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At the 2008 National STD Prevention Conference held in Chicago in early March, Dr. Sara Forhan released an alarming set of data referring to a study of Sexually Transmitted Diseases in female teenagers.
Forhan studied 838 participants in the 2003-2004 National Health and Nutrition Examination survey, all of whom were female teenagers between the ages of 14 and 19. The study showed that approximately one in four teens had one of the four most common STDs found in women—HPV (Human papillomavirus,) Chlamydia, HSV-2 (Herpes simplex virus type 2), or Trichomoniasis.
That is 3.2 million members of America’s female population that have STDs that can cause lifelong damages such as genital cancers, genital herpes, and infertility, among other symptoms. Out of those 3.2 million, 15 percent have more than one of the four major STDs.
While there is no comparable data for male teenagers or young adults
between the ages of 20 and 24, it is no secret that STDs in teen and
young adults are on the rise. Quite often, it is more difficult to
detect STDs that are generally symptom-free, such as HPV and Chlamydia
in men, who typically do not undergo regular STD screening tests such
as those for women. While the diseases are more prevalent in certain
genders and backgrounds, it’s time for every one of us to take to step
back to see what we’re up against and how we can fix this ever-growing
problem.
Of the four STDs targeted in this study, the most prevalent STD
found in teen girls was HPV, which affected 18 percent of the study’s
participants. According to the Center for Disease Control, over 25
percent of women aged 20 to 24 also have the disease at any given time.
The majority of the American population will come in contact with one
of the many strains of HPV before their 50th birthday. This is especially
unfortunate because there is a strong link between HPV and cervical,
penile, and anal cancers, as well as the occasional case of genital
warts.
Next comes Chlamydia, a disease with little to no detectable
symptoms. The rate of Chlamydia has gone up 36% in men and 16% in women
from 2002 to 2006, the CDC says. Still, the disease is more than three
times more common in women than men. Unfortunately for these women,
Chlamydia is an extremely destructive force if left untreated and can
lead to damage of the reproductive organs and infertility.
One out of five adolescents has genital herpes, the catalyst of
which is primarily HSV-2, according to the CDC. Apart from genital
herpes outbreaks, which do not occur right away and may be mistaken for
another condition such as skin irritation in the early stages, there is
no way to track HSV-2.
“Genital HSV-2 infection is more common in women (approximately one
out of four women) than in men (almost one out of eight),” the CDC
website states. “This may be due to male-to-female transmission being
more likely than female-to-male transmission.”
Forhan’s study also found a disparity in the race of infected
teenagers in her study. While 20 percent of non-Hispanic whites and
Mexican females were infected with one of the main four STDs, a
shocking 48 percent of African-American females were affected.
“Factors contributing to the severe STD impact among African
Americans include limited access to quality health care, as well as
poverty. Additionally, a higher prevalence of STDs in this population
may translate into a greater risk of being exposed. Finally,
misperceptions of personal or partner risk may also be factors in
increased risk for STDs among African American women,” says Nikki Kay
of the Center of Disease Control.
However, Dr. John Douglas, Director of the STD Prevention Division
at the CDC, assures that the minority trend is not exclusive to
African-Americans. “When compared to whites, the Chlamydia rate among
Hispanics is three times higher and the gonorrhea rate is twice as high.
Hispanics also have the second highest rate of syphilis in the nation,
followed closely by Native American/Alaska Natives, who also have the
second highest rate of gonorrhea and Chlamydia in the U.S.”
Overall, young females have more STDs than young males. Young
African-Americans have more STDs than other races. Now we must consider
that statement and ask ourselves why this is happening.
“We are seriously overdue to re-invent ‘sex education’ – to ensure
that adolescents gain understanding about the underlying gender norms
that actually shape much of their sexual health and well-being.
Specifically, policies and programs need to emphasize young people’s
critical thinking skills and their awareness of gender issues,” Nicole
Haberland and Debbie Rogow say in an editorial reacting to Forhan’s
study. The two authors wrote the article on behalf of the Population
Council, a program which seeks to improve programs and policies for
HIV/AIDS; poverty, gender, and youth; and reproductive health.
Haberland and Rogow suggest that the rise in STDs is directly linked
to America’s perception of the traditional gender roles men and
women play out in a sexual relationship.
“Girls who are submissive to male partners, or who agree that males
should ‘have more power in the relationship’ are less able and less
likely to negotiate condom use or to refuse unwanted sex. Boys who are
socialized to equate masculinity with physical strength, emotional
toughness, and aggressive behavior; with proving their heterosexuality;
and with having multiple sexual partners are also at greater risk.”
According to the authors, the only way to fix the problem is to develop
a stronger focus on gender dynamics among teens. This focus is absent
in most sexual education programs, whether they are abstinence or
prevention-based.
“Unfortunately, sex educators in the US are busy battling right wing
opposition and have had little time or space to heed this call,”
Haberland and Rogow explain. “Indeed, most sex education programs
ignore gender issues, or touch on them at best superficially.”
The call for education on gender relations and stereotypes also
offer a solution to the controversial call for “sex education” to be
taught at a younger age since many students drop out of school before
high school, when sexual education is usually taught. The
authors discuss this in a November 2005 article entitled Sexuality and
Relationships Education: toward a Social Studies Approach:
“Unfortunately, in some cases, implementing this shift boils
focusing only on negative aspects of sexuality (protection against
abuse) or on lessons about intercourse and contraception for children
who are not prepared for such information. In contrast, a culturally
appropriate focus on social norms related to gender might also be
considerably more appropriate for under-12 children than focusing
predominantly on sexuality per se.”
Even when taught to teens, Haberland and Rogow have found that the
few gender-based sexual education programs that exist have had their
success. In Latin America, the Project H program for young males
targets gender awareness issues. An evaluation of the program showed
more condom use and less STD symptoms among its participants.
In the US, where there is also a great concern about the growing
levels of STDs in youth, the authors have also found a program that’s
got the attention of teens. “Another example, closer to home, is the
Brooklyn-based nonprofit Scenarios USA. Scenarios sponsors a critical
thinking and creative writing program through public school districts
in New York City, Cleveland, South Texas, and Miami, as well as through
Planned Parenthood and through Black Entertainment Television.”
Scenarios USA presents a new theme based around issues of love, sex,
and gender every year. This year’s theme is “What’s the real deal about
masculinity?” The theme was discussed through a story, play, and
scriptwriting contest, which will be translated into publications,
performances, and films that will be displayed throughout high schools
and via television.
The data released by Dr. Sara Forhan at the National STD Prevention
Conference only supports a pattern that America has been trying to
deter for years though health and education programs. STDs have a
significant prevalence in teens between age 14 and 19, as well as young
adults between age 20 and 24. This is especially true for women and
minorities, who are as much affected by society’s social constructs as
they are sexually transmitted diseases.
It is only through gaining a greater understanding of our own
strengths and, perhaps more importantly, vulnerabilities that teens can
conquer the norms of sex as we know it. We need to recognize the faults
of traditional gender roles and utilize that knowledge to protect
ourselves from undesirable sexual situations and consequences.
Those
who see themselves as being in a favorable sexual situation must still
be aware of both contraceptive and STD screening services available to
them, both of which are crucial to STD prevention and treatment.
According to a study by Sherry Farr and her colleagues at the CDC, it shows
that only 39% of women are actually taking advantage of both services,
thus putting themselves at unnecessary risk.
The old cliché “knowledge is power” has never been more relevant
than in a case such as the struggles of teens and young adults against
sexually transmitted diseases, so get educated and get involved!
Special thanks to The Center for Disease Control, Nicole Haberland, Debbie Rogow, and the Population Council.
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