Startling government research on teenage girls
and sexually transmitted diseases sends a blunt message to kids who
think they’re immune: It’s liable to happen to you or someone you know.In
the first study of its kind, researchers at the federal Centers for
Disease Control and Prevention found at least one in 4 teenage American
girls has a sexually transmitted disease.
The
most common one is a virus that can cause cervical cancer, and the
second most common can cause infertility. Nearly half the black teens
in the study had at least one sexually transmitted infection, versus 20
percent among both whites and Mexican-American teens.
The study, released Tuesday at an STD
prevention conference, has adolescent-health specialists pointing to
possible reasons and offering potential solutions.
Blame
is most often placed on inadequate sex education, from parents and from
schools focusing too much on abstinence-only programs. Add to that a
young person’s sense of being invulnerable.
“This
is pretty shocking,” said Dr. Elizabeth Alderman, an adolescent
medicine specialist at Montefiore Medical Center’s Children’s Hospital
in New York.
“To
talk about abstinence is not a bad thing,” but teen girls — and boys
too — need to be informed about how to protect themselves if they do
have sex, Alderman said.
Only
about half of the girls in the study acknowledged having sex. Some
teens define sex as only intercourse, yet other types of intimate
behavior including oral sex can spread some diseases.
Among those who admitted having sex, the rate was even more disturbing — 40 percent had an STD.
“Those
numbers are certainly alarming,” said sex education expert Nora
Gelperin, who works with a teen-written Web site called sexetc.org.
“Sexuality
is still a very taboo subject in our society,” she said. “Teens tell us
that they can’t make decisions in the dark and that adults aren’t
properly preparing them to make responsible decisions.”
Cecile
Richards, president of Planned Parenthood Federation of America, said
the study shows that “the national policy of promoting abstinence-only
programs is a $1.5 billion failure, and teenage girls are paying the
real price.”
Similar
claims were made last year when the government announced the teen birth
rate rose between 2005 and 2006, the first increase in 15 years.
The
overall STD rate among the 838 girls in the study was 26 percent, which
translates to more than 3 million girls nationwide, the CDC said.
HPV most common
The
study by CDC researcher Dr. Sara Forhan is an analysis of nationally
representative data on 838 girls aged 14 to 19 who took part in a
2003-04 government health survey. Teens were tested for four
infections: human papillomavirus, or HPV, which can cause cervical
cancer and affected 18 percent of girls studied; chlamydia, which
affected 4 percent; trichomoniasis, 2.5 percent; and genital herpes, 2
percent.
Dr. John
Douglas, director of the CDC’s division of STD prevention, said the
results are the first to examine the combined national prevalence of
common sexually transmitted diseases among adolescent girls. He said
the data likely reflect current prevalence rates.
HPV
can cause genital warts but often has no symptoms. A vaccine targeting
several HPV strains recently became available, but Douglas said it
likely has not yet had much impact on HPV prevalence rates in teen
girls.
Chlamydia
can cause an abnormal discharge and painful urination, but often has no
symptoms. Signs of trichomoniasis are similar, and both diseases can be
treated with antibiotics. Genital herpes can cause blisters but also is
often symptomless. It can’t be cured but medicine can help.
The
CDC recommends annual chlamydia screening for all sexually active women
under age 25. It also recommends the three-dose HPV vaccine for girls
aged 11-12 years, and catch-up shots for females aged 13 to 26.
The
CDC’s Dr. Kevin Fenton said that given the potential complications from
STDs, “screening, vaccination and other prevention strategies for
sexually active women are among our highest public health priorities.”
Douglas
said screening tests are underused in part because many teens don’t
think they’re at risk, but also, some doctors mistakenly think:
“Sexually transmitted diseases don’t happen to the kinds of patients I
see.”
Teens need
to hear the dual message that STDs can be prevented by abstinence and
condoms — and hear them often, said Dr. Ellen Kruger, an
obstetrician-gynecologist at Ochsner Medical Center in New Orleans.
“You’ve got to hammer at them,” with
appropriate information at each stage of teen development to make sure
it sinks in, she said.
She
said there are a lot of myths out there, too — many sexually active
teens think the withdrawal method will protect them, or that douching
with Coca-Cola will kill STD germs.
Dr.
Margaret Blythe, an adolescent medicine specialist at Indiana
University School of Medicine, said some doctors hesitate to discuss
STDs with teen patients or offer screening because of confidentiality
concerns, knowing parents would have to be told of the results.
Blythe,
who heads an American Academy of Pediatrics committee on adolescence,
noted that the academy supports confidential teen screening.