Talking to your teen: Advice from James Allen, MD

Dr. Allen, a former President and CEO of ASHA, earned his medical and public health degrees at the Johns Hopkins University, and completed his clinical training in pediatrics at the Johns Hopkins Hospital and his preventive medicine residency through the CDC. He has been certified by the National Board of Medical Examiners and is a Diplomat of the American Board of Pediatrics.

Parents often have trouble talking with their adolescent children about sex. Most schools are constrained by societal pressures and funding sources to provide “abstinence only” messages rather than comprehensive sexual health information. In contrast, entertainment media portrays human sexuality as spontaneous and easy, without complications of relationships or sexually transmitted infections and unintended pregnancy.

The truth is that sexually transmitted infections (STIs) are an enormous problem in the United States, especially for adolescents and young adults. Each year, one of every four sexually active teens will get a sexually transmitted infection. By age 25, half of all youth will have acquired one or more infections, which are more than 9 million people!

Many of these are silent infections without clinical symptoms. Despite the absence of symptoms, long-term damage such as infertility can occur if infections are not diagnosed and treated. And many youth (and adults) assume that they would know if they, or their partner, had an infection.

The best way to be diagnosed with a sexually transmitted infection is to be tested for it. Great strides have been made in recent years in development of reliable tests.

Most youth assume they are being tested for “all” STIs when they go to their doctor. In fact, testing rarely occurs even for the more common infections, even though healthcare guidelines and medical associations recommend testing be done routinely.

Communication is an important issue in obtaining testing. Just as adults are reluctant to discuss sexual health issues with youth, youth are also reluctant to discuss this with adults, including health care providers. Young people need the necessary information to know how to take care of their sexual health. Testing, treatment and communication are all important in addressing STIs but they are not sufficient. Knowledge and prevention are essential.

Of great concern is the politicization of sexual health information, which makes it difficult to be certain about the accuracy and context of messages. Groups that attack the effectiveness of condoms, for example, hope this will encourage abstinence. Instead, it leaves our young people at risk. The simple fact is that condoms, used correctly and consistently, provide substantial protection against STIs, including HIV.

The stigma attached to many diseases such as cancer a generation ago has disappeared. But sexual behaviors and STIs remain highly stigmatized in our country. This stigma inhibits discussion with parents, partners, and health care providers and discourages youth from seeking needed health care. Social attitudes that reinforce this do not reduce the frequency of sexual contact, but they do reduce prevention behaviors and increase risk.

It is biologically certain that our children will grow up and become sexually mature. STIs have been with humans for centuries. Information, education, supportive social environments, and sound, well-funded public health programs are effective at reducing risks of infection. Our failure to address these issues leaves our youth vulnerable. We as a nation need to review the lessons of the past and make protecting our sexual health a high priority.