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Boston To Unveil New Teen Sex Awareness Program After Spike In STI Cases

Boston"s health agency on Tuesday is scheduled to launch a safer-sex campaign that reaches out to teenagers through Web sites such as Facebook and YouTube, the Boston Globe reports. The campaign was created in response to rising rates of sexually transmitted infections among young people in the city, according to the Globe. The $100,000 campaign originally was intended to address communicable diseases in general. However, experts noticed the increase in STI cases among teenagers and decided to spend all the funding on the campaign targeting STIs.The increase in chlamydia cases in particular demonstrates the "scope of the challenge," as 1,383 Boston youths between ages 15 and 19 were diagnosed with the STI in 2007, a 70% increase since 1999, the Globe reports. The overall rate of chlamydia in Boston is more than twice the national average, and chlamydia and gonorrhea are more common among adolescents than any other age group in Boston. According to the Globe, a city study released in early 2009 found that 56% of Boston public high school students have had sex, and 24% of the sexually active students said they have had more than six partners.For the campaign, "teenagers will do much of the talking" in a video that offers information on STIs, the Globe reports. The video will air on cable channels that are popular with teenagers, such as MTV, FX and BET. It shows teenagers in a classroom receiving information on safer sex, including details about condoms and STI screening. The video does not discuss sexual abstinence.The campaign also includes advertisements on mass transit and the radio, as well as a team of teenagers that will travel around Boston performing street theater addressing the risks associated with STIs. Through the social networking Web site Facebook, teenagers can post questions anonymously regarding sexual health that will be answered by a disease specialist. Videos related to the campaign also will be posted on YouTube.Margaux Joffe, multimedia coordinator at the Public Health Commission, said teenagers "told us, "We don"t want some 40-year-old woman telling us about sex and STIs."" Joffe added that it "makes sense" because a teenager "may not trust the advice of an adult as much as you would someone in your peer group." Mark Schuster, the chief of general pediatrics at Children"s Hospital Boston who was not involved in the design of the campaign, said that using a "multilevel approach" to address the issue is a "great strategy." He added that young people "can be interested and learn from" a sex education curriculum in school, but "they need it in other settings too."Specialists speculate that the rise in STIs may reflect teenagers" casual attitudes about sex and parents" shifting attention to other children"s health concerns, the Globe reports. Experts also have said that the increase in STIs could reflect increased screening efforts by physicians, who have been "pressed for many years to screen much more carefully kids at younger and younger ages," Stephen Boswell, president of Fenway Health, said. The Globe reports that teenagers do not view HIV/AIDS in the same way previous generations have because of advancements in treatment, so preventing the virus "no longer seems quite as important." Experts are concerned that the spread of other STIs could be a forewarning of a rise in HIV/AIDS cases among teenagers. Anita Barry, a top disease specialist at BPHC, said the gonorrhea and chlamydia cases are "our future HIV cases unless we intervene" (Smith, Boston Globe, 8/4).

Health Affairs Study Finds No Link Between Cost, Quality Of Care

Quality of care is not linked to the cost of care, according to a study published last week on the Web site of the journal Health Affairs, CQ HealthBeat reports. For the study, researchers from Dartmouth College and Harvard University analyzed the health care bills of chronically ill Medicare beneficiaries in their last two years of life who received end-of-life care from 2,172 unidentified hospitals. The patients had one of three common conditions: heart attack, pneumonia or congestive heart failure. The study -- sponsored by the National Institute on Aging -- looked at common quality indicators at a hospital-by-hospital level instead of regional level (Norman, CQ HealthBeat, 5/22). Researchers compared the data with some of the quality measures reported on the HHS Hospital Compare Web site (Goldstein, "Health Blog," Wall Street Journal, 5/21). The study found that among the one-fifth of hospitals that spent the least, the cost of end-of-life care was $16,059 on average. In comparison, the cost of end-of-life care at the top 20% of highest-spending hospitals was $34,742 on average. The study also found no link -- or even evidence against a link -- between spending and the quality indicators. The researchers noted that the results might be skewed because the quality indicators they used might penalize hospitals that treat sicker patients. In addition, the study used process-of-care measures instead of patient outcomes. According to CQ HealthBeat, the findings of the study could have an effect on the debate over health care reform legislation because lawmakers and President Obama both have said that a reform plan must be able to control costs and expand access to high-quality, affordable health care (CQ HealthBeat, 5/22).