels of knowledge about STIs other than HIV infection 5 and concluded that while the media provides information on HIV/AIDS, balanced information about other STIs is not provided. 5 Young people often develop a 'lay epidemiological' response to observations of cases of illness in personal networks.…”

mentioning

confidence: 99%

“…4 Studies have found alarmingly low levels of knowledge about STIs other than HIV infection 5 and concluded that while the media provides information on HIV/AIDS, balanced information about other STIs is not provided. 5 Young people often develop a 'lay epidemiological' response to observations of cases of illness in personal networks. 4,11 Few young people in the developed world have personal knowledge of individuals with HIV or AIDS which reduces their perception of personal risk, a major factor in altering behaviour, and may partially account for their low use of protective contraception.…”

mentioning

confidence: 99%

“…5,6 If they believe that HIV is the most common STI, and this is something they consider outside their own experience and thus rare, it is then unlikely that teenagers will consider other STIs a threat. 5 The acquisition of an STI is also something that can be kept hidden from the wider peer group as there are no Results: 1,136 students participated in the study, half of whom were sexually active.…”

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confidence: 99%

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Young people's use of condoms and their perceived vulnerability to sexually transmitted infections

Abel

Brunton

2005

Australian and New Zealand Journal of Public Health

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Objective: Although sexually transmitted infections (STIs) are most prevalent among young people, they do not use condoms consistently to prevent infection. This study examined young people's perceptions of vulnerability to STIs and pregnancy. Method: A cross‐sectional survey on sexual behaviour was carried out on a stratified random sample of school‐going Year 12 and Year 13 young people aged 16–18 years in Christchurch, New Zealand. Results: 1,136 students participated in the study, half of whom were sexually active. Fewer than half of the sexually active participants (44.6%) used condoms on every occasion of sexual intercourse. Only 23% of participants reported that they felt vulnerable to acquiring an STI, with a quarter of respondents reporting not using condoms because they did not think that either they or their partner had an infection, and a quarter reported not using condoms because they used other contraceptive measures. Conclusions: The results of this study support the premise that young people are more concerned about preventing unwanted pregnancy than STIs. Their perception of low risk of acquiring STIs is not without substance, however, as it was established that there was a low prevalence of Chlamydia trachomatis among this school‐going population. The key to achieving more consistent condom use for STI prevention for young people may be through finding ways to get them to accept that they are vulnerable to STIs, despite the low prevalence among their peers, because the consequences of infection are far‐reaching.

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Comparing Generalist and Specialty Care

Donohoe

1998

Arch Intern Med

166

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Policymakers, managed care organizations, medical educators, and the general public are showing an increasing interest in the amount and quality of care provided by generalists and subspecialists. This article reviews studies comparing the knowledge base of and quality of care provided by these 2 groups of physicians. English-language articles were identified through MEDLINE (1966-present) using the following keywords: generalist, generalism, (sub)specialist, (sub)specialty, (sub)specialization, consultation, referral, and quality of care, and through the bibliographies of these citations. All studies were evaluated. With respect to quality of care, only American studies were chosen. Data quality was assessed by me. Evidence is strongest that the knowledge base and quality of care provided by specialists exceeds those of generalists for certain conditions such as myocardial infarction, depression, and acquired immunodeficiency syndrome. Differences in many other areas are multifactorial, and often a function of study design or patient selection. The differences, however, are not as striking or important to the health of the public at large as those deficiencies in disease management, preventive care, and health maintenance that are common to all physicians. Furthermore, overuse of diagnostic and therapeutic modalities by certain specialists leads to increased costs with either no benefit or added risks to patients. The quality and coordination of care provided by generalists and specialists may be improved through changes in education and training, via quality improvement methods of providing patient care, and by increasing visit length and optimizing use of referrals and strategies for generalist-specialist comanagement. Further study of these areas is warranted and should concentrate on outcomes.Arch Intern Med. 1998;158:1596-1608 This article evaluates the amount and quality of care provided by generalists and specialists, a subject of increasing interest to medical educators, managed care organizations, and the general public. Weaknesses in the knowledge base of practicing physicians are reviewed, and investigations attempting to compare generalist and specialty care for common conditions are described. While some of the differences in quality of care may be due to generalists' knowledge deficits, many are secondary to system factors and most are remediable. Furthermore, disparities between generalist and specialty care likely have less impact on the population's health than the deficiencies all physicians share. After discussing the nature of these deficiencies, I explain how they might be corrected and how generalists and specialists can work together, building on their respective strengths, to improve the quality of health care in this country.

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Teenagers and the risks of sexually transmitted diseases: a need for the provision of balanced information.

Cited by 17 publications

References 13 publications

Sexual health needs of the under-16s attending an STI clinic: what are they and are they being addressed?

Sexual health needs of the under-16s attending an STI clinic: what are they and are they being addressed?

Young people's use of condoms and their perceived vulnerability to sexually transmitted infections

Comparing Generalist and Specialty Care

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