Sexually transmitted infection and teenage sexuality

The twin epidemics of sexually transmitted infection and nonmarital pregnancy and their consequences are two of the most significant issues faced by Americans today. Approximately 900,000 teenagers become pregnant each year. Research indicates that these pregnancies often limit future educational and economic opportunities for mother, father, and child. Sexually transmitted infections also pose a major threat to adolescents. For example, during a 3-year study of sexually active women at a major university, 60% were infected with human papillomavirus. Research indicates that adolescents, especially female ones, are physically more susceptible to sexually transmitted infections than adults. There have been a number of attempts by the medical and public health communities to confront these problems. In fact, the most popular strategy of the past 15 years has relied on increasing contraceptive use. For reduction of sexually transmitted infections, this approach depends on condoms, and for reduction of pregnancy, on oral contraceptives. The problem with condom-based approaches, however, is that physicians are often unaware of the limitations in the protection provided by condoms from sexually transmitted infections. For example, condoms offer inadequate protection from 3 of the most common sexually transmitted infections--human papillomavirus, type 2 herpesvirus, and chlamydia. By helping adolescents delay their sexual debut, we can offer hope to the greatest number of teens. Physicians can take the lead in emphasizing this approach both with their patients and in their medical organizations. (Am J Obstet Gynecol 2000;183:334-9.)