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Asked by MinisterValorHyena6
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In Nebraska the chlamydia rate has always been discussed to have the highest prevalence across the state. I hope to continue to stay in Nebraska after graduation and practice here. Therefore, I need to be aware of the most prevalent STD in the state.
The data presents progressively increasing rates across all ages, genders, and races for the disease. Since 2000, the rates have steadily increased from 4,000 cases to 10,000 by 2019 (CDC,2021). The CDC found that chlamydia has been found in all age groups from younger than 14 to 64 years old. The age with the most cases was found to be 20-24 years old with 3,529 cases just in the year 2019 (CDC, 2021). Caucasian persons have the highest prevalence by more than 1,000 cases compared to all races and it was found in two times more females than males (CDC,2021). The more interesting face I found was that in all of Nebraska’s counties only two were the main sources of chlamydia cases. Douglas and Lancaster County had the highest number of cases at 1,802 in Lancaster and 4,137 in Douglas. All other counties had less than 800 cases. This is interesting because yes Douglas County is highly populated but Lancaster significantly less than other counties with far less cases. However, a theory of this could be that Lancaster County is home to two four-year universities for undergraduate degrees.
Majority of those who attend undergraduate are ages 18 to 25, it is interesting that in both highly evidenced counties there are multiple universities for undergraduate and graduate degrees. Possible barriers or biases is the social stigma of having an sexually transmitted infections. Already in the clinic I have had discussions with young adolescents about STI’s and their understanding of them. One young girl described it as “being dirty”. It was important to educate that having an STI does not determine a person’s hygiene. Fear of embarrassment or having to tell future partners of STI history prevent many from getting tested. Also, in rural Nebraska it is difficult to find private clinics that offer affordable STI screenings and treatment. Douglas and Sarpy County are the most populated counties that may have enough privacy. This could be why Douglas County has the most cases reported.
In comparison to the United States as a whole, the trending data from 2000 to 2019 has the same progressive escalation of cases as Nebraska. The highest age was also the same with 20-24 having the most cases by a significant amount than any other age. However, the eldest age to have chlamydia was 65 + whereas Nebraska it was found up to age 64 (CDC, 2021). Another similarity found was that females had double the number of cases compared to males; This was also found in Nebraska’s data. The only significant difference found in data was the most prevalent race to have chlamydia in Nebraska was Caucasian, but across the USA it is African Americans. There are almost 100,000 more cases in African Americans than Caucasians.
Two patient-centered actions I can utilize to promote active STI awareness are, early discussions during adolescent wellness exams and collaboration with STD and pregnancy clinics within the community. Starting early with discussions of what STI’s are, how they present and how common they are can make young teens feel more comfortable talking about them and asking questions that will lead to awareness for their lives. Discussing patient preferences with sexual partners can enhance the patient/ provider relationship as a safe space. Also, having connections with clinics around town that are confidential will make teens and young adults feel they are able to resolve issues in private being able to give substantial information and options will hopefully make patients more comfortable.
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