Women who come to your center for a pregnancy test may not be aware of their risk of contracting a sexually transmitted infection. The United States has the highest STI rate of any country in the industrialized world.4 Consider the following alarming statistics:
- Over 65 million Americans currently have an incurable STI/
- At least one in three sexually active people are estimated to have
contracted an STI by age 24.*
- Each year there are 15 million new STI cases in the United States, of which 50% are incurable."
Rates of reported sexually transmitted diseases (STIs) are particularly high among young women. Women aged 20-24 have the highest rates of the two most common STIs. Chlamydia and gonorrhea.5 All of today's viral STIs have no cure, and they can leave a path of sterility, cancer, death, and heartache. The heartache and pain that women now experience because of a sexually transmitted disease might have been prevented had they waited until marriage for their first sexual experience.
Teens are in particular need of accurate information about STI prevention. Consider these facts:
- Each year over 3 million teens are infected with an STI."
- Gonorrhea rates are highest among females 15-19 years-old.
"Saying that the use of condoms is safe sex is in fact playing Russian roulette. A lot of people will die in this dangerous game."
-- Dr. Teresa Crenshaw, past President of the American Association of Sex Educators.
- At least 10% of all sexually active teens are infected with pelvic inflammatory disease, a condition most often caused by untreated gonorrhea or Chlamydia that can lead to infertility and ectopic pregnancy."
Comprehensive sex educators assert that equipping sexually active women with knowledge about STI prevention is the best solution. However, conveying the message that "safe sex" can be achieved with contraceptives is dangerously misleading. Young people are often led to believe that they will be safe from STIs and pregnancy if they use condoms. However, even proponents of condoms caution that condoms may only help reduce the number of new cases of some STIs. Condoms do not provide total protection in sexually transmitted diseases that are spread by skin contact rather than fluid transmission.
For adolescent females, the increased risk for STIs stems largely from
Initiating sexual intercourse at earlier ages, engaging in intercourse
with older male partners, and having multiple partners. If there were multiple partners in the past, she may carry a risk of exposure to several STIs.'2 Young women frequently underestimate their partners' risks. They tend to form perceptions of their partners' risks based on impressions rather than factual information.1"' Many sexually active young women do not view
themselves as being at risk for STIs regardless of the number of their
sexual partners or whether they had been tested in the past.
Encourage a sexually active client to be tested for sexually transmitted diseases if she has never done so. The CDC recommends screening for asymptomatic Chlamydia and gonorrhea for any woman who has had a new sexual partner. An immature immune system places adolescents at increased risk for STIs. Having had less exposure to STI pathogens, they have subsequently less circulating antibodies for protection. Another reason teen girls face a greater risk of developing an STI from sexual experimentation is due to an anatomical variance. The cervix of a teenage girl has an outer covering, which is more susceptible to infection by the bacteria and viruses of STIs.
Human papilioma virus infection (HPV) is the most common STI that the typical American adolescent and young adult will be exposed to. Recent studies document that even with 100% condom use there is no evidence of any risk reduction. A study done by the Department of Health and Human Services concluded that there was no epidemiological evidence that condom use reduced the risk of HPV infection. Furthermore, there is no evidence of any risk reduction for sexual transmission of STIs from sores outside the areas covered by. or protected by. condoms.
The charts below list common bacterial and viral STIs and how they are transmitted:
| BACTERIAL | MODE OF TRANSMISSION |
|---|
| Chlamydia | Contact with infected genital fluids |
| Gonorrhea | Contact with infected genital fluids |
| Syphilis | Contact with infected skin lesions |
| Chancroid | Contact with infected skin lesions |
| VIRAL | MODE OF TRANMISSION |
|---|
| Human Papilloma Virus | Contact with skin lesions/body fluids |
| HIV/AIDS | Contacted with infected genital or body fluids |
| Herpes Simplex Virus | Contact with infected skin lesions or body fluids |
STI prevention efforts have focused on vaginal sexual intercourse largely because of efforts toward pregnancy prevention, but it is clear that this focus is too narrow. Young adults and teens need to understand the risks associated with oral and anal sex. Several STIs can be transmitted by oral sex, including: Chlamydia, chancroid, gonorrhea, syphilis, genital! herpes (HSV). hepatitis B. and human papilioma virus (HPV). The information gap needs to be closed to reduce the risk associated with all forms of sexual activity, not just vaginal intercourse. This is especially true as there is evidence that teens are increasingly experimenting with oral sex based upon the false assumption that it is far less dangerous than vaginal intercourse.15
*Information provided by CareNet
