Ask the Doctors

Dear Doctor: My son and daughter are now 17 and 19, and my sister, who worries about everything, keeps telling me that STDs in teens are on the rise. Is this really true? If so, is there anything I can say to my kids? You know how teens are; will they even listen?

Dear Reader: Considering the context, we regret to inform you that your sister is correct. According to data collected by the Centers for Disease Control and Prevention, the rate of sexually transmitted diseases in the United States has hit a record high for the fourth year in a row, and a whopping 50 percent those new infections were acquired by young people aged 15 to 24 years old. It's estimated that one-quarter of all adolescent females who are sexually active currently have an STD, such as chlamydia or human papillomavirus, also known as HPV.

Despite an increase in the numbers of young people using condoms, which are an effective (but not foolproof) barrier against STDs, and the fact that teens and young adults are less sexually active and have fewer partners than did previous generations, the numbers continue to climb. Statistics show that adolescents between the ages of 15 and 19 and young adults between the ages of 20 and 24 have the highest risk of acquiring an STD.

This trend is believed to be the result of a complex combination of factors. A drop in federal funding for STD prevention education, as well as clinics for screening and outreach, has certainly played a role. So have cultural factors. The advent of effective antiviral drugs, which have turned once-deadly AIDS into a manageable chronic condition, may have also had the unintended effect of making other STDs seem less dangerous. Also at play may be the increasingly changing views of gender identity, with more young people having sexual partners of both sexes.

Whatever the cause, the spike in STDs in people of all ages is a serious concern. In their early stages, these diseases are asymptomatic, which makes it easy for an infected person to unknowingly transmit the disease. That's why baseline STD screening for young people who are sexually active is so important. In its later stages, each STD comes with its own serious health concerns. A number of viruses and bacteria have become antibiotic-resistant, which means problems continue even after seeking treatment.

The truth is the only foolproof way to avoid STDs is to not have sex. But whether or not your kids are sexually active, protection begins with education. That means teaching your kids about STDs and the grave health problems they cause. Stress using condoms as a barrier, even when other birth control methods are in use. As you point out, a single conversation probably won't be enough. Young people feel invincible, so this should be an ongoing dialogue. And don't forget about the HPV vaccine, which is recommended for preteens and young adults of both sexes. You'll find specifics at vaccines.gov/diseases/hpv.

Some parents fear the STD talk implies approval of sexual activity. In our opinion, it's an opportunity to state (or restate) your position on sex, and to offer up some stark reality.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10880 Wilshire Blvd., Suite 1450, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.)

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