Alexandra England, NP, CHA Cambridge Teen Health, Cambridge Ridge and Latin School
By: Alexandra England, NP, CHA Cambridge Teen Health, Cambridge Ridge and Latin School
Talking about the birds and the bees is far more complicated these days. While sexually transmitted diseases (STD’s) aren’t usually discussed around the dinner table, they do need to be talked about somewhere because teens need accurate information to make healthy decisions.
We know that people of all ages get STD’s, but young people are getting diseases like Chlamydia, gonorrhea, HIV, HPV and now syphilis (again) at a much higher rate than adults. The Centers for Disease Control “estimates that youth ages 15-24 make up just over one-quarter of the sexually active population, but account for half of the 20 million new sexually transmitted infections that occur in the United States each year.”
Teen Health Centers offer a unique setting to protect young adults who are sexually active from getting STD’s. In all 50 states, minors can provide consent to receive health services for STD treatment, but it’s not always kept confidential when insurance is involved. Often times, providers are mandated to report health information that is then sent to the beneficiary.
That is not the case at Cambridge Health Alliance’s (CHA) Teen Health Centers. All reproductive counseling and services are free and confidential at CHA Teen Health Centers, offering a safe place for teens to receive care for sexually transmitted diseases. Teenagers are especially concerned with their privacy when accessing care for STD’s and reducing any barrier is important to helping stop the spread of these diseases.
What’s out there?
- Chlamydia: Chlamydial infections are the most frequently reported infectious disease. If untreated it can lead to PID – Pelvic Inflammatory Disease, prevent future pregnancies, and ectopic pregnancy. Symptoms may include abnormal vaginal or penis discharge and burning when urinating. Most people do not have any symptoms at all. For that reason, it is recommended that sexually active teens under 24 get tested annually. Once detected Chlamydia is easily treated with antibiotics.
- Gonorrhea: Gonorrhea is the second most frequently reported infectious disease after chalmydia. Similar to Chlamydia, if left untreated it can lead to PID, infertility and ectopic pregnancy. Gonorrhea is also treated with antibiotics.
- Herpes: There are two viruses – HSV-1 and HSV-2 – that cause herpes. HSV-1 is usually associated with cold sores around the mouth but can cause genital sores as well. Most genital herpes is caused by HSV-2. Herpes is easily transmitted when sores are present from kissing and sexual contact, although even people who are asymptomatic can spread the disease. There is no cure. Symptoms include small, painful blisters and itching before they appear. The blisters usually last a few weeks but will come back.
- HIV (Human Immunodeficiency Virus): Anyone can get HIV through sexual contact, but some sexual activities carry higher risk than others. HIV is transmitted mostly through anal sex and vaginal sex without the use of a condom. Oral sex is the least risky and poses little threat to getting HIV. Multiple partners increases the risk, especially considering 22% of new HIV cases in 2014 were between the ages of 13 and 24. If not treated, HIV leads to AIDS (Acquired Immune Deficiency Syndrome), the last stage of HIV infection. People with AIDS must receive medical treatment to prevent death.
- HPV (human papillomavirus ): Most people don’t even know they have HPV, unless they get genital warts or are tested. However, the long-term effects can be serious – cervical cancer, ectopic pregnancies and other cancers. There is a vaccine that is recommended for girls and boys aged 11 and 12, which is also available at older ages.
- Syphilis: Sadly, this disease was almost eradicated, but is now on the rise. Without treatment, syphilis can cause severe problems with the brain, eyes, heart and other organs.
What can teens do to protect themselves?
The most obvious prevention is to not have sex. But many teens are sexually active. To protect themselves, teens can take precautions to reduce the risk of getting any of these diseases.
Here’s what the CDC says:
- Be in a healthy, long-term relationship with one person (mutually monogamous) who does not have an STD.
Use condoms, correctly and every single time. (Note that condoms are not guaranteed protection from herpes.)
Get tested. And, if test positive, get treated.
Talk with health providers.
Parents need to be engaged in the conversation. Healthy sexuality is also about emotional well being and needs to include understandings of intimacy, respect, responsibility, sexual orientation, gender differences, body image and self-esteem. Don’t assume that teens are getting accurate information from their friends or information that shares your values from school. Creating a space where your child can talk with you about any health issue will help teens get the answers they need and strengthen relationships – yours and theirs.
Cambridge Health Alliance is an academic community health care system committed to serving all members of our communities. We have expertise in primary care, mental health and substance abuse, and caring for diverse and complex populations. CHA patients receive high quality care in convenient neighborhood locations, and have seamless access to advanced care through CHA’s affiliation with Beth Israel Deaconess Medical Center. With over 140,000 patients in Cambridge, Somerville Everett and Boston’s Metro North, CHA is working hard to offer the integrated services its communities need now, and in the future.