Why You Need To Talk To Your Teens About STDs, And How To Do It

by Dr. Jane van Dis
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As a parent, you probably spend a lot of time talking to your teen about how to prevent situations that could put them in harm’s way. But there’s probably one topic that you aren’t discussing: risk of sexually transmitted diseases (STDs).

And that lack of dialogue may be putting their future at risk.

According to the Centers for Disease Control and Prevention (CDC), cases of STDs are at an all-time high, with more than two million cases of chlamydia, gonorrhea and syphilis reported in the United States in 2016. And those statistics don’t tell the whole story. Young men and women aged 15–24 years acquire half of all new STDs, with 1,008,403 new cases of chlamydia and 218,302 new cases of gonorrhea reported in 2016 for this age group alone. And one in four sexually active adolescent females has an STD, such as chlamydia or human papillomavirus (HPV).

Although treatments are available, people often don’t know they have an STD unless they are tested. I diagnose patients every week with chlamydia, syphilis, and HPV who have no symptoms and no idea they are infected. Unfortunately, STDs can cause chronic (and often painful) pelvic inflammatory disease, and, in the case of HPV, cervical cancer. STDs can also cause infertility. In fact, a woman becomes infertile due to an STD every 30 minutes.

A new survey suggests that false beliefs about STD risk, and miscommunication between females 15-24 years of age and their mothers – and even their doctors — may be factors behind the record highs in sexually transmitted diseases.

Commissioned by Quest Diagnostics, the survey polled young women (15-24 years), mothers of young women in this age group, and primary care, OB/GYNs and other specialty physicians regarding sexual behavior, sexual health, and knowledge of and screening for STDs. The survey looked at young women because the CDC guidelines recommend that doctors screen any sexually active woman 25 years of age or younger at least once a year for chlamydia and gonorrhea – even if they don’t have symptoms. Yet, young women continue to be at heightened risk of these and other STDs.

The findings suggest many young women are at high risk for a STD, but they don’t seem to be aware of it. According to the survey, more than half of young women between the ages of 15-24 say they are sexually active. Yet, only 39 percent of these women used a condom the last time they had sex. Only about half (56%) of sexually active young women say they’ve been tested for an STD. Sixty-two percent of those who haven’t been tested say it’s because they “don’t feel at risk.”

While these findings are specific to young women, the survey also showed that mothers and fathers can do more to help their sons and daughters reduce their risk of STDs.

For one thing, parents may not be fully informed about their sons’ or daughters’ sexual activity. While 56% of young women report that they are sexually active, only 47% of mothers believe their daughter is sexually active. The first thing parents can do, therefore, is acknowledge that their son or daughter may be sexually active, even if they claim otherwise, regardless of age. The average age that the American young man and woman become sexually active is about 17 years old – meaning it could be years earlier, or years later.

Parents may also want to consider the possibility they aren’t communicating clearly or frequently enough about sexual behavior and STDs. The Quest survey found that most mothers feel they are very direct with their daughters when they talk about sex — eight out of ten mothers say they and their daughters have discussed risk of STDs (88%), having safe sex (86%), using birth control (86%), going to an OBGYN (84%), or delaying sexual activity until over the age of 18 (82%). Yet, only one in three (33%) of young women say their mothers have talked to them about these issues. And it is likely that conversations about sexual health with young men are equally as infrequent.

In an ideal world, every primary care physician would offer chlamydia and gonorrhea testing for all asymptomatic female patients age 25 and under – unfortunately, this doesn’t always happen. Maybe the conversation doesn’t happen due to time constraints, or lack of education on the subject. The bottom line: only 75% of primary care doctors in this study said they would offer STD testing to asymptomatic women in the target group. Unfortunately, one of the reasons cited was the feeling they were uncomfortable about discussing STD risk with their patients.

There are three simple ways to overcome the communication barrier and help keep your teen or young adult safe.

First, talk to your teenager about his/her sexual health. Let them know that it’s very important to protect themselves from the risk of infection by using condoms and asking potential sexual partners to get tested as well before sexual intimacy. Ask your daughters and sons to be completely honest with their healthcare team, and in the case of young women, to ask to be screened for STDs every year.

You can also help keep your teens and young adults safe by making sure they are vaccinated for HPV to help prevent cervical cancer. According to the CDC, HPV causes 30,700 cancers in men and women every year. HPV vaccination can prevent about 28,000 of the cancers from occurring. All children (male and female) who are 11 or 12 years old should get two shots of HPV vaccine 6-12 months apart (certain individuals with compromised immune systems and adolescents who receive their two shots less than five months apart will require a third dose of HPV vaccine). And all women age 21-65 should be screened for cervical cancer (Pap Smear) every three years.

Two, if your son or daughter is a teenager, talk to their physician. The physician may not know if you want your son or daughter screened for STDs, and your teen may be too uncomfortable to be that direct with the doctor. Let the physician know that you want your teen screened annually for STDs according to medical guidelines.

Three, consider letting your teen speak one-on-one with the doctor. No matter how open you are with your teen about sexual health and even if you let your teen’s doctor know that you are supportive of STD testing, letting your teen speak privately with a doctor allows them to foster a positive relationship and have candid, important conversations.

Open, candid dialogue about STD risk may be one of the most important things you as a parent can do to safeguard your teen’s future health — and ensure an optimal path to parenthood.