At-risk teens? Help them to 'get teSTeD'

When it comes to sexually transmitted diseases (STDs), new data released by the American Social Health Association (ASHA) in Research Triangle Park, NC, shows that the average age of people who are tested for chlamydia is 28.9 for women and 30.5 for men.1 Yet the Centers for Disease Control and Prevention (CDC) reports 79% of new chlamydial infections occur in people between ages 15 and 24.2 How can providers get the STD prevention message to those most at risk: sexually active adolescents?

Urge teens to "Get teSTeD," a new campaign developed by ASHA. The initiative, developed in time for the April 2006 observance of National STD Awareness Month, encourages those who are sexually active to get tested in an effort to reduce the spread of STDs. As part of the campaign, ASHA has developed a new brochure, STDs, The Real Deal, which provides advice to teens who might feel uncomfortable talking about sex and STDs with their provider. It lists information about STDs, testing sites, and how teens can protect themselves through the use of condoms.

ASHA has developed two web sites, and (a Spanish-language counterpart), both which have been written for and tested by teens, says James Allen, MD, MPH, ASHA president and chief executive officer. These web sites get more than 250,000 annual visitors as young people gather the information they need to make healthy decisions, he notes. ASHA also answers thousands of e-mails each year from adolescents who are searching for information that is complete and nonjudgmental, yet accurate, says Allen.

Focus in on chlamydia

When it comes to STDs in adolescents, chlamydial infection is of particular concern. Like other common STDs, chlamydia typically has mild symptoms such as an abnormal vaginal discharge or a burning sensation when urinating, or none at all.3 If left untreated, up to 40% of women with chlamydia develop pelvic inflammatory disease, which can result in infertility.4

In the first nationally representative study of chlamydia prevalence in the general adult population (ages 14-39), CDC researchers found nearly one in 20 women between the ages of 14-19 (4.6%) were infected — the highest proportion of any age group.5 Among men, 20- to 29-year-olds were most heavily affected, with a prevalence of 3.2%.5 The findings were based on responses from participants in the National Health and Nutrition Examination Survey from 1999 to 2002.

What's 'the real deal'?

When talking with adolescents about STD prevention, health care providers should emphasize that everyone who is sexually active, including those engaging in oral, anal, and vaginal sex, should get tested for STDs, says Peter Leone, MD, medical director of the HIV/STD Prevention and Control Branch of North Carolina's Department of Health and Human Services in Raleigh. Most sexually transmitted infections are associated with little to no symptoms, yet can lead to future complications and disease, says Leone.

"Adolescents often do not realize that they can get and spread STDs through oral sex," notes Leone. "Many do not consider oral sex to be 'sex'; however, this behavior is becoming increasingly common in this age group."

Recent information from the National Survey of Family Growth underlines Leone's concern. Its data reveals that about one in four teens ages 15 to 19 who have not had sexual intercourse report oral sex with an opposite sex partner.2 As a result, adolescents must know what tests to ask for, identify testing sites in their area, and learn how to protect themselves through the use of condoms, says Leone.


  1. American Social Health Association. New Data Indicate Few Young Americans Tested for Common STD. Press release. March 28, 2006.
  2. Mosher WD, Chandra A, Jones J. Sexual behavior and selected health measures: Men and women 15-44 years of age, United States, 2002. Adv Data 2005; 362:1-55.
  3. Weinstock H, Berman S, Cates W. Sexually transmitted diseases among American youth: Incidence and prevalence estimates, 2000. Perspect Sex Reprod Health 2004; 36:6-10.
  4. Rein D, Kassler W, Irwin K, et al. Direct medical cost of pelvic inflammatory disease and its sequelae: Decreasing, but still substantial. Obstet Gynecol 2000; 95:397-402.
  5. Datta SD, Sternberg M, Johnson R, et al. Prevalence of chlamydia and gonorrhea in the United States among persons aged 14-39 years, 1999-2002. Presented at the 16th biennial meeting of the International Society for Sexually Transmitted Diseases Research. Amsterdam, the Netherlands; July 2005.


To download a free copy of the American Social Health Association brochure, STDs, The Real Deal, visit the organization's web site, Click on the "Get TeSTeD" logo; the brochure is available in English and Spanish. Printed brochures are $17.50 (for 50), plus shipping and handling; for 1,000 or more, discounts begin at 15%. Call (800) 783-9877 for a direct quote on quantity discounts. Shipping and handling charges are $0-59, $5; $60-$499, 9%; more than $500, 7%. For orders outside the United States and Canada, add 20%. Orders may be mailed to ASHA Customer Service, P.O. Box 13827, Research Triangle Park, NC 27709, or faxed to (919) 361-8430, Attention: Customer Service.