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In the United States, Chlamydia is the most common bacterial sexually
transmitted disease, particularly among sexually active adolescents and young
adults. Chlamydia is a common and curable infection caused by the bacteria
Chlamydia trachomatis. The bacteria target the cells of the mucous membranes.
Receiving a diagnosis of chlamydia was a shock, and all reported experiencing
feelings that ranged from mild self disgust to distress. Those diagnosed also
expressed worry about disclosing their condition to others. Most did tell
selected friends or family members, but none did so without some anxiety about
negative reactions. Disclosure to others functioned as a mechanism for garnering
social support, and feelings of isolation were reported by those who felt unable
to tell members of their usual support network. Despite the norm of serial
monogamy among participants and, reportedly, their partners, disclosure was
associated with fears of negative reactions by sexual partners. Feelings of
guilt, regret, and “dirtiness” were also reported. (Pub Med Central, 2001)
Diagnosis of a sexually transmitted infection introduced the possibility of a
current partner's infidelity which is another source of anxiety related to this
diagnosis.(Pub Med Central, 2001)
The possibility of infertility after infection provoked a mixed reaction: relief
that the infection had been diagnosed and treated but also anxiety about future
reproductive morbidity. These anxieties were exacerbated by clinical uncertainty
about the natural course of chlamydia and the difficulty of providing a
prognosis in relation to reproductive effects.(Pub Med Central, 2001)
Clamydia infection is one of the most widespread bacterial STD’s in the United
States. The U.S. Centers for Disease Control and Prevention (CDC) estimates
that more than 4 million people are infected each year. Health economists
estimate that Chlamydial infections and other problems they cause cost Americans
more than $2 billion a year.
What is Clamydial Infection?
Chlamydial infection is a curable sexually transmitted disease, which is caused
by bacterium called Chlamydia trachomatis. You can get genital chlamydial
infection during oral, vaginal, or anal sexual contact with an infected partner.
It can cause serious problems in both males and females as well as in newborn
babies of infected mothers.(NIAID, 2002) Chlamydia trachomatis is the most
common sexually transmitted bacterial pathogen in the United States and
disproportionately affects African-American adolescents. Adolescents testing
positive for Chlamydia trachomatis infection are significantly more likely to
test positive for gonorrhea. (NCBI, 2002)
What are Symptoms of Chlamydia?
You can have Chlamydia and not even know it because it doesn’t cause most people
to become sick. Symptoms usually appear within one to three weeks after being
infected. (NIAID, 2002) Those who do have symptoms may have an abnormal
discharge from the vagina or penis or pain while urinating. These early
symptoms may be very mild or non-existent, because of this you might not seek
care and get treated.
The infection may move inside the body if it isn’t treated. There, it can cause
pelvic inflammatory disease(PID) in women and epidimitis in men, these are two
very serious illnesses. The bacteria also can infect the throat from oral
sexual contact with an infected partner, or can cause inflamed rectum and
inflammation of the lining of the eye. (NIAID, 2002)
How Does the Doctor Diagnose Chlamydial Infection?
The most reliable ways to find out whether the infection is Chlamydia are
through laboratory tests. Chlamydial infection is easily confused with
gonorrhea because the symptoms of both diseases are similar and the diseases can
occur together. One way in which the infection is tested for is that a doctor
or other health care worker will send a sample of pus from the vagina or penis
to a laboratory that will look for the bacteria. A urine test can also be used
which doesn’t require a pelvic exam or swabbing of the penis and results are
available within twenty four hours. (NIAID, 2002)
What can happen if left untreated?
Untreated chlamydial infections in women can lead to PID. When men aren’t
treated it leads to pain or swelling in the scrotal area, which is a sign of
inflammation of part of the male reproductive system located near the testicles
known as the epididymis. These complications can prevent people from having
children. Scarring may interfere with the passage of the fertilized egg to the
uterus during pregnancy. When this occurs, the egg may attach itself to the
fallopian tube. This is called ectopic or tubal pregnancy. This can cause a
miscarriage or death to the mother. (NIAID, 2002)
Yearly up to one million women in the United States develop PID, a serious
infection of the reproductive organs. As many as half of all cases of PID may be
due to chlamydial infection, and many of these don’t have symptoms. Researchers
estimate that 100,000 women each year become infertile because of PID. (NIAID,
2002)
How is Chlamydia Treated?
Those infected with chlamydia are prescribed an antibiotic such as azithromycin
(taken for one day only) or doxycycline (taken for seven days) by either their
doctor or other heatlh care worker. (NIAID, 2002)
In the United States, nearly half of all high school students are sexually
active. Almost twenty-five percent of seniors in high school have had four or
more partners. Even with these numbers, only thirty-five percent of the students
use a condom every time they are involved in sexual intercourse (Illinois
Department of Public Health).
Chlamydia is transferred primarily during anal or vaginal sex. The chances of it
being passed through oral sex are much less likely, because the bacteria that
cause Chlamydia prefer to target the genital area rather than the throat.
Chlamydia is passed through the mucous membrane secretions or the semen of an
infected person. The only true way to prevent Chlamydia is abstinence (American
Social Health Association).
Although Chlamydia can be found in a person of any age, it is most commonly
found in adolescents and young adults. Out of any sexually transmitted disease,
it is the most common bacterial sexually transmitted disease among teenagers. It
is estimated that as many as three million cases of Chlamydia occurred in 2000,
and that as many as one in ten females were infected. With numbers like these,
it is very easy for Chlamydia to spread quickly, especially with the low amount
of people using condoms (American Social Health Association).
There are several factors that can cause a person to become infected with
Clamydia. Some of the ways a person can become infected is by vaginal, anal, or
oral sex. An estimated 3 millon Americans get chlamydia each year. Three of
every four reported cases occur in young people under age 25.By age 30, 50
percent of sexually active women probably have had chlamydia.Chlamydia is a
serious disease that can damage a woman's reproductive organs-the uterus
(womb)., ovaries, and fallopian tubes. The disease often has only mild or no
symptoms. Chlamydia can also be passed from one infected mother to her baby
during childbirth. Babies born to infected mothers can get chlamudial infections
in their eyes and respiratory tracts. When diagnosed, chlamydia can easily be
treated and cured with antibiotic drugs.The more sex partners a person has, the
greater the risk of getting infected with chlamydia. Chlamydia often occurs
together with gonorrhea, another STD. Gonorrhea and chlamydia have similar
symptoms and can have similar complications. It is important to remember that
infection occurs so often without symptoms, people that are sexually active, are
always at risk of exposure.
The state board of education in Michigan recommends that local school board
support their school administrators and faculty to select, adopt, and implement
comprehensive sexuality education programs that are based on sound science and
proven principles of instruction. Local school districts programs must be in
compliance with Michigan laws regarding reproductive health education and HIV
and other STD prevention programs. (State Board of Education, 2003)
In its recently updated recommendations on Chlamydia screening, the U.S.
Preventive Service Task Force strongly recommended that clinicals routinely
screen all sexually active women aged 25 years and younger. (Aetna, 2003)
Teenage girls have the highest rates of chlamydia infection, with 1 in 10 girls
tested for the disease infected. It has been determined that the rate of
re-infection among young women treated for chlamydia is between 15% and 30%, and
reinfection can increase the likelihood of severe complications associated with
chlamydia. As a result, it is extremely important to ensure that the partners
of persons that have been treated for chlamydia also be treated, to avoid
re-infection. In California, as of January 2001, medical providers can
prescribe or dispense antibiotic without having to perform an exam on the
partner. This form of treatment is known as Patient Delivered Partner Therapy,
and is intended to decrease the incidence of re-infection by treating all
partners of the infected individual. (Health Policy Coach, 2003)
Implementation #1
Implementation Policy: Students should be better informed of how the diagnosis
of Chlamydia impacts a persons quality of life.
Process Evaluation: To implement this policy all students should be required to
attend a conference about STD’s where testimony will be given by those
diagnosed.
Impact Evaluation: The impact of this policy will help students to better
understand the psychosocial aspect of being diagnosed with Chlamydia.
Outcome Evaluation: 100% of students will better understand how to interact
with those treated and will know ways in which to ease the anxiety of those
infected.
Implementation #2
Implementation Policy: Based on findings, it is a good idea that students be
screened for chlamydia.
Process Evaluation: To implement this policy, all 10th grade students are to be
screened before moving on to their 11th grade year.
Impact evaluation: The impact of this policy will allow all 11th and 12th grade
students to have been screened and the result will be an increase in awareness
of actual chlamydia cases in the school setting.
Outcome Evaluation: The outcome of this policy will allow the faculty to become
aware of the cases of chlamydia that the school may have, therefore, being able
to prepare for specific precautions that need to be taken.
Implementation #3
Implementation Policy: Based on research findings, it is advised that students
be made aware of how sexually transmitted diseases, such as Chlamydia, are
transmitted and how to reduce the risk of contracting them.
Process Evaluation: To implement this policy, it is suggested that one hundred
percent of students attend a mandatory health class, which includes a section on
sexually transmitted diseases, every year.
Impact Evaluation: The impact of this policy will enable seventy percent of
students to become more responsible for their health and well-being.
Outcome Evaluation: The outcome of this policy will allow students to reduce the
frequency of contracting a sexually transmitted disease.
Implementation #4
Implementation Policy- Research shows that people should practice
abstinence(don't have sex). Delaying having sex for the first time is another
way to reduce a persons changes.
Process Evaluation: Upon hiring 100 percent of employees at schools wil attend a
mandatory meeting in which they will be taught the proper way to teach sex ed.
Impact Evaluation: The impact of this evaluation will result in a decrease in
number of chlamydia outbreaks in schools. Further research is necessary.
Outcome Evaluation: The outcome of this evaluation will result in 100 percent of
school workers being aware of how to prevent chlamydia.
Implementation #5
Implementation policy: Educating the school community about Chlamydia ranging
from general information such as signs and symptoms to complications related to
pregnancy.
Process Evaluation: Health Unit Officials will be required to provide
information to students as well as parents regarding chlamydia. School nurses
will provide handouts for all students to take home to parents at routine
checkups during the school year.
Impact Evaluation: Parents, students, and school faculty will have some basic
knowledge of Chlamydia and be able to answer survey questions regarding
Chlamydia with 70% accuracy.
Outcome Evaluation: At least 75% of persons in the school community will be able
to identify Chlamydia and have an understanding of what to do and where to go
for assistance if exposed.
- State of Michigan State Board of Education, Policy to Promote Health and Prevent
Disease and Pregnancy. September, 2003. Retrieved October 3, 2003, from
http://www.michigan.gov/documents/Sex_Ed_Policy_77377_7.pdf.
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