Raising the Alarm on STDs in Teen Girls
Did you hear the recent study that showed that one in four girls and young women are infected with an STD - Chlamydia, genital herpes, trichomonas, or human papillomavirus (HPV)? And 15% had more than one STD!
Given what I've seen in practice, this is not that surprising, but it is very alarming.
What is surprising is the complete lack of understanding of the consequences of these infections.
According to the study - which looked at a sampling of teenage girls (ages14-19) in 2003 and 2004 -- the two most common STDS were HPVand Chlamydia. HPV can cause cervical cancer and genital warts, and Chlamydia, if left untreated, can cause infertility and chronic pelvic pain.
Interestingly, the study has reignited the debate over what it will take to prevent these infections in young women.
The current administration has spent over a billion dollars on abstinence programs that they believe will curb the spread of STDs.
Some experts say that this current study shows that these programs are a failure. Some even suggest this approach is unethical because it only presents one option - abstinence - but leaves out information on STDs and how to prevent pregnancy or infection if you are having sex.
In light of this latest study, most experts agree that more money should be spent on promoting HPV vaccination, improving screening of Chlamydia (studies show less than a third of girls get properly screened) and developing other prevention measures against STDs.
One observation from my practice is the inability to effectively ensure that the sexual partners of my patients are being treated, or even informed about a potential STD. In my view, if the sexual partners don't know they could have an STD, they are a significant point of contact for other people - and that's how these diseases are often spread unchecked.
It's difficult to get a teen to open up about his or her sexual contact(s). And the typical physician visit isn't usually conducive to this sort of open discussion.
Moreover, I find that follow up after an STD is often poor. I usually want to retest my patients with STDs after 3 months to detect reinfection, or failure of infection or the presence of other STDs. Most never show up.
The other "hole" that I notice, is our failure to take EVERY opportunity to educate our teen patients and offer appropriate interventions to prevent STDs. For example, one study showed that only 40% of women presenting for emergency contraception, receive advice and testing for STDs.
So what do you think? How can we help prevent others from getting herpes, or other STDs? Do you think abstinence only programs work or do we need to tell teens that STDs can be prevented with abstinence OR condoms?