Sexually Transmitted Diseases

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There are many types of STDs which can affect youth and over half of STDs occur to adolescents (1,3,29-31). The majority of STDs involve individuals aged 15 to 29 years. Each year, 1 in 20 adolescents in the world obtains a curable STD (3). STDs can be asymptomatic and youth often do not seek treatment even if symptomatic. Adolescents are less likely than adults to use protection (i.e., condoms). The most common STDs among youth are infections due to human papillomavirus (HPV), herpes simplex virus, Chlamydia trachomatis, Neisseria gonorrhoeae, and Trichomonas vaginalis. HPV is main cause of cervical cancer in females under 30 years of age and the recently developed HPV vaccine can prevent 70% of these cervical cancers.

Worldwide, the WHO estimates there are over 300 million curable STDs (Table 6), including an estimated 12 million cases of syphilis; 62 million cases of gonorrhea; 89 million cases of chlamydial infections; and 170 million cases of trichomoniasis (31). Every day, 725,000 STD cases develop: 360,000 trichomoniasis; 140,000 chlamydial infections; 84,000 HPV; 70,000 gonorrhea; 56,000 HSV; 10,000 syphilis; 5000 chancroid (3,31). Globally, 250,000 adolescents are infected with a STD each day (3).

Table 7 lists factors involved in the development of high rates of STDs in adolescents. Youth at the highest risk for STDs are runaways, involved in sex for survival (prostitution), housed in jails or detention centers, involved in male homosexual behavior, those who have been abused, are mentally retarded, or have a history of STDs (32). The cost in terms of preventable health care spending is staggering and the complications of STDs are severe, especially for females—chronic pelvic pain, ectopic (tubal) pregnancy and poor pregnancy outcomes, among others (32,33).

Table 6 Estimated Number of Curable STDs by Regions of the World

Region

Annual

North America

14

Western Europe

16

Australasia

1

Latin America and the Caribbean

36

Sub-Saharan Africa

65

Northern Africa and Middle East

10

Eastern Europe and Central Asia

18

East Asia and Pacific

23

South and Southeast Asia

150

Total

333

Source: Adapted from Ref. 32 (www.who.int/asd/figures/global report.html).

Source: Adapted from Ref. 32 (www.who.int/asd/figures/global report.html).

It is important to provide STD services to adolescents around the world in a confidential manner that provides enough time to manage the youth properly. Primary prevention involves confidential youth counseling about STDs; proper immunizations (including hepatitis A and B as well as the HPV vaccine); encouragement of abstinence; and, if sexually active, use of latex condoms (32,34-36). Seconary STD prevention involves regular STD screening, proper STD treatment, and partner notification if an STD is identified (30,32,35,36).

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