Sexually transmitted diseases affect one in four adolescent girls

Three million U.S. girls aged 14 to 19 years are estimated to have at least one of the five most common sexually transmitted diseases, data from a nationally representative survey indicate, prompting researchers to call for early, comprehensive sex education courses and screening.

CDC researchers analyzed interviews and biological specimens collected from 838 girls who participated in the 2003-2004 National Health and Nutrition Examination Survey to determine the prevalence of Neisseria gonorrhoeae, Chlamydia trachomatis, Trichomonas vaginalis, herpes simplex virus type 2 and human papillomavirus (23 high-risk types or type 6 or 11).

Twenty-percent of adolescents who reported one lifetime sex partner tested positive for at least one of these five infections, and 26% of girls tested positive within their first year of sexual activity, data indicated. HPV was the most common STD (18.3%), followed by C. trachomatis (3.9%).

Additionally, demographic analysis revealed that although overall STD prevalence was similar among non-Hispanic white (19.4%) and Mexican American participants (18%), it was significantly higher among non-Hispanic black participants (43.9%; P=.001) compared with non-Hispanic whites.

“These findings highlight the importance of both primary and secondary STD prevention, including early, skill-based sex education; HPV vaccination of preadolescent girls; and chlamydia screening of all sexually active female adolescents,” the researchers wrote.

Vaccinating girls against HPV by ages 11 and 12 is especially important, the researchers noted, as previous studies have shown that most parents believe sexual initiation occurs later and the currently approved HPV vaccines are most effective in girls who have not had an HPV infection.

Educational prevention strategies should focus on the following areas:

Delaying initiation of sexual activity.
Minimizing the number of sexual partners..
Avoiding concurrent sexual partnerships.
Consistent and correct condom use.
Informing adolescents about their ability to obtain medical care for a sexually transmitted infection without parental consent in all 50 states after the age of 14. .

“[R]acial differences in ST[D] prevalence cannot be fully explained by individual risk behaviors,” the researchers wrote, stating that a combination of social and environmental determinants, coupled with factors including poverty, lack of access to health care, and characteristics of sexual networks are to blame. Steps to lessen racial disparities should be included in prevention efforts.

Forham SE. Pediatrics. 2009;124:1505-1512.