Who still thinks that youth is innocent and uncomplicated? The teenage years are increasingly demanding on children and their burgeoning sexuality. In addition to their need to learn and relearn their changing bodies, it is becoming more evident that the youngest sexually active people are the most vulnerable to negative outcomes, especially sexually transmitted infections (STIs). And even more so than the boys, young girls top the list.
Females are more vulnerable for so many reasons. Our bodies act as collectors of body fluids in more ways than male bodies typically do and our genital tissue is softer and tears easier, so we are physiologically at greater risk of infection. Socially, females as a whole are not taught the assertiveness necessary to negotiate the conditions of having sex, or to stand up their wishes to have it at all. When something goes wrong, too often they do not know who to turn to. If a girl gets pregnant, in one way or another it will be dealt with before long. But when she get infected with an STI, it will often be ignored or not noticed and left without treatment. The outcomes include deterioration of the infection, high stress, future fertility problems, poor body image issues and ongoing infection of other partners.
Sexually transmitted infections do not only happen to “others”. A study published in December 2009 (Archives of Pediatrics and Adolescent Medicine) found that half of all teenage girls in the US contract either Chlamydia, Gonorrhea or Trichomoniasis within 2 years of having sex for the first time. Fortunately all three of these most common infections are easily curable with a quick round of medication, but they will not be treatable forever because as they are being treated more and more, the bacteria are developing resistance and a few years from now, as things are going, the antibiotics will not be able to fight them off.
Another finding of the same study was that 1 in 4 females had contracted some STI by age 15. Just think about how this can brand the positive sexual image and behaviour of a person who is exposed to such a tough and harshly stigmatized lesson so early. Her chances of getting help and getting it on time are much lower that an older person’s. Even if she gets treated, her chances of speaking to her sexual partner and getting him to get tested and treated are lower. She then stands to be reinfected with the same disease (because unlike viruses, bacterial infections do not leave an immune response that protects from reinfection). This is highly likely with such prevalent infections, if she doesn’t start using condoms religiously.
The solution lies in everyone taking responsibility
Teenaged patients need to demonstrate that they have knowledge on the ways to protect themselves and keep themselves safe from future threats. They will be more likely to respond positively if they are not judged for being sexually active. This is a fact and health care providers’ opinions on their patients behaviours have no place in the treatment setting, unless solicited.
Parents and educators need to integrate messages about prevention of STIs at every health education and sex education opportunity. But they also need to include information on treatment and neutralize stigmas about STIs so that they will increase the chances of teens turning for help when they suspect a problem.
Health care providers need to reconsider when to begin screening and to widen the target groups to respond to changing needs. Doctors who treat diagnosed cases need to instigate follow-up checks for reinfection. They should speak to their patients about the importance of sending all exposed sexual partners for testing, but they need to find a way to speak to teens under circumstances that the teens are comfortable divulging information, such as with a nurse in the room instead of their parents.
STI testing and outreach centres offer a precious opportunity to provide counseling along with testing. Properly carried out, they can leave the patients with a positive resource to which they can return for more information or simply to reinforce messages that get easily worn bare when young people are forced to deal with challenging pressures and misinformation from their peers.