By Libby Cluett
lcluett@mineralwellsindex.com

When the Centers for Disease Control and Prevention published a report Tuesday finding that one in four, or 26 percent of, teenage girls in America is infected with a sexually transmitted disease, doctors across the nation and locally seemed somewhat stunned.

Although it relies on data from a 2003-04 government health survey, the first-ever federal study to examine the combined prevalence of common STDs among girls ages 14 to 19, “provides the clearest picture to date of the overall STD burden in adolescent women,” states the CDC.

The prevalence of STDs among teenagers is “consistent with what we see here,” said local physician Dr. Patrick Hisel.

He added that he has seen all of the STDs present in the community in his five years as a family physician in Mineral Wells.

Education
While the federal report has some adolescent-health experts calling the findings “shocking,” some doctors attribute the numbers as a possible reflection of both abstinence-only sex education and teens’ own sense of invulnerability.

“I agree with that,” said Hisel, who helps with the Mineral Wells ISD “Worth the Wait” abstinence-based program.

“I prefer – first and foremost – abstinence. I [also] prefer to talk to students and youth from a scientific-based approach rather than an abstinence-only-based approach. I think it’s more effective in terms of preventing disease and teen pregnancy,” explained Hisel.

He added that his approach includes addressing the “unwanted physical and emotional consequences of having sex.”

While only about half of the teenage girls in the CDC study acknowledged having sex, some defined sex as only intercourse. However, other types of intimate behavior, including oral sex, can spread some diseases.

The STD rate for those who admitted having sex was an even more disturbing 40 percent.

“That is almost every other one,” said Hisel. “That just shows you how prevalent STDs are.”

The CDC’s “numbers are certainly alarming” and they reflect “the sad state of sex education in our country,” said sex education expert Nora Gelperin, who works with a teen-written Web site called sexetc.org.

“Sexuality is still a very taboo subject in our society,” she said. “Teens tell us that they can’t make decisions in the dark and that adults aren’t properly preparing them to make responsible decisions.”

When one local parent discussed Tuesday’s report with her daughter, the teenager replied, “You don’t know how true that could be.”

“The peer pressure on the girls to have sex with guys is really high,” the teen’s mother quoted her daughter, adding that the teen knows two pregnant 14 year olds and another adolescent with three children.

Her strategy with her daughter – “I’m open,” said the mother. “When she has questions I answer them so she doesn’t seek answers to those questions elsewhere.”

National advice
Teens need to hear the dual message that abstinence and condoms can prevent STDs, according to Dr. Ellen Kruger, an obstetrician-gynecologist at Ochsner Medical Center in New Orleans.

Kruger added that there are a lot of myths out there, too, such as many sexually active teens think the withdrawal method will protect them, or that douching with Coca-Cola will kill STD germs.

“To talk about abstinence is not a bad thing,” but teen girls — and boys too — need to be informed about how to protect themselves if they do have sex, said Dr. Elizabeth Alderman, an adolescent medicine specialist at Montefiore Medical Center’s Children’s Hospital in New York.

The CDC also supports a comprehensive approach to STD prevention, which includes:

• The promotion of abstinence as the surest way to prevent getting an STD.

• Being in a mutually monogamous relationship with a partner known to be uninfected.

• The consistent and correct use of condoms for sexually active people to reduce the risk of acquiring many infections.

Cecile Richards, president of Planned Parenthood Federation of America, said the study shows that “the national policy of promoting abstinence-only programs is a $1.5 billion failure, and teenage girls are paying the real price.”

Similar claims were made last year when the government announced the teen birth rate rose between 2005 and 2006, the first increase in 15 years.

The health toll
The study examined four common STDs – human papillomavirus, chlamydia, trichomoniasis and genital herpes. Findings show that among teenage girls who had an STD, 15 percent had more than one.

With potentially severe health risks from these infections, including infertility and cervical cancer, CDC officials recommend STD screening, vaccination and other prevention strategies as well as early treatment to help prevent some of the most devastating effects of untreated STDs.

According to Dr. John M. Douglas Jr., director of CDC’s Division of STD Prevention, screening tests are underused partly because many teens do not think they are at risk.

“Eighteen percent of teenage girls screened tested positive [for HPV],” said Hisel, a finding he called “incredible,” yet consistent with what he sees locally.

“This is the virus that leads to cervical cancer and genital warts,” he said.

Because HPV lives on everyone (on the skin) and is “so common,” Hisel seemed somewhat hesitant to consider it an STD.

“Studies have shown that if you take a sampling of 50-year-old women at the end of their reproductive years, 80 percent have been exposed to HPV,” cited Hisel. “In other words, if a woman lives long enough and has sex, she’ll get it – it’s out there.”

“There’s a vaccine for this one,” said Hisel of the series of three shots, which target several HPV strains.

The CDC recommends the vaccine for girls ages 11-12 and catch-up shots for ages 13-26. For more information on the HPV vaccine, contact a local family physician or Palo Pinto General Hospital.

The Food and Drug Administration has said in a report that latex condoms are “highly effective” at preventing infection by chlamydia, trichomoniasis, HIV, gonorrhea and hepatitis B.

The agency noted that condoms seemed less effective against genital herpes and syphilis. Protection against HPV “is partial at best,” the report said.

Besides the overall prevalence of the four STDs, key findings of the new study include the following:

• Approximately half of all the teens in the study reported ever having had sex. Among these girls, the STD prevalence was 40 percent.

• Even among girls reporting only one lifetime partner, one in five (20.4 percent) had at least one STD. Girls with three or more partners had a prevalence of over 50 percent.

• African American teenage girls had the highest prevalence, with an overall STD prevalence of 48 percent compared to 20 percent among both whites and Mexican Americans.

“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,” said Douglas.

The Associated Press contributed to this article