Street wisdom drives 16-year-old Meta Jones crazy. Sexually transmitted diseases (STDs) are at record-high levels among teens, yet the kids Meta knows at Coolidge Senior High in Washington D.C., have more faith in superstition than science. "They believe in the 'quick-withdrawal method'," she says. "They think you can't catch anything if he pulls out quickly enough." A lot of boys don't worry, she says, because "they think it's the girls who catch [diseases] more easily." And everyone seems to think STDs are someone else's problem. "They say, 'We're young. This isn't going to happen to us'."
Meta knows they're wrong. Every week for the past year, she and 10 other Washington high-school students have met in a conference room at the Center for Population Options, a nonprofit educational organization. As members of the center's volunteer Teen Council, they are preparing a pamphlet on STDs to be distributed to high-school students around the country.
The need for such information is acute. Experts on adolescent health say that ignorance of how STDs are spread is one of the main reasons 15- to 19-year-olds have a higher risk of getting many of these diseases than any other age group. But even though sex-education classes have become more prevalent in the last few years, many schools don't include information about STDs in their curriculum. And those that do often concentrate on diseases such as gonorrhea and syphilis--neglecting more common infections such as chlamydia and genital warts.
Since the 1960s, when more and more teens started having sex at younger and younger ages, the infection rates of several STDs have increased steadily, says Dr. Stuart Berman of the Centers for Disease Control (CDC). Only 3 percent of women born between 1938 and 1940 had had sex by the time they were 15. By 1988, more than a fourth of all 15-year-old girls were sexually experienced. Teens who have sex early are more likely to have multiple partners, which increases their risk of infection. Teens have also been the age group least likely to practice safe sex because they tend to have spontaneous rather than planned intercourse. And, like Meta Jones's friends, they believe they are immune to illness. AIDS seems to be one of the few things that has altered teens' behavior. Recent surveys show more young people using condoms.
Treating infected teens is as troublesome as trying to prevent illness. Because some of the most common STDs don't always have overt symptoms, young people may be unwitting carriers. And those who do receive medical attention may still end up infected. Doctors say adolescents frequently stop taking medication after the first few days--when the symptoms begin to disappear--and don't finish their prescriptions. Often, teens have more than one infection, which complicates treatment.
Some of the diseases threatening teens:
Although teens say they fear AIDS more than any other illness, fewer than 1 percent of all reported AIDS cases involve adolescents. That does not mean that teens are AIDS-free. Nearly a fifth of all people with AIDS are in their 20s and it can be as long as 10 years between infection and the onset of symptoms. That means that many of the young adults who have AIDS today probably got the disease as teenagers. Many researchers think today's teens may have similar rates of infection as they get older. Particularly at risk are inner-city kids. In a 1988 study of adolescent AIDS cases in New York, 58 percent were black and Hispanic males. Even more disturbing: the high levels of AIDS infection among babies born to teen mothers at urban hospitals around the country.
Although it doesn't get as much attention as AIDS, chlamydia--probably the most common bacterial STD--is potentially a more serious threat to teenagers. Girls 15 to 19 years old appear to have the highest infection rates of any age group. Chlamydia often has no overt symptoms, but it can also cause abdominal pain, nausea and low fever in women, and a discharge from the penis or painful urination in men. These symptoms can easily be confused with other conditions, making chlamydia a difficult disease to detect. Left untreated, chlamydia can have disastrous consequences for men and women. In women the infection usually begins in the cervix and spreads to the fallopian tubes or ovaries. The result can be pelvic inflammatory disease, a major cause of sterility. Men can also become sterile.
The human papillomavirus causes small growths that can be found on the vulva, vagina, cervix, anus, penis and urethra. Certain strains also occasionally show up in the throat. They're usually painless, but they may itch. Some studies have indicated that as many as a third of all sexually active teenagers have genital warts. A few growths are not necessarily dangerous, but if they keep growing they may eventually block body openings. Doctors are also concerned about an apparent association between genital warts and cervical cancer that researchers still don't fully understand. Like chlamydia, warts sometimes go undetected. There's no permanent cure: warts can be removed but at least 20 percent grow back.
Although herpes got a lot of attention a few years ago, researchers think it is not quite as common as genital warts among teenagers. There is evidence, however, that infection rates may be increasing. Although herpes has no cure, medication does ease the pain when sores are active. Undiagnosed herpes during pregnancy is a serious threat. The virus can cause miscarriage and stillbirth and can damage infants during childbirth. Obstetricians perform Caesarean sections if the virus is active.
In the past 15 years the total number of gonorrhea cases in teenagers has declined considerably, largely because of a national gonorrhea-control program that was begun in the 1970s, says Dr. Willard Cates of the CDC. However, among black teenagers, rates of infection actually increased in the 1980s. By 1988 the numbers of young blacks reported with the disease were 20 to 40 times greater than those of white teens, according to the CDC. Researchers blame the gap on inadequate health care.
Teenagers have fewer cases of syphilis than other age groups, but they have not been immune to what Cates describes as a syphilis epidemic in the 1980s. In 1989, he says, syphilis-infection rates among the general population were at their highest level since post-World War II. The most dramatic increase among teenagers was among 15- to 19-year-old black girls. That trend threatens babies born to these young women, especially if the mothers have no prenatal care. There's also some evidence that open syphilis sores may increase the risk of contracting the AIDS virus. These complications and so many others, have turned sex for teens into a medical minefield.