Sexually Transmitted Diseases

Written by Robert T. Brown, MD

Introduction

At any age, sexual activity has its risks. During the adolescent and young-adult years, the risks are magnified considerably. Still, in spite of the risks, many adolescents choose to engage in sexual activity. Even for the most mature teenager or young adult who takes all the proper precautions, sex still can be a risky business.

Sex during adolescence is risky for several reasons. First, adolescents may have sex because they are pressured into it, either by a partner or by an adult in an abusive relationship. Sex under these circumstances can lead to depression and feelings of low self-esteem. Another major negative consequence of sexual activity among adolescents is pregnancy and all that it implies. Finally, there are sexually transmitted diseases or infections (STDs or STIs), or what used to be called venereal diseases (VD).

Adolescents have the highest rates of sexually transmitted diseases of any age group, and when we

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calculate the rate of STIs among sexually active teens rather than all teens, the numbers are even higher. Every year, approximately three million adolescents in the United States, about one in four, acquire STIs. In one act of unprotected sexual intercourse, an adolescent woman has a one-percent chance of acquiring HIV, a 30-percent chance of getting genital herpes, and a 50-percent chance of becoming infected with gonorrhea. And when we consider that chlamydia infection occurs about four times more often than gonorrhea, we can see how prevalent this problem is. This is without considering the most common STI, human papilloma virus (HPV) infection, which can be the cause of cancer of a woman's cervix when she gets older.

Teen Risk Factors

Why are teenagers at such great risk for getting these serious infections? There are several reasons. First, adolescents are prone to having more than one sex partner-not at the same time, but sequentially. In other words, kids may have several successive boy- or girlfriends during their teenage and young-adult years. If they have sex with more than one of these partners, they are increasing their chances of coming in contact with germs that cause STIs. Teenagers often have sex without thinking of the consequences. They are less likely to take precautions, such as using condoms, to prevent the spread of disease. Another reason teens are at greater risk is that they may not have learned ways of saying no. They may feel that they have to go along with their partners and have sex, even if they really don't want to. Finally, in teenage girls, the mucous membranes of the vagina may still be immature for three or four years after they start to have periods, and this immaturity can increase their chances of getting STIs.

Varieties of STIs

STIs are infections caused by some type of germ. Some are caused by viruses, some are caused by bacteria, and one is even caused by protozoa, little one-celled animals like amoebas or paramecia. Let's describe the various ones and tell a little about them.

Gonorrhea

One of the most well-known STIs is gonorrhea. It is caused by a bacteria called Neisseria gonorrhea and it is spread almost exclusively by sexual contact. Gonorrhea can cause an infection of the urethra (tube in the penis) in men and of the cervix (the canal leading from the vagina to the uterus) in women. Gonorrhea can be quiet and not produce any symptoms, but frequently it causes pus to come out of the penis or cervix, and it can cause a lot of discomfort. In both boys and girls, gonorrhea can travel up into more internal reproductive organs and cause damage to the tubes in men that transport sperm and the tubes in women that transport the eggs. This means that gonorrhea can really hurt someone's chances of having children later on in life.

Chlamydia trachomatis

Another bacterial infection is caused by Chlamydia trachomatis. This infection is very much like that caused by gonorrhea, but it usually has fewer symptoms, so it may not be treated and it may quietly cause more damage. Both chlamydia and gonorrhea can be prevented by abstinence, of course, and by using condoms every time a teenager or young adult has sex.

Syphilis

Another STI caused by a bacteria is syphilis. Syphilis is a famous disease that is nowhere as near as common as gonorrhea or chlamydia. It can be very serious and damaging, especially to babies who are born to women who have syphilis. Syphilis caused much suffering in the late 19th and early 20th centuries, but it is not that common anymore.