Teen Girls Beware

By Christine Gorman

While Washington continues its obsession with Bill and Monica's dirty laundry this week, it's time for the rest of us to focus on a different kind of sex scandal. I'm talking about the epidemic of sexually transmitted diseases--everything from genital herpes to HIV to human papillomavirus--that is ravaging the U.S. and has taken a particularly harsh toll on teenagers. Things have got so bad that researchers from Johns Hopkins University last week called for routine screening every six months of all sexually active teenage girls for infection with Chlamydia trachomatis, a germ that can inflict permanent infertility. First isolated from the genital tract in 1959, chlamydia causes 4 million infections in the U.S. each year.

There are several reasons for singling out teenage girls. For one thing, they develop chlamydia more often than adults. In fact, whenever health experts track cases by age, they find that about half of all chlamydia cases occur in girls ages 15 to 19. Reason: the younger the woman, the more vulnerable to infection is her cervix, the ring of tissue that protects the opening to her uterus. In addition, chlamydia often infects silently, with few or no initial symptoms. Although it is easily cured with antibiotics, the longer it remains undetected and untreated, the more likely it is to cause extensive internal scarring. The disease, after months or years, can lead to an excruciatingly painful condition called pelvic inflammatory disease and a lifelong inability to conceive children.

Since most of the attention has been focused on girls, researchers don't know much about how chlamydia affects boys. There's an impression that it's not as harmful, but no proof. In some cases, the infection does produce a painful swelling of the testes. But no one yet knows if it can lead to scarring and infertility in males.

That uncertainty could be changing. In the past few years, pharmaceutical companies have developed highly sensitive urine tests for chlamydia that work equally well for boys and girls. (The previous test required more invasive sampling of the cervix or urethra.) Such tests should permit more extensive screening campaigns. Already, a pilot program in the Pacific Northwest has achieved a dramatic decline, from 9% to 3%, in chlamydia rates among women in family-planning clinics. But the goal should be getting to zero, which means that both men and women need to be tested and treated. Otherwise, they'll just be reinfected.

Of course, whenever you talk about screening sexually active teenagers these days, you're bound to get an argument. Which is why I'm impressed by some schools in New Orleans that have asked for, and received, parental permission to test nearly all their students, regardless of what they say about their sexual experience. That way, doctors and nurses can focus on treating sick kids, ensuring that one day, preferably when they're older and married, they can still have children.

And what can you do at home? Talking to your children about sex and values is an obvious first step. Be sure to note that STDs do not discriminate: you can't tell if another person is infected by how "clean" or "nice" he or she is. Nor are condoms, which generally provide pretty good protection, entirely foolproof. So don't be afraid to let your teenagers get tested for chlamydia. You may not like the results, but at least a treatment is available.

See time.com/personal for more on chlamydia. Send a brief e-mail about this article to Christine at [email protected]