Sexually transmitted diseases & women's health

National Women's Health Report, June, 2002

The ultimate risk of HIV--death--is fairly well known. But that doesn't stop sexually active women from taking chances. "Despite the campaigns and efforts to educate people, we're just not getting through, especially to the teen population," says Ms. Cheney. "I think there's just this sense of 'It won't happen to me."' And yet it does. It's estimated that at least half of all new HIV infections in the U.S. are among those under 25. The majority of young people with the virus are infected sexually. (9)

Ironically, the AIDS epidemic may, in part, be contributing to the STD epidemic. "Maybe in the wake of the AIDS epidemic people have not come to appreciate just how incredibly complicated these other diseases are," says Dr. Berman, "and that they run a far greater risk of getting them." And that, while STDs may not kill you, they will, by their very prevalence, negatively affect your life, he notes.

Pondering Prevention

Whenever Alvin F. Goldfarb, MD, professor of obstetrics and gynecology at Jefferson Medical College in Philadelphia, sees a teenage girl in his office, he asks her mother to wait outside. Then he quizzes the teenager: Do you have a boyfriend? Are you sexually active? What do you use for birth control? What about STD protection? Then, without question, he screens her for chlamydia and gonorrhea, and conducts a Pap to check for HPV. Then he has an incredibly blunt discussion with her about STDs. "I tell her, 'inspect the merchandise.' Look for pimples on the penis, any discharge."

"I believe very strongly in education, and in everyone knowing that they must be respectful of themselves and of anyone they're going to share their body with," he says. Unfortunately, Dr. Goldfarb, who is also the President and CEO of the Adolescent Wellness and Reproductive Education Foundation (AWARE), which attracts more than 16,000 visitors a month (most of them teens), knows that too few teenagers have someone like him in their life and so have no clue as to how to protect themselves from STDs.

Americans overall have misguided notions on how to protect themselves from STDs. In one study of 3,500 STD clinic visitors, nearly half believed douching protected against STDs, 20 percent thought birth control pills would do it and 16 percent thought washing their genitals after sex was effective. None of these approaches protects against STDs. In fact, irritation caused by douching may increase STD infection risk. (3) And testing for HIV does not prevent the disease, as more than 40 percent of women involved in a New York study believed. (10)

Your best bet? Abstinence and properly used latex condoms. The diaphragm may also provide some protection against gonorrhea, chlamydia and trichomoniasis. (16) Within the next few years, however, there may be a host of new weapons to fight STD transmission, including vaccines against chlamydia, HPV, genital herpes, gonorrhea and HIV, (12) and virus- and bacteria-killing gels, foams, creams or films, known collectively as topical microbicides. (13)