We know it's an epidemic attacking our young people. But we may be underestimating just how widespread the reach of this epidemic is. A new study conducted in Baltimore City reveals that the true rate of sexually transmitted infections might be much greater than the reported numbers.
The study, published in the Journal of the American Medical Association, tested a sample of Baltimore residents ages 18 to 35 for gonorrhea and chlamydia. The researchers found that, based on the number of positive tests for sexually transmitted diseases (STD) in the people tested, that the true rate of STD infection in Baltimore almost surely substantially exceeds the number of individuals found to be infected by testing.
What we know about infection rates among our young people is scary enough. There are 25 significant STDs today, as opposed to two in 1960. In the 1970s, one adolescent in 47 contracted a STD. Today, that figure is one in four. About 15 million new STD infections occur each year in America -- 25 percent are in people younger than 20. A recent study of 18 to 22-year-old sexually active women showed 50 percent were infected with human papillomavirus (HPV) at some time during the three-year study period. Therefore, a sexually transmitted disease (HPV) is responsible for more than 99 percent of cervical cancers and nearly all abnormal Pap smears.
This study tells us the truth is worse than our nightmares. If we want to stop far too many of our kids from growing up worrying about abnormal Pap smears or crying over infertility, we better do something. Prior to opening The Medical Institute for Sexual Health, I had a thriving ob-gyn practice. My saddest sessions were spent with adult women who could not have children because of a STD contracted as a young woman.
But if we think we're going to rely on medical professionals, we're making a mistake. "It's embarrassing," Jonathan Zenilman of Johns Hopkins School of Medicine and co-author of the Baltimore study told the Wall Street Journal. Doctors "aren't trained to do this. It's not revenue producing." And he's right. When the daughter of a friend of mine had an abnormal Pap smear, her doctor didn't take the time to talk to her about STDs and the risks of sexual activity. Instead, he told her that her abnormal Pap was due to the stress of being a freshman at college. As someone who travels the country speaking about this epidemic, including to medical professionals, I can report that the knowledge of STDs among medical professionals is often not much greater than among the lay public.
Along with the Baltimore study, the Journal of the American Medical Association published an editorial by J. Dennis Fortenberry of the University of Indiana Medical School. He says it's time for routine school-based urine testing for STDs. Well, that's an appropriate response if our only concern is to find out how many young lives have already been damaged.
But the clear and compelling lesson of the Baltimore study is prevention -- how do we protect our young people? The answer is to tell them the truth, to tell them that "safe sex" as an unmarried teen or young adult simply doesn't exist. Our current public health approach to STDs is based on the belief that condoms will keep kids safe enough. But that's not what the National Institutes of Health found when it convened a panel to explore the scientific evidence determining whether male latex condoms are effective in preventing STDs.
The panel found that condoms can reduce the risk of HIV by approximately 85% but only if they are used 100% of the time. It also found that even with a 100 percent use there is no evidence that condoms have an impact on the risk of sexual transmission of HPV infection.
Teens don't need STD testing in schools. They need the facts, which reveal two things: the only sure and reliable way to avoid becoming a victim in this epidemic is to abstain from sexual activity -- not just intercourse -- until marriage and that the risk of contracting an STD increases dramatically the more sexual partners one has.
Parents better start telling their kids this because most doctors surely aren't.
Joe S. McIlhaney, Jr., M.D., is president and founder of The Medical Institute for Sexual Health. A nonprofit organization based in Austin, TX, The Medical Institute disseminates accurate data, credible information and professional products that emphasize the medical importance of teens and nonmarried young adults delaying the onset of sexual activity due to the impact of sexually transmitted diseases and nonmarital pregnancy.