By Laura Sessions Stepp and Katherine Shaver
Washington Post Staff Writers
Thursday, March 13, 2008
Elizabeth Alderman, adolescent specialist at the Children's Hospital at Montefiore Medical Center in New York, was astounded by a federal report this week showing that two out of five teenage girls who have had sex have experienced at least one sexually transmitted infection.
Lorena Granados, a junior at W.T. Woodson High School in Fairfax County, was not the least bit surprised.
"A lot of girls fall in love, and it doesn't seem they care about protection," she said yesterday. "It's 'What am I going to enjoy right now?' Or they'll say, 'I know he hasn't been with anybody. . . . He's clean.' Or, 'He'll stop before we go too far.' "
That same attitude shows up in doctors' offices, Alderman said yesterday.
"Kids are not comfortable disclosing what they do," she said. "Or when they do come in, every single one will tell you they or their partner are using a condom. Obviously, many are not."
The study, released by the Centers for Disease Control and Prevention, analyzed data on 838 girls ages 14 t0 19 who took part in a 2003-04 government health survey. Overall, one in four girls in the sample, which officials said was nationally representative, had a sexually transmitted disease. The teens were tested for four infections: chlamydia, trichomoniasis, herpes simplex and the human papillomavirus.
There was a big difference by race: Nearly half of the black teens had at least one STD, compared with 20 percent among whites and Mexican Americans.
About half of the teens acknowledged having sex, though studies indicate that by the time they finish the first year of college, more than two-thirds of young women have engaged in intercourse.
The report follows other studies indicating that girls today are as active sexually as boys -- and it suggests that many girls are paying a price for that.
In 2005, the CDC reported that slightly more than half of teenage girls and boys had engaged in oral sex, which carries the risk of herpes and HPV, among other infections. Still another survey disclosed this year that after 16 years of decline, the birthrate among 15- to 19-year-olds has started rising.
"When you look at the grand sweep of data, it's a rather sobering picture," said Bill Albert, deputy director of the National Campaign to Prevent Teen and Unplanned Pregnancy in the District.
Sobering, as in the fact that Khadijah Marrow, an eighth-grader at Thomas Johnson Middle School in Lanham, knows a friend who has had a sexually transmitted disease.
"I didn't change the way I acted around her just because she had it," said Khadijah, 14, whose right cheek has a smiley-face sticker. She said she continued to invite the friend to her house for sleepovers.
"She was my friend," Khadijah said. "I wouldn't treat her any different."
Sobering also was the fact that Washington area public health officials were not surprised by the latest CDC findings.
"What we see on the ground on the front lines really confirms the study," said Shannon Hader, senior deputy director of the D.C. Health Department's HIV/AIDS Administration.
Hader and other public health officials said a large number of young people have unprotected sex, many with multiple partners. In a 2007 study by the D.C. public school system, 60 percent of high schoolers and 30 percent of middle schoolers reported having had intercourse. Twenty percent of the high school students said they had had sex with four or more people, and 12 percent of the middle schoolers said they had had three or more partners.
Officials said many teenagers aren't aware that birth control measures, such as the pill or the patch, don't protect against STDs.
"We got the message out about preventing pregnancy," said Molly Love, who works with teens and young adults at a nonprofit health clinic in Silver Spring. "Perhaps young women learned about birth control at the expense of using condoms. Young women don't think as much about the risk of STDs as they do the risks of getting pregnant."
Love said many clients initially visit the clinic for HIV testing only to learn that they have other, more common STDs. Many aren't aware that diseases such as gonorrhea and chlamydia often don't exhibit obvious symptoms, she said.
Khadijah's two older sisters, Christine and Christina, who attend Charles Herbert Flowers High School in Springdale, find this odd. At their school, the danger of STDs is hammered into them in sex education classes, they said, as is the advice to use protection if they choose to have sex.
"They stress it at that school," Christine, 17, said. If one of her friends got a sexually transmitted disease, she said, "I would be scared for them. . . . I know the symptoms of all of the STDs, so I would know what they were going through."
Mandy Dols, a junior at Rockville High School who wrote about the rise in STDs for her student newspaper, said the high rates reported among girls didn't shock her. "It's that whole mentality of teens being reckless and rebellious and just that people aren't as careful," she said.
The Marrow girls offered several reasons why teenagers have sex.
"It's to fit in, peer pressure," Christine said, noting that virgins are often mocked. Also, "sex sells on TV."
Khadijah chimed in that some young girls found their inspiration in the popular R&B singer Rihanna, whose latest album is titled "Good Girl Gone Bad."
But Christina suggested something closer to home. "Write this down," she said. "Bad parenting."
Local health officials suggest that parents speak more openly about sex with their children and as early as the fourth grade. More youth education programs about delaying sex and taking care of one's body also would help, they said.
Granados, the Woodson junior, says peer education would be more effective.
Woodson, she said, offers college-preparation forums for students that include presentations by former students. Why not do something like that with STD education?
"If girls saw other girls come onstage and tell what happened to them, maybe they'd say, 'Oh, it really can happen to me.' "
Staff writers Nelson Hernandez and Lori Aratani contributed to this report.