Recently, I was reviewing an alarming study in an issue of Pediatrics. The statistics only corroborated what I've seen in my own pediatric practice, where I take care of many adolescents.
Despite our parental and societal "admonitions" not to have sex before marriage, teenagers are engaging in sexual activity, and they're also developing sexually transmitted infections. The statistics continue to show that somewhere between 60 and 70 percent of high school seniors have had "sex," and by 12th grade, more girls than boys admit to having had intercourse. More than 15 percent have had multiple partners.
In this study, conducted by the U.S. Centers for Disease Control and Prevention (CDC), 838 girls ages 14 to 19, who were participating in the National Health and Nutrition Examination Survey 2003-2004, provided specimens that were tested for gonorrhea, Chlamydia, trichomonas, herpes, and HPV (human papilloma virus). The prevalence of any of these five sexually transmitted infections (STI) was 24.1 percent. When results were broken down further, those teens who reported only one lifetime sexual partner had 19.2 percent prevalence of any STI, and for those teens who'd had more than three sexual partners, the prevalence increased to 53.3 percent for an STI.
Once again, as in previous studies, the most common STI was HPV (types 6 and 11), followed by Chlamydia. HPV infections accounted for nearly three-quarters of the overall STI prevalence. Both of these infections may be silent, in other words, young girls may not have outward evidence of the infections, but HPV may lead to cervical cancer and Chlamydia may cause problems with infertility.
Unfortunately, I don't think many teens are thinking about long-term consequences when they engage in pre-marital sexual behaviors. Teens are impulsive, live in the moment and typically feel that "these things happen to other people." Even when talking about these issues with my own teenage sons I often hear, "Mom, we get it! We are smart!" Smart kids get STI's, too.
We need to continue discussing sexuality with our children, even at young ages. The more knowledge the better, and while still supporting abstinence, they need to learn how to protect themselves if they do have sex. Abstinence only education has not been successful, as we've seen teen pregnancy rates rising, and sexually transmitted infections are even more prevalent and occur quickly after a girl's sexual "debut."
All girls (and now boys) ages 11-26 should receive HPV vaccinations, and sexually active adolescent females need to be screened yearly for Chlamydia. We need to ensure that all of our adolescents have access to sex education and sexual health care. Keep up the dialogue.
(Dr. Sue Hubbard is a nationally known pediatrician and co-host of "The Kid's Doctor" radio show. Submit questions at www.kidsdr.com.)