Adolescents and sexually transmitted diseases.

The US Department of Health and Human Service reported that 25% of sexuality active teenagers have had a sexually transmitted disease (STD). In school youth are reported to have a lower STD prevalence of 4% based on Centers for Disease Control high school surveys. The seriousness of the problem is approached through discussion of the prevalence and health impact the determinants (behavioral social biological institutional) control strategies and educational strategies. STD educational strategies can be effective only when part of a larger health education program (human sexuality and family life education) rather than including HIV infection instruction in a biology class. Populations particularly affected are young women and low income urban minority youth. The adolescent risk of STDs is higher than in other age groups. Unfortunately severe consequences may involve reproductive health i.e. tubal infertility from pelvic inflammatory disease and ectopic pregnancies from for instance chlamydia and gonorrhea. Females suffer more damage than males although more males die of AIDS. Behavioral factors are sexual behavior drug use and health care behavior. Psychological factors such as self-esteem and locus of control are associated with STD risk behavior. Sexual activity is possible earlier due to a decrease in the average age of menarche. Access to services is a critical factor in prevention. Effective intervention programs should take into account risk factors and adolescent development. Adolescent clinical services need to be improved through better diagnosis treatment and counseling; research and education are needed also. The goal of STD education is to provide adolescents with an increased self-sufficiency in practicing STD prevention and risk reduction. Programs must be sensitive to youth subcultures and include messages about HIV and AIDS. School and community programs are essential to reach all teenagers. The optimum conditions for controlling STDs are an improved social and economic environment accessible and effective health clinics and quality education.