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Kees Rietmeijer's Blog

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The Goose and the Gander - STI/HIV Prevention and the Adult Entertainment Industry

Kees Rietmeijer: on April 03, 2017 at 02:59:08 PM

In a sexual health discourse that has started to shift the focus from disease prevention to health promotion, to embrace sexual and ethnic diversity, to support sexual rights and to reduce stigma, there are two topics that are often avoided: prostitution and pornography. Both the provision and consumption of each continue to be shrouded in prudishness, prejudice, and punition.  Trafficking, coercion, and the potential for exploitation of women, adolescents and other vulnerable populations complicate the formulation of a place for these activities, if any, in the spectrum of sexual health. However conflicted we may be though, most would agree that professional engagement as a sex worker or adult entertainer should not deprive one of ways to prevent the untoward consequences of one’s work, specifically the risk for HIV and other sexually transmitted infections (STI).

In this context, policies and laws to regulate the adult entertainment industry that stipulate regular testing for entertainers and mandatory condom use during professional sexual activities appear to be justified,
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ASTDA Summer Update

Kees Rietmeijer: on August 22, 2016 at 10:58:39 AM

From the ASTDA President

20 August, 2016

Dear Colleagues

As the days are getting longer and the time to the 2016 STD Prevention Conference shorter, here’s your late summer ASTDA update.

First, elections for the ASTDA Executive Committee (EC) were held last month and the 2016/2018 EC will be composed of the following members:

President: J. Dennis Fortenberry, MD, MS

President-Elect: Barbara van der Pol, PhD, MPH

Past-President: Kees Rietmeijer, MD, PhD

Secretary Treasurer (3rd term): Edward W. Hook III, MD

On behalf
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STD Express Visits at a New Level

Kees Rietmeijer: on June 23, 2016 at 04:23:50 PM

Thirteen years ago we initiated a mandatory co-pay for patients visiting our STD clinic in Denver. The results were dramatic: a precipitous decline in patient visits and an almost 40% reduction in diagnosed gonorrhea cases. Alarmed, we introduced an “express visit”, a no-cost alternative to a full-exam visit for asymptomatic patients, offering basic STI and HIV testing without a clinical examination. Currently, many STD clinics in the U.S. and abroad offer some type of express visit or fast-track option to reduce costs and enhance efficiencies in their clinics. However, with advancing computer and diagnostic technologies, the express visit model is evolving rapidly.

Just how far the express visit envelope can be pushed is shown at the Dean Street Express clinic in London’s SoHo district. I recently had a chance to visit Dean Street Express on a tour organized by the National Coalition of STD Directors.

This store-front clinic was conceived when a large HIV clinic down
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ASTDA Spring 2016 Update

Kees Rietmeijer: on May 09, 2016 at 07:22:40 AM

May 9, 2016

Dear Colleagues,

With spring slowly changing to summer, I wanted to give you an update on what’s happening in the Association.

First, it gives me great pleasure to announce and congratulate the richly deserving recipients of the 2016 ASTDA Recognition Awards: Dr. Anne Rompalo (Distinguished Career Award), Dr. Joan Chow (Achievement Award), and Dr. Lindley Barbee (Young Investigator Award).  Thanks very much to the members of this year’s awards committee that yielded such excellent results: Dennis Fortenberry, Anna Wald,  Marc Steben, Ina Park, Bobbie van der Pol, and Kim Workowski. The awards will be presented at the Annual ASTDA Awards Luncheon during the National STD Prevention Conference on Thursday September 22. All attendees to the conference are invited to the event.  

Preparations for the STD Prevention Conference are in full swing. 
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Syphilis Summit

Kees Rietmeijer: on February 03, 2016 at 07:40:20 AM

Syphilis Summit

On behalf of the American Sexually Transmitted Disease Association, I attended the CDC “Syphilis Summit” conference last week in Atlanta. It was a very intensive meeting attended by over 100 scientists, clinicians and program staff. Trying to summarize this meeting in a short blog and not omit important detail is a hazardous task, but I will try anyway.

Syphilis has been on the rise in the U.S. since the late 1990s, when the availability of highly active anti-retroviral treatment profoundly changed the perception of HIV/AIDS as an invariably fatal disease and risk behaviors increased, particularly among MSM. Some may find this reasoning somewhat simplistic, however, the fact is that the current syphilis epidemic was initially largely confined to men and disproportionally affecting MSM. Recently, though, there has also been an increase among heterosexual men and women and, as a result, an increase in congenital syphilis cases. In 2014, the CDC reported 458 cases of congenital syphilis, compared 359
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Training, Program, Science

Kees Rietmeijer: on November 07, 2015 at 04:52:49 PM

Dear Colleagues,

Last week, the National Network of STD Prevention Training Centers (NNPTC) and the National Coalition of STD Directors held their annual meetings back-to-back in Savannah, GA. Obviously, this was no coincidence.  Since the NNPTC started their new funding cycle last fall, there has been a clear expectation from CDC that the prevention training centers work closely together with the state and local STD AAPPS (Assessment, Assurance, Policy Development and Prevention Strategies) grantees and indentify areas where the NNPTC can provide targeted training and technical assistance. For many in the NNPTC this is a departure from clinical training business as usual and requires a new approach. While challenging, especially for those centers that are working with new states in their jurisdiction, this is also a great opportunity to expand the reach of NNPTC expertise. This new direction is accompanied by a shift in the focus of clinical training. Where in the past, there was little
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From the ASTDA President: ASTDA Bylaw Changes

Kees Rietmeijer: on October 16, 2015 at 07:57:09 PM

The below letter went out to the ASTDA membership. However, if this email peaks your interest in ASTDA, please visit www.astda.org and find out more about our organziation. We would love to have you join as a member!

 

October 12, 2015

 

To: Membership of the American Sexually Transmitted Diseases Association

Dear Colleagues,

Our Association is a very dynamic organization and periodically we need to ensure that our activities are in line with the Association’s bylaws. There have been a number of developments this last year that in the opinion of the ASTDA Executive Committee requires changes to the bylaws. I am writing you to inform you about these changes and to request your input and vote. 

Formalizing the relationship between ASTDA and the International Union Against Sexually Transmitted Infections (IUSTI)

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You Say STD....

Kees Rietmeijer: on September 24, 2015 at 01:53:08 PM

In a recent article in the journal Sexually Transmitted Diseases co-published as a blog on STDPO, Dr. Hunter Handsfield rekindled a long-standing debate: what, if any, is the difference between STI (sexually transmitted infection) and STD (sexually transmitted disease)?1 While there may be more critical issues in our field to lose sleep over, the STI/STD debate is not quite trivial. The question comes up often enough in our trainings and most of our students think that there is indeed a difference, even though they may not know what it is. Thus, arguments from an undisputed leader in the field like Dr. Handsfield, suggesting that we should not fret too much about the difference between “infection” and “disease” and that STI and STD may and probably will be used interchangeably for times to come, appear to put this issue to rest.

However, before
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From the ASTDA President: What's Happening?

Kees Rietmeijer: on July 06, 2015 at 01:51:52 AM

From the ASTDA President: What’s Happening?

At the start of the second year of my two-year tenure as ASTDA’s president, this is a good time to take stock of the Association’s accomplishments this past year and also tell you about some things on the immediate horizon.

First, I hope you will join me in celebrating the 2015 ASTDA recognition award winners at the ISSTDR meeting in Brisbane, Australia during the annual ASTDA Awards Luncheon. At this event, the ASTDA Distinguished Career Award will be presented to Dr. Anna Wald from the University of Washington, while Dr. Jeanne Marrazzo, also from the University of Washington will be the recipient of the ASTDA Achievement Award, and Dr. Robert Kirkcaldy from the Centers for Disease Control and Prevention will receive the ASTDA Young Investigator’s Award.

Congratulations to all!

2015 CDC STD Treatment Guidelines – What Next?

Kees Rietmeijer: on June 19, 2015 at 09:26:59 AM

Two weeks ago, the CDC released the long awaited 2015 edition of the Sexually Transmitted Diseases Treatment Guidelines. Rigorous review of relevant national and international STD research over the past decade and a consensus meeting of more than 100 STD experts in Atlanta 2 years ago have culminated in a 200 page document, not counting 60 pages of references.

Many of our colleagues have spent an incredible amount of time in the review process, most of them members of our Association.  CDC should be complimented on pulling this report together once again and one person in particular, Dr. Kim Workowski, should be recognized for her long-standing work on the guidelines that earned her the ASTDA Achievement Award back in 2012.

Beyond applauding our colleagues for this wonderful piece of work, what should we do with the new guidelines?  Let me offer some suggestions. First, we should take time to read the text cover to cover and then - read it again. This is arguably
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