Investigating the quiet epidemic of sexually transmitted diseases among teen-agers, researchers say that adolescent girls and boys who have sex need to be screened twice as often as doctors thought for the most common infection, chlamydia.
The recommendation, published in today's Journal of the American Medical Association, stems from a three-year Johns Hopkins University study of about 3,200 Baltimore teens ages 12 to 19, mostly girls. Roughly a third of them tested positive for chlamydia, a finding that confirms smaller studies.
Chlamydia is a bacterial infection that can be diagnosed with a urine sample and cured with a week's worth of antibiotics. Untreated, it can lead to infertility among women and other serious complications in both sexes.
Like other sexually transmitted diseases, or STDs, it is at epidemic levels.
It's the most commonly reported infectious disease in the United States, yet a combination of factors has conspired to keep the high incidence and the tragic consequences secret.
Nine out of 10 women don't get any symptoms, and, uncomfortable with the issue, physicians and the public rarely discuss it.
"We don't talk about STDs; we assume that they aren't there, that other people get them, and that other people's patients get them," said Dr. Donald P. Orr, professor of pediatrics at Indiana University School of Medicine, and director of theMid-America Adolescent STD Research Center.
In an editorial accompanying the study, he said more frequent screening should be done in cities such as Baltimore that have a high incidence of STDs.
By 12th grade, statistics show, 70 percent of teen-agers have had sex, and a quarter of them have had four or more partners. Typically, doctors test these teens about once a year, based on certain risk factors.
The Johns Hopkins study, the largest of its kind, found those criteria useless and says all sexually active teens should be tested every six months.
"The only predictor that we found was just being a sexually active adolescent, and most of these infections didn't have any symptoms," said the study's lead author, Dr. Gale R. Burstein, a pediatrician and adolescent medicine specialist at Hopkins.
That makes it difficult for some to believe anything is wrong.
"I was kind of like, 'I don't have it.' That was my attitude. I thought, 'They're wrong,' and I wanted to be retested," said one young woman who was diagnosed with chlamydia at age 16.
