The spread of STDs in America

A year ago when we were a month into Covid-19 shutdown, I wrote about the most common STD, HPV, as the “other virus” we should be talking about. This January, the CDC reported that the most recent data shows that 1 in 5 Americans has a sexually transmitted infection. Of newly acquired STIs (26 million), nearly one in two occur in people 15 to 24 years old.

One in 10 people in the U.S. now has had Covid-19. That’s, of course, still big news. But how is it that I didn’t get the CDC report on STIs to my news apps, which I read every night? Isn’t this continuing epidemic of STDs also big news?

One thing that is good, is that now teens have seen how infections can spread from to person. I’ve mentioned in my Zoom teaching this year that it’s not like one person came from overseas and infected the entire U.S. single-handedly. Likewise, it’s not just one promiscuous person in a high school spreading STDs to everyone else. Instead they are spread from relationship to relationship when those relationships have been sexual. It’s important to help teens understand that being sexually active puts them at risk of exposure not just to the person they have sexual contact with, but ALL their partner’s past partners (and their past partners, etc.) as well. Consider using the example of the Covid-19 epidemic to help your teen understand the spread of STDs, and ask your teen what they think is the most foolproof way of avoiding STDs, some of which can cause lifelong pain or even death. Hint: The CDC says abstinence from all forms of sexual activity is THE ONLY sure way to avoid unwanted pregnancy and STDs.

Zika Virus…a New STD?

We’ve all heard by now about the damage the Zika virus can cause to babies developing in the womb. Up until a few days ago, we thought there were no mosquitos wmosquito-213805_960_720ith Zika here in the U.S. But in the last week, two possible cases of mosquito transmission in Florida have emerged. What you may not have heard is that Zika is being transmitted sexually from infected men (via semen) to their sexual partners. This causes me great concern, and adds to the number of serious consequences of STDs.

Most parents of today’s teens took health classes in which they learned about 4 known STDs: herpes, HIV, gonorrhea and syphilis.  Now, most health classes teach about 10 to 12 common STDs, all HERE in our area.  And young people from the ages of 15-24 account for HALF of all new STDs diagnosed each year! Teen Decision gives the facts to teens about STDs, and urges teens to avoid the risks by choosing to wait to have sex.  But, it’s up to parents to keep the conversation going.  To learn more about STDs and their consequences, click on this LINK.

How a Bad Apple can change a School

Rotten Apple

Most of the stats that we include on our site, in our blogs, or in our classroom instruction refer to the general population of the US. While they are generally accurate, and I can confidently say they reflect many if not most situations, there are always exceptions. We teach at over 35 schools whose health classes vary in size from 5 (yes, 5) to 90. In almost a decade of experience, I have seen a school’s cultural attitudes about sex shift in both positive and negative ways. My experience has taught me a lot about the power of one Bad Apple.

In any given school climate, regardless of how hard teachers, parents, and administrators have worked to instill good values in their students, you occasionally run across a cluster of kids making poor decisions at a disproportionately greater rate. This can happen in both public and private schools, though ironically I find the power of a Bad Apple is more potent in the private schools, simply because they are smaller. It might look like this: at a middle school that almost always has “good” kids, where hardly anyone has actually had sex, suddenly a class comes along that misbehaves more in 6th grade, rebels more when they get to 7th grade, and by 8th grade, the principal is dealing with cases of oral chlamydia.

I don’t have time or space to dissect the sociology behind the phenomenon, but I do want to discuss what parents should consider and how they can help inoculate their child against it. First, I should say that there isn’t always just one “Bad Apple.” I use the term to refer to how an attitude or idea can slowly seep into a population and turn an otherwise positive culture into an unhealthy one. It might start with one person, but one could rarely actually pinpoint that person. So be slow to point fingers.

Parents do need to recognize, however, that the power of a bad apple makes it impossible to completely shield their child from negative influences. For example, I had a friend whose parents sent her to a Christian school, hoping for the environment to shield her from the worst of popular culture. In hindsight, however, she had a harder time making good choices than a similar friend at a public school. In the small, private school, a few bad apples had introduce and normalized oral sex among the students. My friend had been taught to follow the Christian culture of her school, so when oral sex was normalized among her supposedly Christian peers, she felt like it was okay to go along with it. In contrast, my friend at the public school had been taught not to go along with the crowd and to expect to stand out (she was also from a strong Christian family), so when her friends started engaging in oral sex, she figured it was another thing to avoid rather than follow.

The difference between the two is that my friend in the private school had not been taught to recognize and steer clear of the influence of a bad apple. When parents ignore the possibility that an otherwise positive, healthy culture can suddenly become hijacked by a bad apple, they can fail to teach their child to make good decisions despite an unhealthy culture.

What can you do? Talk to your teenager about how the poor decisions of others can influence their thinking, normalizing unhealthy behavior. Here is an example of a small high school of about 300 that suddenly faced 20 cases of Chlamydia. My guess is that a bad apple influenced the school’s cultural attitudes about sex, resulting in high rates of risky behavior. Would your teen know what to do if 20 of their friends were making unhealthy decisions? How would they respond?

FDA Approves HPV Test

The FDA recently approved a test for the STD human papillomavirus (HPV) that could become an alternative for pap smears in women. HPV causes most cases of cervical cancer, as well as some types of head and neck cancers or genital warts, depending on the strain of the virus. In the past, pap smears were used to detect cell changes that could indicate cervical cancer or a risk of cancer. The new test looks for the presence of the actual virus and can detect which strain of the virus is present. More information is also available here.

HPV is one of the most common and easiest to contract STDs. It can be transmitted between partners even with perfect condom use. Two different vaccines are available to prevent the most common types of HPV. These vaccines are recommended for boys and girls ages 9 to 11.

STD Prevention that starts early — but not how you think!

STD prevention can, and should, start in elementary school — but not by distributing condoms or teaching explicit sex ed. Data from the University of Washington looked at risk factors from early in life that predicted a higher number of STDs during the later teen years. There have been many correlations drawn between early sexual debut (the definition of “early” in this study was before age 15) and higher numbers of sexual partners as well as higher numbers of STDs. According the article, “Of youth in the study who became sexually active before age 15, more – about a third – had an STD compared with about 16 percent of those who were older when they started having sex.”

Correlations were also found between youth who grew up in well-managed households with rules, discipline and rewards and later sexual debut. Students who were engaged in school and had positive feelings towards school and their teachers were also less likely to have sex early, as well as students whose friends did not get into trouble. So the secret ingredients to STD prevention (or, some of them, anyway) seem to be a positive, well-managed home environment, strong school engagement, and friends who have a positive influence. Not a huge surprise to those who work with youth, but helpful information nonetheless.

What can YOU do? If you are a parent, continue to learn about positive models of discipline, and don’t shy away from the tough battles during the early teen years. Some of the critical years looked at in the study were ages 10-14. Also, try to find support from one or two other parents who can encourage you in your disciplinary efforts. Raising teens is HARD. You’ll need friends who can act as both coach and cheerleader to make your job a *little* easier.

If you are NOT a parent, look for ways to support positive youth development in your community. Support local schools, volunteer with after school programs, or simply be a friendly, encouraging face to the teens bagging your groceries.

And if you have influence in the community or local school system, support programs that encourage early family engagement and youth development — as early as elementary school. Find ways to encourage teachers and administrators to create positive school environments and fund efforts at early intervention. The earliest STD prevention may look nothing at all like sex education, but if you can help families start off on the right foot and get students engaged in school, it makes a difference!

Learning about Chlamydia

In talking with our teens about the risks they face if they’re sexually active, it’s a good idea to be informed about STDs.  The DuPage County Health Department STD clinic offers (for $50) screening for 4 STDs:  Chlamydia, gonorrhea, syphilis and HIV.  Chlamydia,  is the most commonly reported STD in the U.S.   From dupagehealth.org, and the CDC (Center for Disease Control and Prevention fact sheet), we learn that:

  • Men or women can get chlamydia by having anal, vaginal, or oral sex with someone who has chlamydia.
  • It is a bacterial STD, which means that it can be cured with antibiotics.
  • You can be reinfected even after cured, if you again have sex with someone with chlamydia.
  • About 75% of women and 50% of men don’t know they are infected (they have no symptoms).
  • “It can cause serious, permanent damage to a woman’s reproductive system, making it difficult or impossible for her to get pregnant later on. Chlamydia can also cause a potentially fatal ectopic pregnancy (pregnancy that occurs outside the womb)” (CDC)
  • It can spread to a baby during birth, causing an eye infection or pneumonia in the newborn. Premature birth (and it’s risks) can also occur.
  • In men and women who have symptoms, it can produce symptoms such as an abnormal discharge from the penis or vagina and a burning sensation while urinating.
  • In DuPage County, two out of three cases of Chlamydia and Gonorrhea occur in people under 25 years of age.
  • DuPage County cases of Chlamydia have risen 81 percent since 2000.

Pills Don’t Erase Consequences

You may have already heard that the FDA just approved the “morning after” (Plan B) pill for over-the-counter purchase by teens as young as 15.  Those who believe young people can have sex without consequences are applauding this decision.  But those who care about the health and emotional well-being of teens are concerned.  There is a good argument that this is just one more message we send teens that we expect them to be sexually active, and that nothing will happen if they are.

As an educator, teaching teens about how to have healthy relationships (the healthiest choice being abstinence) I have had to keep up-to-date on condoms, pills, abortion, etc. as the “alternative” practices.  Yes, this drug can stop a pregnancy from continuing, but it’s not 100% effective. In fact, ads for the drug admit 1 out of 8 women WILL get pregnant despite taking Plan B.   No pill on the market does anything to protect teens from the epidemic of STDs they face if they are sexually active.  The CDC reports that half of all next STD infections occur among young people.  Indeed, Jeanne Monahan of the Family Research Council commented that “Additionally… a study released in 2010 revealed that adolescent use of Plan B was correlated with an increase in unplanned pregnancies and a high STD rate.”

And of course, no “protection” offered by condoms or pills does anything to protect the human heart.  The powerful bonding chemicals produced through sexual activity affect teens emotionally in lasting ways…something ignored when our culture merely tries to erase the consequences of teen sexual activity by encouraging teens to just pop pills.

STD-related Cancers Increase

A USA Today article reporting on a new study of HPV cases included some alarming facts about this sexually transmitted disease.  HPV (human papilomavirus) is the most common STD in the world, and it can cause not just genital warts, but cancer.  While cases of cervical cancer have decreased (due to better screening), cancers of the head, neck,throat, tongue and tonsils have increased significantly.  In addition, according to the article, “More than 10% of men and 3.6% of women have a current oral HPV infection, according to a study published last year in the Journal of the American Medical Association.”  HPV-related cancers can take decades to show up and, according to the article, “there are no early detection methods for cancers of the throat, tonsils and base of the tongue.”  When there are symptoms, “for many oral cancer patients — who tend to be in their 50s or early 60s — their first symptom is a swollen lymph node.”

Defining Sex, and What is Safe

I think it’s time for a reminder.  Sex is NOT just about losing one’s virginity.  A Fox News article out today had this confusing (to me) title:  “Teens Who Don’t Have Sex Still at Risk for HPV Infection.”  Since HPV is a sexually transmitted disease, what did they mean?  The problem was that the article didn’t clearly define what was meant by “sex.”  Generally, our society defines sex the same way teens do…as intercourse.  However, as we clarify to teens in our classroom discussions, thinking of sex in terms of “sexual activity” is a more valuable way to think about sex, since other kinds of sexual activity bear risks as well.  The article went on to clarify that a recent study indicated that HPV is being “transmitted through genital-to-genital, or hand-to-genital contact” as well as the more common modes of transmission: vaginal or anal intercourse.  The article didn’t cover the transmission of several STDs orally, including HPV, but that is happening as well.  SO…here’s our definition of sexual activity (all behaviors that carry risk):

Intercourse, Oral Sex, Anal Sex, AND Touching of Private areas (whether genital to genital, or hands to genitals).

Abstinence is choosing to avoid all of those behaviors.

(To learn why condoms are not a safe solution, see this 2011 Amplify Youth Development newsletter article.)

One Reason STDs are Spreading Among Teens

I can just hear the wheels turning in the minds of kids who have just been seriously unsettled by the revelation that about 1 out of 4 sexually active teens will get an STD by the time they graduate high school.  Occasionally someone will ask what the others are thinking:  “But what if its the first time for both of them?”  I give an honest answer, “Well, then they can’t get an STD.”  But then I follow up with a couple of questions:  “How do you know it’s someone’s first time…for SURE?  Do you think people ever lie about their  sexual pasts?”  Sometimes they even figure that if the other person has only had one previous partner, that’s not too bad, and surely doesn’t pose much of a risk.

Many youth, and adults, assume that it’s a small group of promiscuous teens who are out there spreading nasty diseases, but that doesn’t appear to be an accurate analysis of what’s really going on.  A study of sexual encounters at a midwestern high school showed a long chain linking many of the students.  “Of about 1,000 students at the school, 832 were interviewed and asked to identify their sexual and romantic partners over the previous 18 months. Just more than half reported having sexual intercourse….  Of all the pairings, 63 involved two students who had not partnered with anyone else.”  The article concluded that “Sharing of partners was rare, but many students were indirectly linked through one partner to another and another.”  Can you get an STD the first time you are sexually active?  You bet.   This study clearly has implications for the spread of disease, and is another reason why an abstinence message is all the more critical to the health and well-being of our children.