Compulsory Sexual Education

The Centers for Disease Control (CDC) recently released its report on Sexually Transmitted Diseases for 2011. Sadly, there are few surprises. With a total of 1,412,791 cases Chlamydia trachomatis infection remains the STD leader. This figure is the largest number of cases ever reported to CDC for any condition and represents an increase of 8.0% compared with the rate in 2010. The national Gonorrhea rate increased as well after over a decade of fluctuation and/or decline. However, the greatest concern about the "clap" as we used to call it is its increasing resistance to the medications commonly used to treat it, cephalosporins and azithromycin. Syphilis, which we once actually believed could be eliminated, continues to thwart those efforts. Although the 2011 rate remained unchanged from 2010, it continues to grow in MSM and now, women. With other STDs such as HPV, Trichomoniasis and Herpes also showing consistent increases, the overriding conclusion that one must draw is that we continue to experience this epidemic of preventable diseases. The most troubling aspect remains the disparities in race and age. Younger minorities continue to be disproportionately affected by STD'S. Which brings me to my main point: the need for compulsory sex education in schools. A recent report by the Guttmacher Institute highlights the information gap: * One in four adolescents ages 15-19 received abstinence education without any instruction on birth control or disease prevention. * 46% of teen males and 33% of teen females receive no formal instruction about contraception before the having sex. * Of older teens, ages 18-19, 41% said that they knew little or nothing about condoms and 75% say the same thing about the birth control pill. * Only 21 states and the District of Columbia mandate sex education. See the disconnect here? With STD rates rising in children especially minority children, over half the states don't require education to prevent STDs, as well as unwanted pregnancies. I understand that discussions about sex education in school are like the proverbial "third rail," because parents feel that they should be the ones providing the information. The problem is that many don't do it and others are poorly informed. While the Guttmacher report states that parents are considered an important source of information on sexual health for teens, it adds that their knowledge may often be inaccurate or incomplete. The report also fails to mention the number of children who are not living with their parents, such as those living with other relatives, in foster care or in group homes. The bottom line here is that this belief system that sex education should remain at home isn't working. As there is no evidence to support that sex education promotes more sexually activity (most parents greatest fear), then it is time that we have a substantive dialogue with parents to allay their fears and gain their support. Legislators too, should be more assertive is passing legislation to mandate it. Its time that we address this issue before more young lives are ruined.

World AIDS Day 2012

Saturday was the 25th commemoration of World AIDS Day. The theme this year was "Getting to Zero: zero new HIV infections; zero deaths from AIDS-related illness and; zero discrimination. While these may sound like lofty goals, the last year has shown some real progress. Internationally, there are approximately 34 million people living with HIV, two thirds in so-called developing countries. In 2011, 2.5 million people were newly infected with HIV. An estimated 1.7 million people died. That is 700,000 fewer new infections worldwide than ten years ago, and 600,000 fewer deaths than in 2005. In the United States, there are approximately 1.1 million people living with HIV with about 50,000 new infections annually. Currently, only 33 percent of those who are HIV positive in the US are on anti-retroviral treatment and only 25 percent have a suppressed viral load. Perhaps the most disturbing news has been the impact of HIV/AIDS in young people. According to a CDC report, young people ages 13 to 24 years accounted for more than a quarter of new HIV infections in the United States in 2010. That amounted to approximately 12,000 cases, but only about a third of the persons in that age group had been tested. Every month, approximately 1,000 youth are becoming infected with HIV. One of the major implication of this new data is the increasing future healthcare burden: approximately $400,000 over one's lifetime. There has also been some significant new developments: * Oraquick- The first rapid at-home HIV test that does not require the sample to be mailed in to obtain a result. * Pre-Exposure Prophylaxis (PrEP)-an FDA approved medication (Truvada) to reduce the risk of sexual transmission from the infected to the uninfected. * Stribilid: the first HIV medicine to combine four separate drugs and is the third HIV drug that can be taken once daily. * The number of antiretroviral drugs tentatively approved or approved for use under the President’s Emergency Program for AIDS Relief, or PEPFAR, has surpassed 150. PEPFAR is a program to treat those infected with HIV/AIDS in countries that lack the tools needed to fight the HIV/AIDS epidemic. Yet with all of the progress being made and the advances in medical treatment, we continue to have millions of new infections every year and over a millon deaths. Over two thirds of HIV+ people throughout the world who need antiretrovirals do not take them including in the United States. We cannot allow ourselves to be lulled into a false sense of security with our successes. We still have a lot of work to do.