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The United States has the dubious distinction of leading the industrialized world in overall rates of sexually transmitted diseases (STDs), with 12 million new cases annually. About 3 million teenagers contract an STD each year, and many will have long-term health problems as a result. Women and adolescents are particularly vulnerable to these diseases and their health consequences. In addition, STDs increase the risk of HIV transmission. The Hidden Epidemic examines the scope of sexually transmitted infections in the United States and provides a critical assessment of the nation's response to this public health crisis. The book identifies the components of an effective national STD prevention and control strategy and provides direction for an appropriate response to the epidemic. Recommendations for improving public awareness and education, reaching women and adolescents, integrating public health programs, training health care professionals, modifying messages from the mass media, and supporting future research are included. The book documents the epidemiological dimensions and the economic and social costs of STDs, describing them as "a secret epidemic" with tremendous consequences. The committee frankly discusses the confusing and often hypocritical nature of how Americans deal with issues regarding sexualityâ€"the conflicting messages conveyed in the mass media, the reluctance to promote condom use, the controversy over sex education for teenagers, and the issue of personal blame. The Hidden Epidemic identifies key elements of effective, culturally appropriate programs to promote healthy behavior by adolescents and adults. It examines the problem of fragmentation in STD services and provides examples of communities that have formed partnerships between stakeholders to develop integrated approaches. The committee's recommendations provide a practical foundation on which to build an integrated national program to help young people and adults develop habits of healthy sexuality. The Hidden Epidemic was written for both health care professionals and people without a medical background and will be indispensable to anyone concerned about preventing and controlling STDs.
Adolescence is a time when youth make decisions, both good and bad, that have consequences for the rest of their lives. Some of these decisions put them at risk of lifelong health problems, injury, or death. The Institute of Medicine held three public workshops between 2008 and 2009 to provide a venue for researchers, health care providers, and community leaders to discuss strategies to improve adolescent health.
Adolescence is a developmental period of accelerating physical, psychological, social! cultural, and cognitive development, often characterized by confronting and surmounting a myriad of challenges and establishing a sense of self-identity and autonomy. It is also, unfortunately, a period fraught with many threats to the health and well-being of adoles cents and with substantial consequent impairment and disability. Many of the adverse health consequences experienced by adolescents are, to a large extent, the result of their risk behaviors. Many adolescents today, and perhaps an increasing number in the future, are at risk for death, disease, and other adverse health outcomes that are not primarily biomedical in origin. In general, there has been a marked change in the causes of morbidity and mortality among adolescents. Previously, infectious diseases accounted for a dispro portionate share of adolescent morbidity and mortality. At present, however, the over whelming toll of adolescent morbidity and mortality is the result of lifestyle practices.
Model Programs for Adolescent Sexual Health is a directory of the most promising and proven effective sexual education and prevention programs in the United States. The programs included in this volume were selected for their demonstrated positive impact on STI, pregnancy, and HIV/AIDS-related risk behaviors by a group of eminent HIV/AIDS expert scientists. The programs also show effective prevention strategies aimed at a variety of ages (children, adolescents, college students); a variety of ethnic and cultural orientations (Latino, African-American, GLBT, and more); and for use in a variety of settings (schools, community settings, medical clinics, and more). The following information is provided for each program listed in the directory: The Program Abstract summarizes the program, including its target clientele, site, approach, components, length, staffing requirements, program materials, and implementation costs The Program Rationale and History explains how the program was designed, and its underlying theoretical framework and assumptions Program Schedule explains the goals and activities of each program session Program Materials explains the necessary materials needed to implement the program (note that not all materials are included in this directory; however all can be ordered from Sociometrics) How to Implement the Program explains the ground rules and other necessary steps prior to implementation Evaluating the Program explains how the program was evaluated for its effectiveness
Although sexual activity is common among teenagers, it is not as widespread, and does not begin as early, as most adults believe. This report provides detailed data and analysis of sex among adolescents. Adolescent sexual activity is grouped in ten categories: (1) Rites of passage; (2) The context of adolescents' lives; (3) Sex among teenagers; (4) Risks and prevention of unintended pregnancy and STDs; (5) Incidence and consequences of STDs; (6) Adolescent pregnancy; (7) Outcomes of adolescent pregnancies; (8) Adolescent mothers and their children; (9) Organized responses to adolescent sexual and reproductive behavior; and (10) Where do we go from here? Although young people's sexual behavior today is broadly seen as problematic, no consensus exists as to what the problem is. Most adolescents have always experienced sex, but in the past it was closely linked to marriage, especially for young women. However, over the last century, puberty has slowly moved to earlier ages, as has the initiation of sexual activity, while marriage has been postponed to later years. Adolescents live in a more diverse country than the one their parents knew -- society, family, violence, and sexual messages differ dramatically from the standards of the previous generation. Included in this booklet are numerous graphs. Citations appear for all data. (Contains over 200 references.) (RJM)
Unintended pregnancy and sexually transmitted diseases, including HIV, continue to be important problems among young people in the United States. These problems can be addressed effectively if young people reduce their sexual risk behaviors. This book discusses the measures of lowering sexual risk.
One in five people in the United States had a sexually transmitted infection (STI) on any given day in 2018, totaling nearly 68 million estimated infections. STIs are often asymptomatic (especially in women) and are therefore often undiagnosed and unreported. Untreated STIs can have severe health consequences, including chronic pelvic pain, infertility, miscarriage or newborn death, and increased risk of HIV infection, genital and oral cancers, neurological and rheumatological effects. In light of this, the Centers for Disease Control and Prevention, through the National Association of County and City Health Officials, commissioned the National Academies of Sciences, Engineering, and Medicine to convene a committee to examine the prevention and control of sexually transmitted infections in the United States and provide recommendations for action. In 1997, the Institute of Medicine released a report, The Hidden Epidemic: Confronting Sexually Transmitted Diseases. Although significant scientific advances have been made since that time, many of the problems and barriers described in that report persist today; STIs remain an underfunded and comparatively neglected field of public health practice and research. The committee reviewed the current state of STIs in the United States, and the resulting report, Sexually Transmitted Infections: Advancing a Sexual Health Paradigm, provides advice on future public health programs, policy, and research.
Alcohol use disorder (AUD) is a major public health problem in the United States. The estimated 12-month and lifetime prevalence values for AUD are 13.9% and 29.1%, respectively, with approximately half of individuals with lifetime AUD having a severe disorder. AUD and its sequelae also account for significant excess mortality and cost the United States more than $200 billion annually. Despite its high prevalence and numerous negative consequences, AUD remains undertreated. In fact, fewer than 1 in 10 individuals in the United States with a 12-month diagnosis of AUD receive any treatment. Nevertheless, effective and evidence-based interventions are available, and treatment is associated with reductions in the risk of relapse and AUD-associated mortality. The American Psychiatric Association Practice Guideline for the Pharmacological Treatment of Patients With Alcohol Use Disorder seeks to reduce these substantial psychosocial and public health consequences of AUD for millions of affected individuals. The guideline focuses specifically on evidence-based pharmacological treatments for AUD in outpatient settings and includes additional information on assessment and treatment planning, which are an integral part of using pharmacotherapy to treat AUD. In addition to reviewing the available evidence on the use of AUD pharmacotherapy, the guideline offers clear, concise, and actionable recommendation statements, each of which is given a rating that reflects the level of confidence that potential benefits of an intervention outweigh potential harms. The guideline provides guidance on implementing these recommendations into clinical practice, with the goal of improving quality of care and treatment outcomes of AUD.