In the study, led by Dr.
Sara Forhan of the Centers for Disease Control, girls were medically examined
and given private, computerized questionnaires to discuss their sexual experiences.
The results indicated that 26 percent of all teenage girls tested positive
for at least one of the four sexually transmitted infections (STIs), while 40
percent of sexually active teen girls had at least one STI.
estimate that 3.2 million teenage girls in the country are currently afflicted
with one or more of the most common STIs. Nearly half of all 14-19 year old girls
said they were sexually active.
Greater consequences for girls than
Teenage boys were not included in
the study because methods have only recently become available to test young men
for the same infections, said Dr. Forhan. "It would be nice to have information
on all adolescents, not just young women, she said. "[But] The potential
consequences of these sexually transmitted infections are greater for women than
for men, including cervical cancer and infertility."
Girls face the risk of infertility or cervical cancer from certain STIs, making
the consequences of infection greater than those for boys.
The most commonly
diagnosed infection was HPV, a virus which can cause cervical cancer in women,
followed by chlamydia, a bacteria which can cause pelvic inflammatory disease
and infertility. Trichomoniasis and genital herpes, though less common in the
results, both increase susceptibility to HIV.
Transmission and infection
"These numbers do not surprise
me," said Dr. Margaret Blythe, an adolescent medicine specialist at Indiana
University School of Medicine. She notes that many teenagers mistakenly believe
they are uninfected because some infections do not present noticeable symptoms.
"These infections are asymptomatic-unless you get tested for the common ones
you won't know whether you have it or not," she said.
Doctors recommend that sexually active teens get tested for STIs even if they
show no symptoms.
STIs can be transmitted
through any kind of sexual intercourse-as well as the exchange of body fluids
and skin-to-skin touching of the genital areas.
STIs also spread easily,
American Academy of Pediatrics Fellow Dr. Charles Wibbelsman says, because many
teens unknowingly pass along the infection. "A lot of young people truly
believe unless they've had vaginal intercourse, they're still a virgin. Having
oral sex or anal intercourse; they don't consider that sex," he said. "Anyone
who's engaging in any type of activity with another person should be tested routinely."
key discovery of the study, Dr. Forhan says, was the indication that teens who
have had only one sexual encounter are just as likely to have an STI as those
who have been more active-having had sex for a year or less.
that traditional beliefs of who's at risk really need to be re-thought,"
Dr. Forhan said. "Just because you don't have a lot of partners and just
because you've only been sexually active a short time doesn't mean you're not
at risk for having an STI."
Take charge of your health
Today, it is increasingly important
for all teens, Dr. Blythe says, to take charge of their own sexual health.
Two doctors recommend that teens, parents and doctors maintain an open dialogue
about sex whenever possible.
minors do not know they have the right to be screened, i.e. tested and treated
for an STI, in every state in this country, without parental consent," she
said, noting that in some states teens as young as 12 can be confidentially examined,
and that teens 14 and older do not require consent in any state.
plans, however, require co-payments or insurance information that may alert parents
that a screening exam has occurred, even though the results are not released.
Accordingly, Dr. Lesley Breech and Dr. Jill Huppert, specialists in pediatric
and adolescent gynecology at the Cincinnati Children's Hospital Medical Center,
recommend that teens, parents and doctors maintain an open dialogue about sex
whenever possible to avoid the stigma and fear of getting tested.
study is] a great opportunity to open the conversation to everyone," Dr.
Breech said. "It's given me as a provider some opportunity to bring the [sexual
health] conversation into interactions where it would have been uncomfortable
and maybe even threatening to some families."
"When you make testing and
screening routine, you take the stigma away," added Dr. Huppert.
A new HPV vaccine can prevent 70 percent of cervical cancer and most genital warts.
and treatment for the infections analyzed in the study have advanced significantly
in recent years. Chlamydia diagnoses can now be made without internal examination
by testing urine samples, while herpes can be diagnosed with blood tests. A recent
HPV vaccine, now widely recommended for young women, prevents two types of HPV
that cause 70 percent of cervical cancer and almost all genital warts, Dr. Forhan
"Most of these infections are simply infections and if treated
in a timely fashion, if possible, then long term [effects] can be avoided,"
Dr. Forhan said. "We're trying to avoid the long-term consequences and that's
our ultimate, ultimate goal."