ENHANCING ADOLESCENT SEXUAL HEALTH
|
|
- Terence Felix Neal
- 7 years ago
- Views:
Transcription
1 ENHANCING ADOLESCENT SEXUAL HEALTH SERVICES BY CREATING AN ADOLESCENT MEDICAL HOME Gale R. Burstein, MD, MPH, FAAP, FSAHM Commissioner, Erie County Department of Health, Associate Clinical Professor, SUNY at Buffalo School of Medicine and Biomedical Sciences, Buffalo, NY Faculty, NYC STD/HIV Prevention Training Center Agenda Making the case: Why adolescent sexual health services matter Routinizing sexual health in 1º care: Creating an Adolescents Medical Home Questions 1
2 Disclosures Financial relationships : Dr. Burstein wishes to disclose she has no financial interests or other relationships with the manufacturers of commercial products, suppliers of commercial services, or commercial supporters. I would like to acknowledge NYCDOHMH and NYSDOH for their assistance and data. 2
3 WHY IT MATTERS Overview STD Burden >19 million STD cases occur in USA each year Disproportionately among young people and racial and ethnic minority populations Estimated $17 Billion in annual direct medical costs of treating STDs and sequelae Estimated $6.5 Billion in annual direct medical costs of treating STDs and sequelae among yo STDs can cause serious health problems Ectopic pregnancy, infertility, chronic pelvic pain risk of HIV infection CDC. STD Surveillance Atlanta: U.S.DHHS; Chesson HW, et al. Perspect Sex Reprod Health 36(1):
4 WHY IT MATTERS Adolescent Sexual Behavior NYS high school students who ever had sexual intercourse, 2011 % CDC YRBSS, 2011 Grade 4
5 Sexual behavior with opposite-sex partners among youth aged years, NSFG Age group Vaginal sex Oral sex Anal sex MALES yo 45% 48% 10% yo 82% 80% 32% FEMALES yo 46% 45% 11% yo 85% 81% 30% Sexual behavior with same-sex partners among males aged years, NSFG Age group Oral sex with Anal sex with yo 2% 1% yo 6% 3% 5
6 WHY IT MATTERS STI Burden Estimated Youth STI Incidence, 2000 ~25% Years ~75% Years Sexually Experienced Population Weinstock et al., Persp Sex Reprod Health,
7 Estimated Youth STI Incidence, 2000 ~25% Years Account for: ~48% New Infections ~75% Years ~52% New Infections Sexually Experienced Population Incident STIs* Weinstock et al., Persp Sex Reprod Health, Estimated Youth STI Incidence, 2000 ~25% Years Account for: ~48% New Infections 5% Gonorrhea 7% Genital herpes 16% Chlamydia 21% Trichomoniasis ~75% Years ~52% Sexually Experienced Population New Infections Incident STIs* 51% HPV *Also included <1% each HIV, Syphilis, Hepatitis B Weinstock et al., Persp Sex Reprod Health,
8 Prevalence of 5 STIs Among Females Aged 14 to 19 yrs: United States, All Sexually Experienced STI Weighted Prevalence (%) Weighted Prevalence (%) Any STI HPV* C trachomatis T vaginalis HSV N gonorrhoeae *HPV 6/11 & any of 23 oncogenic types Forhan SE, et al. Pediatrics 2009;124: NYS STIs AND TEEN PREGNANCY 8
9 Reported Chlamydia among Women, NYS, excluding NYC, 2011 Reported Gonorrhea among Women, NYS, excluding NYC,
10 Chlamydia Age and Sex-Specific Rates: NYS excluding NYC, 2011 Gonorrhea Age and Sex-Specific Rates: NYS excluding NYC,
11 50 Reported Cases of Chlamydia by Reporting Source NYS excluding NYC, % of Cases Private Provider Health Dept Family Planning Hospital CHC Other Men Women 35 Reported Cases of Gonorrhea by Reporting Source NYS excluding NYC, Private Provider % of Cases 25 Health Dept Family Planning 20 Hospital CHC Other 5 0 Men Women 11
12 WHY IT MATTERS Who is caring for adolescents? 12
13 WHO IS CARING FOR MORE TEENS NOW COMPARED TO 5 YEARS AGO? Raise your hands!! Clinical Care: Female Adolescents 25 Source: National Ambulatory Medical Care Survey, Hoover et al., J Adol Health,
14 26 Routinizing sexual health in 1º care Create an adolescent medical home Approach to the Adolescent Key Strategies Assess developmental level Discuss confidentiality with adolescent/parent Appropriately ensure confidentiality, time alone Brief risk assessment at most visits STI screening annually if sexually active Systems for follow-up of confidential results 27 14
15 15
16 16
17 32 ADOLESCENT STI RISK ASSESSMENT Available tools 33 Comprehensive HEADSSS H: Home E: Education/Employment/Eating A: Activities D: Drugs S: Suicidality/Depression S: Sexuality/Sexual l Behavior S: Safety S: Spirituality 17
18 SSHADESS* Strength Assessment Tool for Psychosocial Screening 34 Strength or interests School Home Activities Drugs/substance use Emotions/depression Sexuality Safety *Clark and Ginsburg,
19 36 ASSESSING SEXUAL BEHAVIOR Include questions that direct testing CDC Recommendations Assessment: The 5 P s 37 PARTNERS Sexual PRACTICES PAST history of STIs PREGNANCY PROTECTION from STI 19
20 38 Guidelines for Adolescent STI Testing Bright Futures-American Academy of Pediatrics U.S. Preventive Services Task Force Centers for Disease Control and Prevention 39 Bright Futures (3 rd ed; 4 th ed in development) STI Screening for Adolescents Chlamydia and gonorrhea screening appropriate for patient population and clinical setting Offer HIV and syphilis testing based on: Clinical setting: STI Clinic, correctional facility, homeless shelter, TB clinic, clinic for MSM, clinic prevalence >1% STI risk factors: Unprotected sex with > 1 partner Ever been treated for STI Use or ever use intravenous drugs MSM Trades sex for money/ partner has ever Past/current partner bisexual, HIV positive, IVDU 20
21 Bright Futures STI Prevention via Immunization Human Papillomavirus Vaccines Gender neutral recommendation 2012 HEDIS HPV measure for Adolescents Hepatitis B Vaccine Hepatitis A Vaccine USPSTF Chlamydia Screening Recommendations Recommendations by CDC, United States Preventive Services Task Force (USPSTF), medical associations Screen all sexually-active active females aged <25 years annually Screen women aged 25 years if at increased risk USPSTF: A-rated recommended preventive service 21
22 What about males?! Insufficient evidence to recommend routine chlamydia screening in young men feasibility efficacy cost Correctional facilities Selective screening in high- prevalence populations may be beneficial: STD clinics Adolescent-serving clinics MSM Multiple partners How Well Are Providers Chlamydia Screening Annually? 2010 Chlamydia Screening HEDIS Rates Health Plan Type Age Commercial Medicaid (yrs) (%) (%) The State of Health Care Quality, 2011 National Center for Quality Assurance at: 22
23 USPSTF Gonorrhea Screening Recommendations Screen all sexually active if at risk for infection i.e., young (<25 yrs), previous gonorrhea or other STIs, new or multiple sexual partners, inconsistent condom use, sex work, drug use Risk factors for pregnant = non-pregnant African Americans and MSM have higher prevalence of infection than the general population in many communities and settings Insufficient evidence to recommend for or against routine gonorrhea screening in men at risk ik No routine gonorrhea screening and at risk Chlamydia/Gonorrhea Screening: Preferred Noninvasive Genitourinary Specimens Females: Vaginal swab Vaginal swab samples are as sensitive as endocervical swab specimens, with no difference in specificity Urine samples are acceptable, but urine may have performance when compared to genital swab samples Males: Urine In some studies, urethral swab samples sensitive than urine, though equivalently specific 23
24 CDC Adolescent STI Screening Recommendations Annual C. trachomatis (CT) screen all sexually active females aged 25 yrs Annual N. gonorrhoeae (GC) screen all at-risk sexually active females Females aged <25 years are highest risk for gonorrhea infection Discuss HIV screening with all adolescents and encourage testing for those at risk CDC Recommendations Screening for Other STIs 47 Routine screening of asymptomatic adolescents for certain STIs (syphilis, trichomoniasis, BV, HSV, HPV, HAV, HBV) not recommended Consider individual and population-based risk factors Pregnant adolescents require more thorough evaluation Begin cervical cancer screening at age 21 in most cases 24
25 Adolescent Prevention Encourage immunizations, including HPV, HAV and HBV Provide information on HIV infection, testing, transmission, and implications of infection to all adolescents as part of health care Integrate sexuality education into clinical practice USPSTF recommends high-intensity STD prevention behavioral counseling for all sexually active adolescents twice yearly 25
26 50 RESOURCES FOR PRACTITIONERS AAP/SOAH SAHM CDC NCC 26
27 Chlamydia Coalition ncc.prevent.org 53 Coalition includes AAP, CDC, SAHM, ACOG, non-profits, health plans, advocacy groups Aim to increase chlamydia screening Provides tools and resources for practitioners and patients 27
28 28
29 29
30 30
31 60 The GYT om/gyt campaign is a youthful, empowering social movement to reduce the spread of STDs among young people Visit the web sites for provider resources, tools, and GYT materials to help support your local STD prevention efforts: provider.gytnow.org
32 32
33 Changes You May Wish to Make In Your Practice Use adolescent EMR template Prompt on EMR/visit note for confidential contact # Risk behavior screening questionnaire before visit Universal urine collection Make primary care opportunities at sick visits STI Screening Immunizations Assess length of teen pt visit w/ flow study List of community resources for confidential reproductive health/mental health services Resources Useful Websites American Academy of Pediatrics Bright Futures NY State American Academy of Pediatrics Physicians for Reproductive Choice and Health Society for Adolescent Health and Medicine North American Society for Pediatric and Adolescent Gynecology American Civil Liberties Union Reproductive Freedom Project 33
34 Resources Useful Websites Advocates for Youth Guttmacher Institute Center for Adolescent Health and Law Sexuality Information and Education Council of the United States Association of Reproductive Health Professionals National Chlamydia Coalition Emergency contraception 34
35 QUESTIONS? 35
Changes in the 2010 STD Treatment Guidelines: What Adolescent Health Care Providers Should Know February 2011
Changes in the 2010 STD Treatment Guidelines: What Adolescent Health Care Providers Should Know February 2011 Gale Burstein, MD, MPH, FAAP, FSAHM 1 Amanda Jacobs, MD, FAAP, 2 Dmitry Kissin, MD, MPH, 3
More informationPreventive Care Guideline for Asymptomatic Low Risk Adults Age 18 through 64
Preventive Care Guideline for Asymptomatic Low Risk Adults Age 18 through 64 1. BMI - Documented in patients medical record on an annual basis. Screen for obesity and offer intensive counseling and behavioral
More informationThe Minnesota Chlamydia Strategy: Action Plan to Reduce and Prevent Chlamydia in Minnesota Minnesota Chlamydia Partnership, April 2011
The Minnesota Chlamydia Strategy: Action Plan to Reduce and Prevent Chlamydia in Minnesota Minnesota Chlamydia Partnership, April 2011 Section 5: Screening, Treating and Reporting Chlamydia While the information
More information2010 STD Treatment Guidelines Webinar Series
2010 STD Treatment Guidelines Webinar Series Focus on Adolescent Sexual Health An Overview by CDC, SAHM, AAP & the NNPTC June1, 2011 National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention
More informationTHIS IS AN OFFICIAL NH DHHS HEALTH ALERT
THIS IS AN OFFICIAL NH DHHS HEALTH ALERT Distributed by the NH Health Alert Network Health.Alert@nh.gov August 13, 2015 1400 EDT (2:00 PM EDT) NH-HAN 20150813 Updated Centers for Disease Control (CDC)
More informationDiseases that can be spread during sex
Diseases that can be spread during sex Did you know... over 65 million people in the United States have a chronic, incurable sexually transmitted disease (STD)? and that every year another 19 million persons
More informationSexually Transmitted Infections (STIs) and the STI Clinic
Patient & Family Guide 2016 Sexually Transmitted Infections (STIs) and the STI Clinic Where to go. What to know. STIs are more common than you might think! www.nshealth.ca Sexually Transmitted Infections
More informationGuidelines for Preventative Health Care in LGBT Populations
+ Guidelines for Preventative Health Care in LGBT Populations Katie Imborek, MD Department of Family Medicine Co-Director UI LGBTQ Clinic April 2 nd, 2014 + Objectives n Understand CDC screening guidelines
More information4/30/2013 HPV VACCINE AND NORTH DAKOTA HPV IMMUNIZATION RATES HUMAN PAPILLOMAVIRUS (HPV) HUMAN PAPILLOMAVIRUS HPV CONTINUED
HPV VACCINE AND NORTH DAKOTA HPV IMMUNIZATION RATES HUMAN PAPILLOMAVIRUS (HPV) HUMAN PAPILLOMAVIRUS What is human papillomavirus (HPV)? HPV is the most common sexually transmitted infection. There are
More informationRhode Island Department of Health Division of Infectious Diseases and Epidemiology
Rhode Island Department of Health Division of Infectious Diseases and Epidemiology STD (Sexually Transmitted Disease) PROGRAM Expedited Partner Therapy (EPT) for STDs Guidance for Medical Providers in
More informationPREVENTING TEEN PREGNANCY IN URBAN SCHOOL-BASED HEALTH CENTERS
PREVENTING TEEN PREGNANCY IN URBAN SCHOOL-BASED HEALTH CENTERS Mark Hathaway, MD, MPH Medical Director, Family Planning Program Unity Health Care, Inc. Washington DC Disclosures Consultant for Afaxys,
More informationEffective Integration of STI & HIV Prevention Programs
Effective Integration of STI & HIV Prevention Programs Jeanne Marrazzo, MD, MPH University of Washington, Seattle September 27, 2013 Key Points STIs are really common among those at highest risk of HIV
More informationDeveloped by: California Department of Public Health (CDPH) Sexually Transmitted Diseases (STD) Control Branch. In collaboration with:
Best Practices for the Prevention and Early Detection of Repeat Chlamydial and Gonococcal Infections: Effective Partner Treatment and Patient Retesting Strategies for Implementation in California Health
More informationNew Brunswick Health Indicators
New Brunswick Health Indicators Issue 8, July 2013 A population health bulletin published by the Office of the Chief Medical Officer of Health Youth Sexual Health Sexual health is an important aspect of
More informationSpecimen collection and transport for Chlamydia trachomatis and Neisseria gonorrhoeae testing
Specimen collection and transport for Chlamydia trachomatis and Neisseria gonorrhoeae testing Overview Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) infections are two of the most common sexually
More information2014 CDC Treatment Guidelines for STDs What s New, What s Important, What s Essential. STD Treatment Guidelines. How are the guidelines prepared?
2014 CDC Treatment Guidelines for STDs What s New, What s Important, What s Essential Bradley Stoner, MD, PhD Associate Professor, Washington University School of Medicine Medical Director, St. Louis STD/HIV
More informationThe Impact of the ACA and USPSTF Grade Change on Coverage of HIV Testing
The Impact of the ACA and USPSTF Grade Change on Coverage of HIV Testing Lindsey Dawson Public Policy Associate United States Conference on AIDS New Orleans, LA September 9, 2013 Coverage of Preventive
More informationThe Sexual Health of Youth in the United States
The Sexual Health of Youth in the United States An Audience Profile NATIONAL COALITION FOR SEXUAL HEALTH NATIONAL COALITION FOR SEXUAL HEALTH About the National Coalition for Sexual Health The National
More informationCalifornia Guidelines for STD Screening and Treatment in Pregnancy
California Guidelines for STD Screening and Treatment in Pregnancy These guidelines were developed by the California Department of Public Health (CDPH) Sexually Transmitted Diseases (STD) Control Branch
More informationChlamydia THE FACTS. How do people get Chlamydia?
What is Chlamydia? Chlamydia is a common bacterial infection that is sexually transmitted and often causes no symptoms. If not treated, chlamydia can damage reproductive organs and make it difficult for
More informationPREVENTIVE HEALTHCARE GUIDELINES INTRODUCTION
PREVENTIVE HEALTHCARE GUIDELINES INTRODUCTION Health Plan of Nevada and Sierra Health and Life suggest that health plan members get certain screening tests, exams and shots to stay healthy. This document
More informationMaking Sense of Your Pap and HPV Test Results
Making Sense of Your Pap and HPV Test Results Keep this booklet until you get your test results back from your doctor. U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention
More informationRelated TeensHealth Links
Grades 6 to 8 Health Problems Series STDs KidsHealth.org/classroom Teacher s Guide This guide includes: Standards Related Links Discussion Questions Activities for Students Reproducible Materials Standards
More informationBecoming Teenwise 101
Becoming Teenwise 101 May 2, 2013 Teenwise Minnesota 22 nd Annual Conference Presentation Overview Pregnancy, birth and STI statistics and trends Adolescent sexual behavior trends Health disparities Evidence-based
More informationPreventive Care Guideline for Asymptomatic Elderly Patients Age 65 and Over
Preventive Care Guideline for Asymptomatic Elderly Patients Age 65 and Over 1. BMI - Documented in patients medical record on an annual basis up to age 74. Screen for obesity and offer counseling to encourage
More informationCDC 2015 STD Treatment Guidelines: Update for IHS Providers Sharon Adler M.D., M.P.H.
CDC 2015 STD Treatment Guidelines: Update for IHS Providers Sharon Adler M.D., M.P.H. Clinical Faculty, CA Prevention Training Center Disclosure Information Sharon Adler MD, MPH I have no financial relationships
More informationChlamydia trachomatis genital infection is the
CME Activity Inside and Online CHLAMYDIA TESTING AND TREATMENT Take a sexual history of all patients, including adolescents anyone who is sexually active is at risk for chlamydia infection. Screen sexually
More informationPolicy Brief. New Affordable Care Act Insurance Regulations Improve Reproductive Health & Access. November 2010
November 2010 Policy Brief New Affordable Care Act Insurance Regulations Improve Reproductive Health & Access Introduction The Patient Protection and Affordable Care Act (ACA), as amended by the Health
More informationSCREENING FOR SEXUALLY TRANSMITTED INFECTIONS
SCREENING FOR SEXUALLY TRANSMITTED INFECTIONS Take history:- History of presenting problem Full sexual history (refer to guideline on sexual history taking) Relevant past medical history, including previous
More informationProviding Optimal Care for Your MSM Patients
Providing Optimal Care for Your MSM Patients Medical providers have a critical role to play in improving the health outcomes of Black and Latino men who have sex with men (BLMSM). Studies reinforce the
More informationGonorrhoea. Looking after your sexual health
Gonorrhoea Looking after your sexual health 2 Gonorrhoea Gonorrhoea is a bacterial sexually transmitted infection (STI). It can be painful and can cause serious health problems such as infertility in both
More informationTrichomonas vaginalis. Looking after your sexual health
Trichomonas vaginalis Looking after your sexual health 2 3 Trichomonas vaginalis Trichomonas vaginalis is a sexually transmitted infection (STI). It is sometimes referred to as trichomonas or trichomoniasis,
More informationClinical Indicator Ages 19-29 Ages 30-39 Ages 40-49 Ages 50-64 Ages 65+ Frequency of visit as recommended by PCP
SCREENING EXAMINATION & COUNSELING UPMC Health Plan Clinical Indicator Ages 19-29 Ages 30-39 Ages 40-49 Ages 50-64 Ages 65+ Annually Physical Exam and Counseling 1 Blood Pressure 2 At each visit. At least
More informationSEXUALLY TRANSMITTED INFECTIONS (STIs)
SEXUALLY TRANSMITTED INFECTIONS (STIs) The importance of a renewed commitment to STI prevention and control in achieving global sexual and reproductive health STIs: LARGE BURDEN AND SERIOUS CONSEQUENCES
More informationLeader's Resource. Note: Both men and women can have an STD without physical symptoms.
Leader's Resource Information on Sexually Transmitted Diseases (STDs) Signs and Symptoms of STDs Note: Both men and women can have an STD without physical symptoms. Any of the following can indicate to
More informationOverview. Cervicitis, PID, Urethritis & Other GC/Chlamydia Infections. Percentage of High School Students Who Were Currently Sexually Active,* 2011
Overview Cervicitis, PID, Urethritis & Other GC/Chlamydia Infections Susan Blank, MD MPH (sblank@health.nyc.gov) Elizabeth Alderman, MD Professor of Clinical Pediatrics Albert Einstein College of Medicine
More informationAre Booster Doses of Hepatitis B Vaccine Necessary?
Are Booster Doses of Hepatitis B Vaccine Necessary? Current CDC Recommendations And Gaps in Knowledge Division of Viral Hepatitis Centers for Disease Control and Prevention, USA Current United States Recommendations
More information2011 STI Annual Report
STI Annual Report Howard Brown Health Center s third Annual STI Report details sexually transmitted infection (STI) and human immunodeficiency virus (HIV) testing and behavioral trends at many of Howard
More informationPublic Health Services
Public Health Services FUNCTION The functions of the Public Health Services programs are to protect and promote the health and safety of County residents. This is accomplished by monitoring health status
More informationFrequently Asked Questions
Frequently Asked Questions Testing for Gonorrhea Q1: What test should be completed for accurately diagnosing gonorrhea? A1: Testing is done with either a culture or a NAAT (nucleic acid amplification test).
More informationSTANDARD PROTOCOL STD AND HIV SCREENING AND EPIDEMIOLOGIC STD TREATMENT
STANDARD PROTOCOL STD AND HIV SCREENING AND EPIDEMIOLOGIC STD TREATMENT RELEASE DATE: REVIEW INTERVAL: YEARLY REVIEW DATE: SITE/SERVICE UNIT: IMPLEMENTATION DATE: REVIEWED BY: CONTACT: APPROVED BY: CONTENTS
More informationInjection Drug Users in Miami-Dade: NHBS-IDU2 Cycle Preliminary Results
Injection Drug Users in Miami-Dade: NHBS-IDU2 Cycle Preliminary Results David W. Forrest, Ph.D. Marlene LaLota, M.P.H. John-Mark Schacht Gabriel A. Cardenas, M.P.H. Lisa Metsch, Ph.D. National HIV Behavioral
More informationProject AWARE Study Overview. Lisa Metsch, PhD Grant Colfax, MD Dan Feaster, PhD
Project AWARE Study Overview Lisa Metsch, PhD Grant Colfax, MD Dan Feaster, PhD January 9, 2012 Two Testing Strategies Evaluated in 2-arm RCT On-site HIV rapid testing (via fingerstick) with brief participant-tailored
More informationThe Facts. The Truth About Abstinence-Only Programs
The Truth About Abstinence-Only Programs Accurate, balanced sex education including information about contraception and condoms is a basic human right of youth. Such education helps young people to reduce
More informationThere s an App for That: An Innovative Tablet-Based Sexual Health Application. Ashley Scarborough, MPH Linda Creegan MS, FNP
There s an App for That: An Innovative Tablet-Based Sexual Health Application Ashley Scarborough, MPH Linda Creegan MS, FNP Disclosure We have no financial interests to disclose Objectives Describe need
More informationDania Palanker Senior Health Policy Advisor National Women s Law Center December 5, 2012
National Family Planning and Reproductive Health Association ACA Implementation: Health Insurance Exchanges Dania Palanker Senior Health Policy Advisor National Women s Law Center December 5, 2012 Why
More informationHealth Profile for St. Louis City
Health Profile for St. Louis City The health indicators of St. Louis City show that the city has many health problems. To highlight a few, the city s rates of sexually transmitted diseases (i.e., HIV/AIDS,
More informationClinical Scenarios CODING AND BILLING 101. Daryn Eikner, Family Planning Council Ann Finn, Ann Finn Consulting
Clinical Scenarios CODING AND BILLING 101 Daryn Eikner, Family Planning Council Ann Finn, Ann Finn Consulting 1 Always remember Follow coding guidelines If you didn t write it down, it didn t happen The
More informationSlide 1: Chlamydia and Gonorrhea: What You and Your Clients Need to Know. Welcome to Chlamydia and Gonorrhea: What You and Your Clients Need to Know.
Slide 1: Chlamydia and Gonorrhea: What You and Your Clients Need to Know Welcome to Chlamydia and Gonorrhea: What You and Your Clients Need to Know. This is a presentation for healthcare providers about
More informationMorbidity and Mortality among Adolescents and Young Adults in the United States
Morbidity and Mortality among Adolescents and Young Adults in the United States AstraZeneca Fact Sheet 2011 Authors Robert Wm. Blum MD, MPH, PhD William H. Gates, Sr. Professor and Chair Farah Qureshi,
More informationACA Mandates First Dollar Coverage for Preventive Services
I N F O R M A T I O N U P D A T E May 2013 ACA Mandates First Dollar Coverage for Preventive Services The Affordable Care Act (ACA) mandates that, effective for Plan Years beginning on or after Sept. 23,
More informationExpedited Partner Therapy (EPT) for Sexually Transmitted Diseases Protocol for Health Care Providers in Oregon
Expedited Partner Therapy (EPT) for Sexually Transmitted Diseases Protocol for Health Care Providers in Oregon Oregon Health Authority Center for Public Health Practice HIV/STD/TB Section Principles of
More informationPrevention Agenda 2013 2017 is the state health improvement plan for the next five years.
Prevention Agenda 2013 2017 is the state health improvement plan for the next five years. It builds on the current plan, the Prevention Agenda toward the Healthiest State. The Prevention Agenda (launched
More informationA Ministry of the Archdiocese of Galveston-Houston A United Way Agency
A Ministry of the Archdiocese of Galveston-Houston A United Way Agency Integrated Multidsciplinary Approach to Adapt Routine HIV Screening in a Safety Net Clinic Setting Sherri D. Onyiego MD, PhD Baylor
More informationNURSE LED SERVICES IN CARDIFF AND VALE NHS TRUST. Sandra Smith Senior Nurse Manager Cardiff and Vale NHS Trust 28 th June 2007
NURSE LED SERVICES IN CARDIFF AND VALE NHS TRUST Sandra Smith Senior Nurse Manager Cardiff and Vale NHS Trust 28 th June 2007 Reasons for increasing Nurse Led Services The advent of HIV and the dramatic
More informationChlamydia. Looking after your sexual health
Chlamydia Looking after your sexual health 2 Chlamydia Chlamydia is one of the most common sexually transmitted infections (STIs). It is very easy to treat and cure. Up to one in 10 sexually active young
More informationTREATMENT OF STI CONTACTS
This decision support tool is effective as of October 2014. For more information or to provide feedback on this or any other decision support tool, email certifiedpractice@crnbc.ca TREATMENT OF STI CONTACTS
More informationCOMMUNICABLE DISEASE
Public Health Activities & Services Inventory Technical Notes COMMUNICABLE DISEASE CLINICAL SERVICES, SURVEILLANCE AND CONTROL In 2014, decision was made to adopt number of national public health activities
More informationHEALTHY PEOPLE 2020 CORE INDICATORS FOR ADOLESCENT AND YOUNG ADULT HEALTH
HEALTHY PEOPLE 2020 CORE INDICATORS FOR ADOLESCENT AND YOUNG ADULT HEALTH Short Title OUTCOME INDICATORS 1 SYSTEMS INDICATORS 1 HEALTH CARE Medical insurance wellness checkup Vaccine coverage among adolescents
More informationOne of the most highly publicized provisions
Gut tmacher Policy Review GPR Fall 2012 Volume 15 Number 4 Beyond Contraception: The Overlooked Reproductive Health Benefits of Health Reform s Preventive Services Requirement By Adam Sonfield One of the
More informationCervical cancer screening with the HPV test and the Pap test in women ages 30 and older
Cervical cancer screening with the HPV test and the Pap test in women ages 30 and older When to get tested and how to make sense of your test results If you are 30 years or older and your Pap test is normal
More informationSexually Transmitted Infections in Developing Countries
Sexually Transmitted Infections in Developing Countries at a glance Why address s in developing countries? Sexually transmitted infections (s) are among the world s most common diseases, with an annual
More informationHow To Be Healthy And Happy
AND THE COLLEGE STUDENT SEX By: Jenna Ruimveld, Kylie Muntz, Shannon Grabe, a Courteny Rhem ADAPTATION THEORY What is it: A model in which the main goal is to adapt to a changing environment. Applying
More informationWilliam Atkinson, MD, MPH Hepatitis B Vaccine Issues June 16, 2016
William Atkinson, MD, MPH Hepatitis B Vaccine Issues June 16, 2016 Advisory Committee on Immunization Practices (ACIP) The recommendations to be discussed are primarily those of the ACIP composed of 15
More informationAAPPs Gap Analysis: Guidance and Toolkit Development
AAPPs Gap Analysis: Guidance and Toolkit Development Samantha Williams Shaunta Wright AAPPS Webinar Series March 13, 2014 National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention Division
More informationMODULE 11: RTI, STI AND RELATIONSHIP WITH HIV
IMPORTANT: Provide your feedback after reading this module. The feedback link is provided on the last page of this module. Please note that you have been provided with a different link for each module
More informationReproductive Health and Healthy People 2020 is intended to serve as a resource for meeting future reproductive health care needs.
Office of Population Affairs December 2010 Introduction Healthy People 2020 provides a national agenda for improving the health of all Americans by identifying specific objectives in 42 topic areas. The
More informationWASHINGTON STATE DEPARTMENT OF HEALTH FAMILY PLANNING AND REPRODUCTIVE HEALTH ON-SITE MONITOR TOOL FOR TITLE X AGENCIES
WAHINGTON TATE DEPARTENT OF HEALTH FAILY PLANNING AND REPRODUCTIVE HEALTH ON-ITE ONITOR TOOL FOR TITLE X AGENCIE CLINICAL ERVICE: The sub-recipient provides family planning services to clients that are
More informationHPTN 073: Black MSM Open-Label PrEP Demonstration Project
HPTN 073: Black MSM Open-Label PrEP Demonstration Project Overview HIV Epidemiology in the U.S. Overview of PrEP Overview of HPTN HPTN 061 HPTN 073 ARV Drug Resistance Conclusions Questions and Answers
More informationUniversal STI Screening in the Pediatric Emergency Department
Universal STI Screening in the Pediatric Emergency Department I have no relevant financial relationships to disclose or conflicts of interest to resolve. Kari Schneider, MD Pediatric Emergency Medicine
More informationReturn on Investment: A Fuller Assessment of the Benefits and Cost Savings of the US Publicly Funded Family Planning Program
Original Investigation Return on Investment: A Fuller Assessment of the Benefits and Cost Savings of the US Publicly Funded Family Planning Program JENNIFER J. FROST, ADAM SONFIELD, MIA R. ZOLNA, and LAWRENCE
More informationImmunization Healthcare Branch. Human Papillomavirus Vaccination Program Questions and Answers. Prepared by
Immunization Healthcare Branch Human Papillomavirus Vaccination Program Questions and Answers Prepared by Immunization Healthcare Branch (IHB), Defense Health Agency Last Updated: 02 Jan 14 www.vaccines.mil
More informationHIV and AIDS in Bangladesh
HIV and AIDS in Bangladesh BACKGROUND The first case of HIV/AIDS in Bangladesh was detected in 1989. Since then 1495 cases of HIV/AIDS have been reported (as of December 2008). However UNAIDS estimates
More informationHow To Prevent An Std
As is true of other racial health disparities, the disproportional prevalence of STDs among American Indians does not reflect any biological difference in infection susceptibility, but rather inequalities
More informationThe link between cervical cancer and HPV (human papillomavirus)
The link between cervical cancer and HPV (human papillomavirus) The link between cervical cancer and HPV Key facts: HPV is a virus (the human papillomavirus). Almost all abnormal Pap smear results are
More informationIllinois Insurance Facts Illinois Department of Insurance
Illinois Insurance Facts Illinois Department of Insurance Women s Health Care Issues Revised August 2012 Note: This information was developed to provide consumers with general information and guidance
More informationCervical Cancer Screening and Management Guidelines: Changing Again, Huh?
Cervical Cancer Screening and Management Guidelines: Changing Again, Huh? Summary of 2013 recommendations from ASC (American Cancer Society), ASCCP (American Society for Colposcopy and Cervical Pathology),
More informationHIV Pre-Exposure Prophylaxis (PrEP): A brief guide for providers updated January 2016
HIV Pre-Exposure Prophylaxis (PrEP): A brief guide for providers updated January 2016 Daily emtricitabine/tenofovir (Truvada ) is safe and effective for reducing the risk of HIV acquisition in sexually
More informationGet the Facts on Teen Sexuality
1 TEENS AND TRENDS: Get the Facts on Teen Sexuality This document highlights statistics related to trends in teenage sexual behaviour, condom and contraception use, pregnancy, sexually transmitted infections
More informationIN THE SENATE OF THE UNITED STATES , 2003. M. introduced the following bill; which was referred to the Committee on A BILL
DRAFT //0 0TH CONGRESS ST SESS. S. To direct the Secretary of Health and Human Services to establish, promote, and support a comprehensive program for education, prevention, and treatment of Hepatitis
More informationDomestic Violence & Women
Domestic Violence & Women Screening, Intervention, Referral & Resources Breena Holmes, MD Ilisa Stalberg, MSS, MLSP UVM Women s Health Conference May 10, 2013 Objectives 1. Review prevalence data and establish
More informationTake advantage of preventive care to help manage your health
Take advantage of preventive care to help manage your health Preventing disease and detecting health issues at an early stage, if they occur, are important to living a healthy life. Following these recommended
More informationWhat is HPV? Low-risk HPV types. High-risk HPV types
HPV and Cancer What is HPV? HPV is short for human papilloma (PAP-uh-LO-muh) virus. HPVs are a large group of related viruses. Each HPV virus in the group is given a number, which is called an HPV type.
More informationClinical Aspects of Diagnosis of Gonorrhea and Chlamydia Infection in an Acute Care Setting
BRIEF REPORT Clinical Aspects of Diagnosis of Gonorrhea and Chlamydia Infection in an Acute Care Setting Supriya D. Mehta, 1 Richard E. Rothman, 2 Gabor D. Kelen, 2 Thomas C. Quinn, 3,4 and Jonathan M.
More informationHIV/AIDS: General Information & Testing in the Emergency Department
What Is HIV? HIV/AIDS: General Information & Testing in the Emergency Department HIV is the common name for the Human Immunodeficiency Virus. HIV is a retrovirus. This means it can enter the body s own
More informationTen Good Reasons to Be Concerned about the Human Papillomavirus (HPV) Vaccination Campaign
Ten Good Reasons to Be Concerned about the Human Papillomavirus (HPV) Vaccination Campaign This document is a translation and adaption of an information brochure prepared by the Federation du Québec pour
More information04/06/2015. Aaron V. Sapp, MD, MBA University of Missouri Columbia Student Health Center
Aaron V. Sapp, MD, MBA University of Missouri Columbia Student Health Center 1 Men Women 20.6% Talked to doctor 18.2% Talked to doctor 79.4% Did not talk to doctor 81.8% Did not talk to doctor Lack of
More informationsigns suggesting chlamydia:
Chlamydia - uncomplicated genital - Management View full scenario When should I suspect and test for chlamydia? Women: o Test for chlamydia if they are sexually active with symptoms and signs suggesting
More informationSTI case management. Francis Ndowa - GFMER Theodora Wi - WHO
Training Course in Sexual and Reproductive Health Research 2014 Module: Principles and Practice of Sexually Transmitted Infections Prevention and Care STI case management Francis Ndowa - GFMER Theodora
More informationSubstance Abuse Treatment Evaluations and Interventions Program
Substance Abuse Treatment Evaluations and Interventions Program Project Highlights: HIV Interventions in North Carolina Wendee Wechsberg, Ph.D. SATEI Program Director RTI International 3040 Cornwallis
More informationHIV/AIDS Prevention and Care
HIV/AIDS Prevention and Care Nancy S. Padian, PhD, MPH Professor, Obstetrics, Gynecology & Reproductive Sciences Associate Director for Research, Global Health Sciences and AIDS Research Institute: University
More informationOutpatient/Ambulatory Health Services
Outpatient/Ambulatory Health Services Service Definition Outpatient/ambulatory medical care includes the provision of professional diagnostic and therapeutic services rendered by a physician, physician
More informationADOLESCENT CONTRACEPTIVE COUNSELING AND SAME DAY STARTS. Liz Romer, MSN, FNP Children s Hospital Colorado
ADOLESCENT CONTRACEPTIVE COUNSELING AND SAME DAY STARTS Liz Romer, MSN, FNP Children s Hospital Colorado What providers dread about interactions with adolescents Narcissistic, self absorbed Disrespectful
More informationPreventive Services for Pregnancy SERVICE WHAT IS COVERED INTERVALS OF COVERAGE Anemia Screening Screening Annual screening for pregnant women
Preventive Services for Pregnancy SERVICE WHAT IS COVERED INTERVALS OF COVERAGE Anemia Annual screening for pregnant women Bacteriuria For pregnant women at 12-16 weeks gestation or first prenatal visit
More informationEPIDEMIOLOGY OF HEPATITIS B IN IRELAND
EPIDEMIOLOGY OF HEPATITIS B IN IRELAND Table of Contents Acknowledgements 3 Summary 4 Introduction 5 Case Definitions 6 Materials and Methods 7 Results 8 Discussion 11 References 12 Epidemiology of Hepatitis
More informationBridging the Gaps: Eliminating Disparities in Teen Pregnancy & Sexual Health
Bridging the Gaps: Eliminating Disparities in Teen Pregnancy & Sexual Health Evaluation of the Teen Outreach Program (TOP ) in three urban public school districts: Bronx, Chicago and Washington DC Melva
More informationPrevents future health problems. You receive these services without having any specific symptoms.
Preventive Care To help you live the healthiest life possible, we offer free preventive services for most Network Health members. Please refer to your member materials, which you received when you enrolled
More informationPediatric and Adolescent Medical Record Review Tool
Pediatric and Adolescent Medical Record Review Tool Primary Care Provider: Member Name: DOB: Provider Name: Provider ID #: Product: Date of Review: Initials of Reviewer: The Medical Record contains the
More informationProcedure Code(s): n/a This counseling service is included in a preventive care wellness examination or focused E&M visit.
Coding Summary for Providers NOTE THE FOLLOWING: The purpose of this document is to provide a quick reference of the applicable codes for UnitedHealthcare plans that cover preventive care services in accordance
More informationPreventive Services at 100%
September 1, 2014 Update Preventive Care Services Covered Without Cost-sharing Without Copay, Coinsurance or Deductible The Affordable Care Act (ACA) requires non-grandfathered health plans and policies
More information