1 in 4 teen females has an STD, study says
1 in 4 teen females has an STD, study says
Check the next four files of your teenage female patients: chances are one of these young women has a sexually transmitted disease (STD), according to study results just released by the Centers for Disease Control and Prevention (CDC).1
The study, presented at the March 2008 National STD Prevention Conference, is the first to examine the combined national prevalence of common STDs among adolescent women in the United States. It provides the clearest picture to date of the overall STD burden in adolescent women, according to the CDC.
The study results indicate that 26% of women ages 14-19 are infected with at least one of the most common STDs: human papillomavirus (HPV), chlamydia, herpes simplex virus (HSV-2), or trichomoniasis. Data were based on an analysis of the 2003-2004 National Health and Nutrition Examination Survey, a program of studies designed to assess the health and nutritional status of children and adults in the United States.
The new information underscores the significant health risk STDs pose to millions of young women in this country every year, says Kevin Fenton, MD, director of CDC's National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention.
"Given that the health effects of STDs for women, from infertility to cervical cancer, are particularly severe, STD screening, vaccination, and other prevention strategies for sexually active women are among our highest public health priorities," he states.
Look closer at results
To perform the study, researchers analyzed data on 838 female teens who participated in the 2003-2004 National Health and Nutrition Examination Survey. The teens were tested for HPV infection, chlamydia, herpes simplex virus Type 2 (HSV-2) infection, and trichomoniasis. The authors examined high-risk HPV types, including 23 types of the virus that are known to cause cancer and the two types that cause most genital warts.
Based on the overall STD prevalence of 26%, the researchers estimate that about 3.2 million female teens in the United States are infected with an STD. The total prevalence may be slightly higher than the study estimates because some STDs, such as syphilis, HIV, and gonorrhea, were not included in the analysis.
What was the most common STD found among the study population? HPV topped the list at 18.3%, followed by chlamydia (3.9%), trichomoniasis (2.5%), and HSV-2 (1.9%). Among the teens who had a sexually transmitted infection, 15% had more than one, researchers report.
When looking at the population by race, researchers found that African-American teen girls had the highest prevalence of infection, with an overall prevalence of 48%. This figure compares to 20% among Caucasian and Mexican-Americans. While other Hispanics and race/ethnic populations were included in the survey, there were insufficient numbers in any one group to permit valid prevalence estimates for any group, except Mexican-Americans.
John Douglas Jr., MD, director of the CDC's Division of STD Prevention, says, "High STD infection rates among young women, particularly young African-American women, are clear signs that we must continue developing ways to reach those most at risk. STD screening and early treatment can prevent some of the most devastating effects of untreated STDs."
Be alert in screening
What can you do to turn the tide in the prevalence of STDs in adolescent females? Be sure to follow screening protocols. The CDC recommends annual chlamydia screening for all sexually active women under the age of 25.
Also, assess the risk for potential STD infection. Based on the study results, researchers found about half of all the teens in the study reported ever having had sex. Among those who had ever had sex, the prevalence for infection was 40%. Limited sexual activity did not rule out risk for infection. Among teen women reporting only one lifetime partner, one in five (20.4%) had at least one STD. Those who reported having three or more partners had a prevalence of more than 50%, with the predominant infection listed as HPV.
While most HPV infections clear on their own, some infections persist over time, placing women at risk for cervical cancer. Gardasil (Merck & Co.; Whitehouse Station, NJ) is a vaccine that protects against HPV types 16 and 18, responsible for 70% of cervical cancer, and types 6 and 11, which cause nearly all genital warts. The HPV vaccine is recommended for 11- to 12-year-old girls and can be given to girls as young as age 9. The vaccine also is recommended for those ages 13-26 who have not yet received or completed the vaccine series.
"It is important to realize that one of the most important means of preventing STDs in teen-agers is for all young women to receive the vaccine against HPV," says Robert Hatcher, MD, MPH, professor of gynecology and obstetrics at Emory University School of Medicine in Atlanta.
Reference
- Forhan SE. Prevalence of sexually transmitted infections and bacterial vaginosis among female adolescents in the United States: Data from the National Health and Nutritional Examination Survey (NHANES) 2003-2004. Presented at the 2008 National STD Prevention Conference. Chicago; March 2008.
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