Fighting STDs and HIV

Fulton County public health officials 'on the front lines in this battle'

Public health departments are waging war  against what the Centers for Disease Control and Prevention calls “a hidden epidemic.”

Sexually transmitted diseases are on the rise, particularly among young people, causing significant health challenges to individuals and the nation’s health care system, according to the CDC’s Sexually Transmitted Disease Surveillance 2011 survey. The survey estimates that of the 19 million new STD infections occurring annually, nearly half are among  people ages 15 to 24.

Certain populations are more at risk than others. About 72 percent of primary and secondary syphilis cases are found in men who have sex with men. Of those, about four in 10 also test positive for HIV. Chlamydia and gonorrhea cases are highest in men and women ages 15 to 24. Since many STDs go undiagnosed or unreported, the survey’s numbers are likely conservative.

Treating STDs costs the nation’s health system about $17 million a year, according to the National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention. An even greater problem is that STDs increase the risk for HIV.

“Repeated STDs and multiple STDs are the gateway to HIV, and HIV is definitely on the rise. We’re treating about 16,000 STD cases a year in our STD clinic at the Aldredge Health Center (in downtown Atlanta),” said Veronica Hartwell, program administrator with the Fulton County Health and Wellness department. “Community health is on the front lines in this battle. We have a tiger by the tail, and by no means is it under control yet.”

The growth of social media has contributed to the increase in STDs, Hartwell said.

“People can now meet through Facebook, Instagram and other Internet means. Forget the traditional methods of a long courtship leading up to sexual activity,” she said.

The trend has been for teens to be sexually active earlier and with more partners than during previous times.

“Most of the time, males will present with a symptom, but sometimes females come in because something just doesn’t feel right. Our role is to assess, evaluate, counsel and treat them, as well as to get their partners in for treatment,” said Tisa Bright, nursing supervisor at the Aldredge Health Center.

Nurses follow the protocols set by the Georgia Department of Public Health, which are based on CDC guidelines.

“We have specially trained people just to talk to partners, who are still contagious and may infect others if they aren’t treated,” said Bright, RN, BSN.

'An emotional issue’

But it’s never as easy as simply following the protocols.

“An STD is an emotional issue and often patients are upset,” Bright said. “They get this infection from an intimate act and often from someone with whom they are in relationship. They may have thought they were the only partner. The news can be very hard."

A nurse for 27 years, Bright says that it takes time and an extra measure of patience to work with teenagers.

“You have to have compassion and a listening ear, because you’re going to hear a whole lot of other stuff besides what led to the STDs,” she said.

Bright treats the diseases, but she also teaches clients how to prevent future infections. She encourages them to use condoms or protective barriers during any sex act. She tells them how to look for signs of infection in a partner, and to be aware of their own bodies when something isn’t normal.

“Even if they just have a question, they can always come into the clinic and talk one-on-one with one of our counselors,” Bright said.

She takes the conversation further by asking about her young patients’ goals.

“We talk about how an STD infection or an unwanted pregnancy could interfere with their plans to finish high school or go to college,” she said. “I want them to focus on what they want to become.”

While most STDs can be treated by shots or pills, repeated or multiple infections can lead to infertility and other serious health problems, if not adequately treated. Fulton County Health and Wellness offers health care, education and counseling through its adolescent health and youth development programs at several  clinics, including the Adamsville Health Center, the College Park Health Center, the Aldredge Health Center and the Dunbar Teen Center.

“Our staff go out to schools and into community organizations to let young people know about our service, and to talk about abstinence, self-respect and making better choices. We want to raise awareness about our services, to let teens know that help is accessible,” Hartwell said.

HIV 'epidemic’

Fulton, DeKalb, Clayton and Gwinnett counties have an “epidemic” rate of HIV, according to an Emory University Center for AIDS Research study from 2009.

“We’re getting help addressing the burden of that disease from a federally funded grant from the CDC. We received about $5 million the first year and are rolling out an extensive HIV testing campaign,” Hartwell said.

Fulton County’s efforts are part of the Enhanced Comprehensive HIV Prevention Plan for the Atlanta Metropolitan Statistical Area. It has allocated resources to the counties that  account for 60 percent of Georgia’s HIV/AIDS deaths — Fulton, DeKalb, Cobb-Douglas, Clayton and Gwinnett. The plan aims to reduce infections, increase awareness to care and improve health outcomes of HIV/AIDS patients.

“We know where the high-risk areas are in our communities. Our first goal is to get everyone tested, so that they know their HIV status and can get treatment if they need it,” Hartwell said.