A new CDC study estimates that one in four (26 percent) young women between the ages of 14 and 19 in the United States – or 3.2 million teenage girls – is infected with at least one of the most common sexually transmitted diseases (human papillomavirus (HPV), chlamydia, herpes simplex virus, and trichomoniasis). The study, presented today at the 2008 National STD Prevention Conference, is the first to examine the combined national prevalence of common STDs among adolescent women in the United States, and provides the clearest picture to date of the overall STD burden in adolescent women.
Led by CDC’s Sara Forhan, M.D., M.P.H., the study also finds that African-American teenage girls were most severely affected. Nearly half of the young African-American women (48 percent) were infected with an STD, compared to 20 percent of young white women.
The two most common STDs overall were human papillomavirus, or HPV (18 percent), and chlamydia (4 percent). Data were based on an analysis of the 2003-2004 National Health and Nutrition Examination Survey.
“Today’s data demonstrate the significant health risk STDs pose to millions of young women in this country every year,” said Kevin Fenton, M.D., director of CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention. “Given that the health effects of STDs for women – from infertility to cervical cancer – are particularly severe, STD screening, vaccination and other prevention strategies for sexually active women are among our highest public health priorities.”
“High STD infection rates among young women, particularly young African-American women, are clear signs that we must continue developing ways to reach those most at risk,” said John M. Douglas, Jr., M.D., director of CDC’s Division of STD Prevention. “STD screening and early treatment can prevent some of the most devastating effects of untreated STDs.”
CDC recommends annual chlamydia screening for sexually active women under the age of 25. CDC also recommends that girls and women between the ages of 11 and 26 who have not been vaccinated or who have not completed the full series of shots be fully vaccinated against HPV.
The study of STDs among teenage girls is one of several presented March 11 at the 2008 National STD Prevention Conference that highlights the significant burden of STDs among girls and women, and identifies creative prevention strategies for reducing the toll of STDs in the United States.
Contraceptive services represent missed opportunities for STD screening, prevention
Two other studies featured at the conference point to missed opportunities for STD testing, and underscore that it is critical for STD screening to be included in comprehensive reproductive health services for young women.
A study by CDC’s Sherry L. Farr and colleagues found that while the majority of sexually active 15- to-24 year-old young women (82 percent) receive contraceptive or STD/HIV services, few receive both (39 percent). In addition, only 38 percent of a subset of young women who reported receiving contraceptive services associated with unprotected sex (e.g., pregnancy testing) also received STD/HIV counseling, testing or treatment, which indicates that many women at high risk are not receiving necessary prevention services.
A separate study, by CDC’s Shoshanna Handel and the New York City Department of Health and Mental Hygiene, examined STD screening rates among young women seeking emergency contraception, which would suggest recent unprotected sex. The study found that just 27 percent were screened for chlamydia or gonorrhea. A significant proportion of those women (12 percent) had a positive test result, highlighting the need for routine chlamydia and gonorrhea screening at emergency contraception visits.
Innovative programs provide models for effective STD prevention
Other research from the conference highlighted creative programs that are effectively screening and treating people with STDs, and identifying those most at risk.
A CDC-funded confidential chlamydia screening program in high school-based health clinics in California resulted in high rates of screening among those seeking contraceptive or STD services (range: 85-94 percent). It also revealed significantly higher infection rates among African-American women than white women (9.6 percent versus 1.7 percent).
A study by New York City health officials assessed the effectiveness of an express visit option, allowing patients at city clinics to be tested for STDs without a doctor’s exam. Comparing data before and after express visits were routinely offered, researchers found that the express visit option made it possible for an additional 4,588 tests to be performed, and increased STD diagnoses by 17 percent (2,617 versus 2,231).
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