Introduction
A deeper understanding of sexually transmitted diseases (STDs/STIs) is imperative, especially regarding interventions aimed at reducing the associated high prevalence and incidence rates, which are highest among adolescents and young adults aged 15 to 24 years, according to the Centers for Disease Control and Prevention (2013). One main STI that was indicated to have the highest cases in my previous paper was Chlamydial Trachomatis. Hence, this paper seeks to review two peer-reviewed journal articles that have reviewed behavioral approaches that could be employed to address the high rates of STDs, including chlamydia among these adolescents and young adults with a bias towards women. The articles reviewed include: “Programs to Reduce Teen Pregnancy, Sexually Transmitted Infections, and Associated Sexual Risk Behaviors: A Systematic Review” by Goesling, B., Colman, S., Trenholm, C., Terzian, M., and Moore, K., published in the Journal of Adolescent Health in the year 2014. The second article was “Behavioral Sexual Risk-Reduction Counseling in Primary Care to Prevent Sexually Transmitted Infections: A Systematic Review for the U.S. Preventive Services Task Force” authored by O’Connor, E., Lin, J., Burda, B., Henderson, J., Walsh, E., and Whitlock, E., published in the Annals for Internal Medicine Journal in the year 2014.
Hypotheses
Apparently, Goesling et al. (2014) have not articulately stated a hypothesis (es). However, the reader can decipher that the study aims to test the hypothesis that there is a relationship between behavioral-related preventive programs and reduction of pregnancy, STIs, or associated sexual risk behaviors among adolescents and young adults. The study by O’Connor et al. (2014) is also a review, but it contrasts with that of Goesling et al. (2014) because it has a well-stated and specific hypothesis, which is to test high-intensity behavioral counseling intervention as an effective strategy for reducing STDs/STIs among sexually active adolescents and adults at risk. However, O’Connor et al. (2014) have not indicated the adult age bracket, yet it was imperative to do so because the study gives background information related to young adults.
Methods
Both article reviews were guided by a pre-specified protocol with both inclusion and exclusion criteria. Whereas Goesling et al. (2014) executed the protocol in two stages, O’Connor et al. (2014) executed the protocol in just a single phase. The first protocol in the prior mentioned study was developed in the fall of 2009 to identify and review studies from 1989 to January 2010 (Goesling et al., 2014). The second protocol entailed an update of the previous protocol in the fall of 2010, and newer studies from January 2010 to January 2011 were reviewed. This protocol is about the Office of Adolescent Health (2015). The study utilized four-itemized inclusion criteria. To begin with, the study had to focus on intervention effects using quantitative data, hypothesis testing, and statistical analysis. Then, the study had to adopt randomized controlled trials or quasi-experimental approaches in their research designs. Secondly, the study focused on a measure (s) related to “pregnancy, STIs, or associated sexual risk behaviors” (Goesling et al., 2014, p. 500). Thirdly, the studies included had to focus on teenagers/young adults, who were 19 years or younger during recruitment of the sample. Lastly, the programs had to combine any educational, skill-building, and/or psychosocial interventions. The protocol adopted by O’Connor et al. (2014) differed from Goesling et al. (2014) in that it focused on more recent studies from the year 2007. In addition, this study included studies with experimental approaches, and both studies were restricted to the U.S. population. Whereas the study by O’Connor et al. (2014) excluded studies focusing on incarcerated persons or those with HIV/AIDs, Goesling, et al. (2014) did not restrict its study population to either criterion.
Findings
Results by O’Connor et al. (2014) were meta-analyzed using the Der Simonian-Laird method while Goesling et al. (2014) aggregated their results based on the levels of significance presented within the individual studies. In both reviews, the information delivered was relatively the same because it focused on STIs and contraceptive use. The study by O’Connor et al. (2014) indicated that other than gonorrhea, Chlamydia was the other commonly reported STI. In addition, in both reviews, the African-American population was highlighted as a target group of interest depicting high STI rates that have been affirmed by the Center for Disease Control and Prevention (2012). Also, both studies revealed that women are a vulnerable group to STDs/STIs. Goesling et al. (2014) included 31 studies, out of the initial 1900+ result list. Out of these 31 studies, all the five programs that focused on STIs showed significant outcomes while the 14 studies focusing on contraceptive use also showed positive outcomes. The same number of studies was reviewed by O’Connor et al. (2014). The results by O’Connor et al. (2014) also indicated a positive effect of the studied intervention in reducing the incidence of STIs. High-intensity counseling intervention of more than 2 hours in all 8 studies targeting the adolescents led to a 62% reduction in the incidence of STIs after 12 months. Moderate-intensity training resulted in a 50% success rate based on the 2 studies that were presented while low-intensity results were not conclusive. In addition, positive behavior change through increased use of condom use was realized.
Conclusion
The information obtained from this review indicates that behavioral interventions are effective in reducing the incidence and prevalence rates of STDs/STIs in both adolescents and young adults, which is the population mainly affected by chlamydia. The results are in alignment with the World Health Organization’s indications as presented by Okigbo and Eke (2013). Hence, women should formulate and implement policies that integrate behavioral approaches to fight chlamydia.
References
Centers for Disease Control and Prevention (CDC). (2013). Incidence, Prevalence, and Cost of Sexually Transmitted Infections in the United States. Atlanta: Division of STD Prevention, CDC.
Centers for Disease Control and Prevention (CDC). (2012). STDs in Racial and Ethnic Minorities. Atlanta: Division of STD Prevention, CDC.
Goesling, B., Colman, S., Trenholm, C., Terzian, M., & Moore, K. (2014). Programs to Reduce Teen Pregnancy, Sexually Transmitted Infections, and Associated Sexual Risk Behaviors: A systematic Review. Journal of Adolescent Health, 54, 499-507.
O’Connor, E., Lin, J., Burda, B., Henderson, J., Walsh, E., & Whitlock, E. (2014). Behavioral Sexual Risk-Reduction Counseling in Primary Care to Prevent Sexually Transmitted Infections: A Systematic Review for the U.S. Preventive Services Task Force. Annals of Internal Medicine, 161 (12), 874-883.
Office of Adolescent Health. (2015). TPP Resource Center: Evidence-Based Programs. Web.
Okigbo, C., & Eke, A. C. (2013). Behavioural interventions to reduce the transmission of HIV infection among sex workers and their clients in low- and middle-income countries: RHL commentary. The WHO Reproductive Health Library. Geneva: World Health Organization.