New estimates show that 15-24-year-olds, who represent one-quarter of sexually experienced Americans, accounted for half of newly diagnosed sexually transmitted diseases (STDs)-more than nine million cases-in 2000. "It is not surprising that teens and young adults contract a disproportionate number of infections," said Sharon Camp of The Alan Guttmacher Institute, "Most young people are sexually active, and many are ill equipped to prevent STDs or seek testing and treatment."
Three diseases-human papillomavirus (HPV), trichomoniasis and chlamydia-represent nine in 10 new STD infections among 15-24-year-olds. The health impact of all three can be dramatically reduced with early detection and treatment. The vast majority of HPV cases are harmless and resolve on their own. Some strains of HPV lead to genital warts, which can be removed, and other strains occasionally develop into a persistent infection that can progress to cervical cancer if left untreated, usually over the course of decades. Cervical cancer, however, is rare in the United States because of the widespread availability of Pap tests, which can detect not only early-stage cervical cancer but also precancerous cervical abnormalities. Both trichomoniasis and chlamydia are easily treatable with antibiotics.
Yet new estimates suggest that the direct medical costs associated with a lifetime of treating cases of STD infection diagnosed in young people in 2000 could reach $6.5 billion. The majority of that cost-90%-is due to treatment of HIV and the small percentage of HPV cases that result in cervical abnormalities or genital warts. Investing money today in STD prevention and education could dramatically reduce the incidence of these infections, and thus future treatment costs.
"Although abstaining from sexual activity is guaranteed to prevent STDs, some adolescents-and virtually all young adults-will eventually choose to have sex," Camp said. "Before they do, they need realistic sex education that teaches them how to prevent STDs and unwanted pregnancies. It is essential to have medically accurate information about condoms and other contraceptive methods, and guidance in how to access appropriate prevention, testing and treatment services."
Appearing in the January/February 2004 issue of Perspectives in Sexual and Reproductive Health, "Sexually Transmitted Diseases Among American Youth: Incidence and Prevalence Estimates, 2000," by Hillard Weinstock of the Centers for Disease Control and Prevention (CDC) et al., and "The Estimated Direct Medical Cost of Sexually Transmitted Diseases Among American Youth, 2000," by Harrell Chesson et al. of the CDC, estimate the scope and economic impact of new STD infections among young people in the United States.
A related report, also released today, by the School of Journalism and Mass Communication at the University of North Carolina–Chapel Hill, Our Voices, Our Lives, Our Futures: Youth and STDs, summarizes the implications of the CDC estimates and offers solutions.
Also in the January/February 2004 issue of Perspectives: "Adolescent Clinic Visits for Contraception: Support from Mothers, Male Partners and Friends," by Cynthia Harper et al.; and "Characteristics of Men Receiving Vasectomies in the United States, 1998–1999," by Mark Barone et al.