Sexually Transmitted Diseases in Adolescents
Elissa B. Gittes MD1
Charles E. Irwin Jr MD2
1 Senior Fellow, Division of Adolescent Medicine, Department of Pediatrics, School of Medicine, University of California, San Francisco
2 Professor, Division of Adolescent Medicine, Department of Pediatrics, School of Medicine, University of California, San Francisco
Introduction
Sexually transmitted diseases (STDs) are the most common reported infectious diseases among sexually active adolescents. The acquisition of an STD by the adolescent may result in significant morbidity, including eventual death from human immunodeficiency virus (HIV) infection. Serious medical sequelae for the adolescent female include pelvic inflammatory disease (PID), tubo-ovarian abscess, ectopic pregnancy, infertility, anogenital cancer, acquired immunodeficiency syndrome (AIDS), and morbidity and mortality of her off-spring. For the adolescent male, serious sequelae include epididymitis, proctitis, anogenital cancer, impaired fertility, and AIDS. The adolescent often begins his or her sexual career while under the care of a pediatrician, who, therefore, plays a crucial role in the evaluation and treatment of STDs in the adolescent patient. Of paramount importance is the clinician's role in education about and prevention of STDs in both the abstinent and the sexually active adolescent.
Prevalence
During the past 2 decades, the age of onset of heterosexual intercourse has been decreasing, with a resultant increase in the prevalence of STDs. Data from the 1988 national survey on adolescent sexual debut indicate that by age 15 years, 25% of black and white females and white males and 69% of black males have initiated coitus. By age 19 years, 76% of white females, 85% of white males and black females, and 96% of black males report having had sexual intercourse at least once.1
