Doctors, nurses, and other healthcare providers may not be surprised but parents of teenagers will likely be alarmed.  A study just published by the Center for Disease Control and Prevention reports that 25 percent of American teenage girls have at least one sexually transmitted infection.  Among the African American study participants, the rate of sexually transmitted infections rose to nearly 50 percent.  When results are projected nationwide, an estimated 3.2 million adolescent girls are infected with one of the four most common STIs; human papillaoma virus (HPV), chlamydia, herpes, or trichomaniasis. 

Findings were culled from a larger study called the National Health and Nutrition Examination Survey conducted in 2003-2004.  Dr. Sara Forhan, the study's lead author, compiled data from 838 girls aged 14 to 19. The results are a wake-up call to parents, educators, and healthcare providers.  With the average age of sexual debut for American girls at 15 years of age, the CDC study reinforces the need to start discussing safe sex earlier than previously realized.

The problem of sexually transmitted infections among teens has been called a "silent epidemic".  The fact infected individuals are often asymptomatic raises several issues.  Firstly, those who are infected but asymptomatic will not seek treatment, and may spread infection to sexual partners.  Secondly, although infections may be asymptomatic, they are not harmless.  Untreated chlamydia, for example, can lead to pelvic inflammatory disease, scarring of the Fallopian tubes, and eventual infertility.  Thus, the CDC recommends yearly chlamydia screening for all sexually active girls and women under the age of 25.  Chlamydia can be easily and effectively treated with antibiotics when detected. 

Human papillamoma virus, or HPV, is by far the most prevalent STI among American teens.  There are over 100 strains of the HPV virus, some are known to cause genital warts and in rare cases others can lead, when undetected, to cervical cancer. Researchers speculate that over 50 percent of Americans will become infected with the virus during their lifetimes, but that most people's immune systems will clear the infection without much ado.  In certain populations, however, rates of HPV are strikingly elevated.  One study, for instance, conducted among sexually active girls at the University of Maryland found that almost 90 percent of them carried the HPV virus.  

The results of this CDC study reinforce the important role of HPV vaccines which protect against the highest risk strains. Nurses should refer parents and teenagers to pediatric and gynecological providers for the three-shot series for girls over the age of nine.  HPV vaccines are covered by most state and private health insurance plans. 

Herpes, like HPV, cannot be easily or permanently treated following infection, although symptoms can be successfully managed with antiviral agents taken daily or episodically.  While most adolescent healthcare educators and providers stress that abstinence is best, providing education about the importance of consistent condom use is essential in order to protect teens and their partners from contracting infections that may be with them for life.

Nurses should know several key points about STI prevention, detection, and treatment.  We should encourage all females who are or have ever been sexually active to get regular Pap smear screenings.  Many providers now screen for both cervical abnormalities and the presence of high-risk strains of the HPV virus at the traditional "annual exam".  If the high-risk HPV virus is not detected, the frequency of Pap smear screening may be reduced to once every two to three years.  If an adolescent is sexually active, she is at risk of contracting an STI and deserves reliable information and easy access to care. 

References

Desmon, S. (12 March 2008). 1 in 4 U.S. Teen Girls Affected with STD.  The Baltimore Sun. 

Copyright 2008- American Society of Registered Nurses (ASRN.ORG)-All Rights Reserved