Teen-agers learning AIDS is but one of many sexually transmitted diseases In Love, In Danger

January 31, 1995|By Laura Lippman | Laura Lippman,Sun Staff Writer

True love waits. Teens hear that message of abstinence more and more today. To drive it home, parents and teachers often emphasize the scariest potential consequences of sexual activity -- pregnancy or AIDS.

Those exhortations and warnings will be heard again this weekend when an expected 500 area Baptists meet in Towson for a "True Love Waits" conference, a national movement to encourage teens to sign sexual abstinence pledges as part of their commitment to God.

But alongside AIDS, other sexually transmitted diseases often take a back seat in such discussions. That's a disservice to everyone, say local doctors who treat adolescents.

True, the consequences of pregnancy and AIDS may be more NTC extreme. But gonorrhea and chlamydia are statistically more likely -- affecting up to 35 percent of all sexually active women, in the case of chlamydia.

Of the 12 million new cases of STDs diagnosed each year, about one-fourth are in people under age 20. Gonorrhea rates, while down in the general population, have been called an epidemic among black teen-agers.

Meanwhile, gonorrhea and chlamydia are often difficult to detect in women, making them vulnerable to pelvic inflammatory disease, which can lead to fertility problems later in life. An STD infection can make it easier to get HIV, through open sores that allow the AIDS virus to get into the bloodstream.

"I frankly don't think you can care for teen-agers without being acutely aware of STDs," says Dr. Marianne E. Felice, director of adolescent medicine at the University of Maryland Medical Center. "We're not talking about just inner-city youths. This is a problem that crosses socio-economic lines."

Dr. Alain Joffe, director of adolescent medicine at Johns Hopkins Children's Center, hears strange bits of folklore from teen-agers convinced they can tell if a sexual partner is "clean."

"Teen-agers don't believe it can happen to them," he says. "They think: 'It's people who are promiscuous, people who are dirty. Bad kids get STDs.' And they don't see themselves in that light."

At the Laurence G. Paquin School in Baltimore, principal Rosetta Stith says her students began to take STDs seriously only after seeing people in the community with AIDS. Even then, it's difficult to convince teens they can be infected.

"Kids are visual. These diseases, you really can't see," Dr. Stith says of her students -- young mothers and mothers-to-be.

"They've got the awareness, but not the behavior," she continues. "They won't go stand out in the street, because they know they'll get hit by a car. They take their umbrellas when it rains and put on boots when it snows. We ask them, 'When you have sexual contact, what happens to that [preventive] behavior?' "

Only abstinence can guarantee a teen will not contract an STD, although monogamous sexual relationships help reduce the risk of STDs.

Beyond that, prevention is tricky. Barrier methods -- such as diaphragms and condoms -- are considered best for preventing STDs. Oral contraceptives don't offer much protection against sexually transmitted diseases, though the Pill has shown some effectiveness against the pelvic inflammatory disease associated with chlamydia and gonorrhea.

Here's a run-down of the most common STDs facing teens today:

Chlamydia: The most common sexually transmitted disease in the United States -- and the most difficult STD for which to test. Antibiotics are usually successful in treatment, but women often do not know they have chlamydia and do not seek treatment. Untreated, it can lead to pelvic inflammatory disease and even infertility.

One of the greatest mysteries about chlamydia is the number of people infected. In Maryland, state law only recently began requiring that cases of chlamydia be reported, so there is little data on the number of cases. Nationally, it is estimated there are 4 million cases every year.

Gonorrhea: Symptoms may include discharge and, for men, a burning sensation during urination. About 60 percent of women have no symptoms at all. The disease is treated with antibiotics.

Untreated, the infection can damage women's fallopian tubes, with the same consequences as untreated chlamydia.

In 1988, there was a resurgence of penicillin-resistant gonorrhea in the United States. In 1993, the U.S. Centers for Disease Control and Prevention reported that the infection was a runaway epidemic among black teen-agers, even as it declined among other populations.

For example, the infection rate among white adolescents ages 15 through 19 in the Northeast was 41.8 per 100,000, compared with 7,061.1 per 100,000 for black males of the same age.

In Maryland and Baltimore, the health departments do not have rates for teens, but they do compile raw numbers of cases. Baltimore saw 2,704 cases among those 10 through 19. For the other 23 jurisdictions in the state, the figure was 1,474.

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