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Some of the Research: STDs

Global Estimates on STDs

WHO (World Health Organization) estimates that 340 million new cases of STDs have occurred worldwide in 1999. The largest number of new infections occurred in the region of South and Southeast Asia, followed by sub-Saharan Africa and Latin America and the Caribbean. However, the highest rate of new cases per 1000 population has occurred in sub Saharan Africa.

North America 156 3 14

Western Europe

203 4 17
North Africa & Middle East 165 3.5 10
Eastern Europe & Central Asia 205 6 22
Sub Saharan Africa 269 32 69
South and South East Asia 955 48 151
East Asia & Pacific 815 6 18
Australia & New Zealand 11 0.3 1
Latin America & Caribbean 260 18.5 38

Teen with Doctor2 Teens on the telephone

The Choice GameTM introduces the concept of STDs through a conversation between two friends. Peer influence among the youth is universal. As the player speaks to their friend statistics become more reality. The game helps youth make healthier choices in the future.


Wrong. One out of every four teenagers will get an STD, even though lots of teenagers think they know how to protect themselves. There are other STDs out there besides HIV, and they are on the rise among teens. They include chlamydia, gonorrhea, syphilis, herpes and human papillomavirus (HPV) which cause genital warts and abnormal Pap smears.

Most people who have STDs have no symptoms. Someone you know could have gotten an STD, not realized it, and could be spreading it if he or she has unprotected sex. Sometimes the only way to know if you have been infected is to get a test. Some STDs may not yet be detected (seen) even when tested. Using a condom isn't 100% safe against pregnancy or STDs--only abstinence is!

Young man on telephone

The components of The Choice GameTM help young people to explore the dangers to their health and future if they choose to participate in risky behavior.

Chlamydia - Worldwide

Chlamydia is a common cause of pelvic inflammatory disease with subsequent risk for infertility. The higher prevalence of Chlamydia observed amongst female adolescents (24.1%-27%), and the association with young age highlight the important role that screening of sexually active female play in the prevention of infertility.

In 1996 genital chlamydial infection was the most commonly reported notifiable infectious disease in the United States with an annual point estimates of approximately 3 million cases,

In Western Pacific, studies amongst pregnant women have shown a prevalence rate that ranges from of 5.7% in Thailand up to 17% in India. One study in a rural population in Papua New Guinea showed a prevalence rate of 26%.

In Australia, number of STI notified in 1998 was higher than in 1997. Chlamydia infection was the most common STI notified and the third highest for all notifiable diseases.

In Europe, prevalence of Chlamydia infection amongst pregnant women ranges from 2.7% in Italy to 8% in Iceland, with low prevalence and incidence rates in the Nordic countries, following a wide scale screening program in the 1970s.

Prevalence studies from Latin America and Caribbean, show rates from 1.9% amongst teenager in Chile, 2.1% amongst pregnant women in Brazil, and 12.2% amongst attendees to family planning clinics in Jamaica.

Teens at party

The purpose of The Choice GameTM is to teach young people that waiting to have sex until marriage avoids a lot of suffering and heartache. A common theme in several of the scenes is "Chastity is a Lifestyle".

Gonorrhea - Worldwide

In Western Europe, a significant decline of incidence of gonorrhea has been observed during the years 1980-91 down to below 20 per 100 000 for gonorrhea. However, since mid 1990s, an increase in cases of gonorrhea has been observed in England and Wales, with a 35% increase in male cases and a 32% rise in female cases between 1995-97. Significant increases in diagnoses of uncomplicated gonorrhea were seen in most age groups between 1995 and 1998, with the largest average annual increases in the 16 to 19 years old of both sexes, and those over 34 years of age. In Sweden, trends in the incidence of gonorrhea showed a steady decline with a incidence of 2.4 per 100,000 inhabitants in 1996. However, in 1997 the number of new cases was 17% higher than in 1996, which represents the first increase since 1976. The upward trend has persisted in 1998. The ratio male: female has been unchanged since 1995, with 80% of cases amongst male.

Young woman on phone

In the USA, between 1981 and 1996 the incidence of reported gonorrhea decreased 71.3%, from 431.5 to 124.0 cases per 100 000. Rates amongst blacks were 35% times higher than among whites in 1996, compare with 11 times higher in 1981. Among women the highest rates was observed in the 15-19 years old group and in men in the 20 to 24 year olds. An important increased in gonorrhea rates has been seen in Eastern Europe, in the newly independent states of the former Soviet Union, with the highest rate in Estonia, Russia and Belarus (111, 139 and 125 per 100 000 respectively). In the Baltic countries, the average age of patients suffering from STI is decreasing as shown in a study looking the epidemiological situation in the Baltic countries for the period 1990-94. In the Western Pacific the highest estimated prevalence rates for gonorrhea (3% or greater) are found in Cambodia and Papua New Guinea In other countries, estimated rates are below 1%.

HIV and A.I.D.S. - Worldwide Information

Right now, today in the next 24 hours, 16,000 individuals will contract the AIDS virus The folks out there that think it can't happen to them are wrong. It can happen, and it IS happening to 16,000 people a day. One in every 100 sexually active adults worldwide is infected with HIV, and only one in 10 knows they are infected. 30 Million adults and children are infected worldwide.

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As you may know, the population of the world in 2000 was about 6 billion people, and by 2050, there should be about 8.9 billion living. (see http://www.popin.org/pop1998/for the United Nations—Population Division—Department of Economic and Social Affairs—Revision of World Population Estimates and Projections.) Fertility rates are also said to be declining from 5 births to 2.7 per women, over the last 25 years. Hence once massive population explosion, while still exploding, is not in such force, as say, back in the 1950's. The HIV/AIDS epidemic also impacts population and life expectancy in those areas hardest hit by AIDS.

Teens kissing

As The Choice GameTM player meets a member of the opposite sex they can choose to become sexually active. In the game the young couple is shown kissing. The next scene is a conversation where the girl wonders if she is pregnant. At the very same time the information shown here is available to educate the player about HIV and AIDS.

Finally, based on current rates of increase, by 2045, in the vicinity of 8.5 billion HIV/AIDS infections would exist worldwide, and that easily outruns the population projection of 8.9 billion by 2050. This means that by 2045, 100% of the world population would be infected. Pending an actual cure is found, or preventative, in the next few decades, this would mean the entire world population will carry HIV (though this does not predict what percentage of HIV infections will lead to full blown AIDS). The beginning of this already hit home as vast populations of HIV infected peoples expand beyond their political and geographical borders on all major continents.

Syphilis - Worldwide

In Western Europe, syphilis prevalence has declined substantially since the peak after the second World War, with incidence rates below 5 per 100 000 in the majority of countries.

In the USA, trends of congenital syphilis began to decline in 1992 after an increase that follow a national syphilis epidemic in 1980s and early 1990s. Rates of congenital syphilis declined from 78.2 in 1992 to 20.6 per 100 000 live births in 1998, with high rate in the south-eastern United States and among minority racial/ethnic populations. The trend observed is parallel with the trend for primary and secondary syphilis.

In contrast with the decline in rates observed in Western Europe, since 1989 there has been an alarming increased of the rates in the newly independent states of the former Soviet Union. Syphilis incidence has increased from 5-15 per 100 000 observed in 1990 to as high as 120-170 per 100 000 of population in 1996.

In the Western Pacific, relatively high syphilis prevalence rates are found in Cambodia (4%), Papua New Guinea (3.5%) and the South Pacific (8%).

In Mongolia, syphilis rates showed a decreasing trend during 1983-93 from 70 to 18 cases per 100 000 population, followed by an increase to 32 cases per 100 000 in 1995, with a 1.5 - 3.0 fold higher rate amongst the 15-24 age group.

In the eastern Mediterranean Region, in 1997, the highest syphilis prevalence rate amongst pregnant women was reported by Djibouti (3.1%), followed by Morocco (3.0%) and Sudan (2.4%). Amongst blood donors, the highest prevalence was seen in Morocco (1.3%), followed by Qatar (1.1%).

In Africa, syphilis prevalence rates amongst pregnant women varies from 2.5% in Burkina Faso to 17.4% in Cameroon. Prenatal screening and treatment of pregnant women for syphilis is cost-effective, even in areas of prevalence as low as 0.1%. In South Africa, peri-natal death was 19.4 times more likely if incomplete treatment or no treatment at all was received.

Teens discussing

The Choice GameTM also allows the player to choose a chaste lifestyle or a lifestyle, which abstains from sex until marriage. The game introduces the player to the concept that chastity or abstinence is the safest way to avoid all sexually transmitted diseases.

Trichomononiasis - Worldwide

In spite of the fact that Trichomononiasis is the most common of STDs, data on prevalence and incidence are limited.

Vaginal Trichomoniasis has been associated with increased HIV virus seroconversion in women. Additionally, trichomoniasis is associated with adverse birth outcomes as premature delivery or rupture of the membranes and low birth weight.

Recently, a study conducted in the Democratic Republic of Congo amongst HIV positive and negative pregnant women, show that trichomona vaginalis was isolated twice as often in HIV sero-positve women. In addition, trichomoniasis was associated with low birth weight in the group of HIV sero-negative women.

Some STDs are better known than others. Youth often think they are invincible and would never contract an STD. The Choice GameTM tests these ideas and permits young people to suffer through bad decisions.

Trichomoniasis prevalence rates amongst pregnant women in Latin America and Caribbean in the 1990s ranges from 2.1% in Brazil, 3.6% in Barbados, 8% in Nicaragua and 27,5% in Chile.

Prevalence studies amongst pregnant women in Africa show rates from 9.9% in Central African Republic to 41.4 in South Africa.

Few prevalence studies have been conducted amongst men. Recently, a study in Malawi shows a prevalence of 20.8% with symptomatic men and 12.2% with asymptomatic. Another study amongst male patients with urethral discharges in Egypt shows a prevalence rate of 28.8% and 8.2% with men suffering from impotence and infertility.

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