Characteristics associated with genital herpes testing among young adults: assessing factors from two national data sets.

UNLABELLED: OBJECTIVES AND PARTICIPANTS: in the United States, genital herpes (GH) prevalence is 10.6% among 20- to 29-year-olds and about 90% of seropositive persons do not know their status. This study investigated individual characteristics associated with GH screening and diagnosis in sexually active young adults aged 18 to 24. METHODS: two data sets were analyzed: the National Longitudinal Study of Adolescent Health (Add Health) Wave III from 2001 to 2002 (n = 11,570) and the American College Health Association's (ACHA's) national survey of college students from 2000 to 2006 (n = 222,470). RESULTS: in Add Health, 18.4% of females and 7.1% of males self-reported GH testing in the previous 12 months, compared to 0.7% for self-reported GH diagnosis in ACHA. GH testing and diagnosis was strongly positively associated with a history of human immunodeficiency virus (HIV) testing and diagnosis of sexually transmitted infections (STIs) in the previous 12 months for both sexes. CONCLUSIONS: integrating herpes screening and testing into HIV and standard STI screening would identify more infections.

Show me the money: state contributions toward STD prevention, 2007.

The importance of state investment in sexually transmitted disease (STD) prevention has been discussed since the mid-1990s; however, little has become known about state public health funding for STD prevention. To establish a baseline understanding of state STD prevention funding, financial data for fiscal year 2007 were gathered by survey of state STD, immunization, laboratory, and hepatitis program directors. Results revealed that on average states funded 25.8 percent of their total STD prevention budgets and invested $0.23 per capita in STD prevention. The percentage of state funding in the total state STD prevention budget ranged from 0 percent to 70.2 percent, and state investment in STD prevention ranged from $0.00 to $1.55 per capita. The direction and expenditure of state STD prevention resources was also examined. This study strengthens the national understanding of what states are doing to fund STD prevention, and it broadens state public health awareness of the overall STD prevention investment at the state level. The inclusion of Medicaid data and expenditure of federal resources by states would strengthen the study and assist longitudinal analyses focused on the impact of investment on epidemiologic indicators.

Recommendations for Performing Internet-Based Research on Sensitive Subject Matter with "Hidden" or Difficult-to-Reach Populations.

Since the mid-1990s, the rapidly increasing popularity of the Internet has contributed to a situation in which many men turn to Web sites to find sex partners with whom they can engage in risky behaviors. Scholars only recently began to examine the role of the Internet in harm-seeking and help-seeking behaviors. They are just now beginning to study and understand how to apply public health promotion principles to people using the Internet. Due in part to the relative newness of the Internet on the public health landscape, scholars wishing to conduct research or to implement health promotion programs online should consider a variety of challenges to doing such work-challenges that differ from those typically faced when undertaking similar work in other types of venues offline. The purpose of this article is to address several of these research considerations. In particular, the present authors wish to provide researchers and health care specialists with key considerations when developing their own Internet-based research or health promotion programs. We also wish to furbish readers with some experience-based suggestions about how to avoid the potential pitfalls of conducting Internet-based studies. Moreover, our emphasis is on how to develop such programs when they are targeting hard-to-reach or "hidden" populations and/or when they deal with sensitive subject matter. Recommendations pertaining to the planning, recruitment, implementation, and evaluation stages of doing professional work online are provided.

Genital herpes education and counselling: testing a one-page 'FAQ' intervention.

Approximately 17% of adults in the USA have antibodies to herpes simplex virus type 2 (HSV-2), 85-90% of whom are unaware of their infection. Diagnosed patients are more likely to detect HSV reactivation, disclose infection status to partner(s) and employ risk-reduction strategies; therefore, diagnosing more cases may reduce herpes transmission rates. Providers are reluctant to identify genital herpes because of potentially lengthy counselling visits or discomfort in dealing with patients' emotional reactions. This study tested the efficacy of a one-page frequently-asked-questions (FAQ) sheet regarding length of initial diagnostic visit, patient satisfaction with topics covered, provider's coverage of topics and resources/referrals provided to patients. Data from 147 patients and 26 providers were analysed. When pre- and post-FAQ sheet data were compared, diagnostic visit time was not substantially reduced but there were favourable trends in patient satisfaction levels on some topics, and providers covered more topics and offered more resources. This FAQ was useful in simplifying topics, providing prompts for providers and resources for patients. While this FAQ sheet appears favourable in this exploratory study, more investigation is needed to measure the degree to which patients use and understand the FAQ sheet, and find it to be a helpful tool.

Common questions about herpes: analysis of chat-room transcripts.

Patients diagnosed with genital herpes typically undergo a period of psychological adjustment. Although healthcare providers can play a key role in this adjustment, in several patient surveys patients have expressed dissatisfaction with the information and counselling offered by professionals. To address this gap, providers must first identify the common questions and myths that are not addressed, or are addressed inadequately. This article is that first step. Through a content analysis of herpes chat-room transcripts captured on their website from autumn 2001 to spring 2006, researchers from the American Social Health Association identified common herpes questions and myths. The 1968 chat passages were coded into 12 themes and 50 sub-themes. Frequently, visitors' questions concerned transmission, symptoms and diagnosis followed by natural history, psychosocial issues and treatment options. The results of this analysis will aid in the creation of tailored messages to address common factual questions and provide psychosocial support.

Viral hepatitis prevention education: what do people and providers need to know?

Although hepatitis has been on the decline overall, tens of thousands of new infections are still projected for the coming years. Few studies have investigated the basic (core) educational concepts that are essential to understanding viral hepatitis. This study surveyed three categories of people: (hepatitis 'experts', healthcare providers, and patients) to gather ideas for core concepts for two populations (healthcare providers and patients). The first round of data collection generated ideas for concepts and the second round provided rank orderings. Statistical analyses standardized the suggestions, and provided a numerical system of inclusion and exclusion of concepts. From this process, four lists of core concepts were compiled: hepatitis A, B, and C (individually) for healthcare providers, and hepatitis A, B, and C (combined) for patients. These concepts are useful for educators, nurses and trainers in designing hepatitis prevention materials, counseling patients about hepatitis prevention, and teaching healthcare providers about hepatitis prevention.

Evaluating a teen STD prevention Web site.

PURPOSE: Teens are at higher risk than other age groups for acquiring sexually transmitted diseases (STDs) because of biological and behavioral risk factors, but they have few STD prevention resources. Little is known about how teens use the Internet to seek this information. A pilot study was conducted to measure audience and information-seeking characteristics of the www.iwannaknow.org Web site. METHODS: In addition to a formative content analysis and a usability study, an online survey was designed, pilot tested, revised, and launched for three months. This paper briefly describes the first two formative study components, and then focuses on the online survey. RESULTS: The content analyses and the usability tests were useful for revising the site content and aesthetics and preparing the online survey. Fewer than half of all participants (N=3,489) were between 13 and 17 (n=1,242), the intended site demographic. Most accessed the Internet from home. The most frequent topic of interest was sexual expression, followed by teen sexuality, virginity, relationships, contraception, and then STD information and these varied by age and gender. CONCLUSIONS: Methods and findings will assist researchers, Web site developers, and health educators to refine these evaluation methods, develop effective Web sites, and tailor STD prevention messages by age group and gender. The Internet is a cost-effective method for educating teens and those who care for or work with teens about STD risks and prevention, however, more research is needed to assess the behavioral effects of online interventions.

Integrating hepatitis B prevention into sexually transmitted disease services: U.S. sexually transmitted disease program and clinic trends--1997 and 2001.

OBJECTIVE: The objective of this study was to measure the progress since 1997 of implementing sexually transmitted disease (STD) clinic-based recommendations for hepatitis B prevention. GOAL: The goal of this study was to assess improvements since 1997 in hepatitis B prevention integration in STD services. STUDY: Repeating a 1997 survey, in 2001, a survey was sent to state, municipal, and territorial STD program managers, previously surveyed clinic managers, and a national sample of 500 STD clinics. RESULTS: Large increases were found in the percentage of clinics offering hepatitis B vaccine (from 61% to 82%), providing education (49% to 84%), and accessing federal vaccine programs (48% to 84%). Twice as many program managers considered all patients with STDs eligible for hepatitis B vaccination. Lack of resources and patient noncompliance with vaccine series completion were program barriers. CONCLUSIONS: Hepatitis B policies and vaccination and education efforts in STD clinics have improved; however, many barriers reported in 1997 remained in 2001.

Education and counselling for genital herpes: perspectives from patients.

The incidence and prevalence of genital herpes continue to increase in the USA, and the availability of new, accurate serological tests for herpes simplex virus (HSV) may identify millions of previously unrecognized cases. Newly diagnosed genital HSV infections place a serious burden on healthcare providers in terms of education and counselling. The study was initiated to assess the need for and potential use of an improved system for education and counselling of patients newly diagnosed with genital herpes. Patients' perspectives on current and ideal care, as well as barriers to education and counselling and recommendations are discussed. In addition, implications for practice and recommendations for future research are suggested.