Becoming sexually active is a major part of becoming an adult.   Sexual activity can lead to unwanted pregnancy and sexually transmitted diseases (STDs), if unprotected. There has been, and continues to be an increase in the incidence of sexually transmitted diseases, especially amongst adolescents and young adults around the world. It is very important that adolescents have a clear understanding of sexually transmitted diseases and other consequences of sexual activity.  This includes knowing the definitions of common STDs, their symptoms, and their possible treatments.

STDs in the United States

Who is at risk?
 

• It has been found that fifty to sixty percent of women do not use contraception the first time they have sexual intercourse (Diaz de Leon, 1996).

• Twenty-five percent of sexually active adolescents have contracted sexually transmitted diseases (Griffiths, 1997).

 One reason for this may be due to the fact that adolescents believe in the “personal fable”, which is the belief that they are unable to be harmed. Many people hold stereotypes about who “they think” would contract sexually transmitted diseases or have an unplanned pregnancy.  Most people never think that they are amongst that stereotype, and therefore feel that they are not at risk (Moore, 1992).

 This also indicates that most people are unaware of the exact consequences they risk by getting involved in risky sexual behavior (Moore, 1992). Unfortunately, many adolescents become sexually active before they reach a maturity level in which they would consider the long term consequences of their behavior.  Just having knowledge about the subject is not enough to influence the adolescent’s behavior.

STD Statistics

How do we compare to other cultures:

Sexually Transmitted Diseases in Australia and South Africa
 

• In Australia, it was found that adolescents who communicate with their partner about avoiding STDs are more likely to use condoms.

• Having less knowledge about sexually transmitted diseases is associated with the use of condoms during intercourse (Donald, 1994).

• These ideas differ from research done in the United States about what leads adolescents to use protection.
•  In the United States, adolescents who are more knowledgeable about STDs are more likely to use protection.
• In Australia, adolescents who use protection do not feel the need to know about sexually transmitted diseases since they are not at risk for contracting them (Donald, 1994).
• In Australia, adolescents are more concerned about unwanted pregnancy than with contracting an STD.  The longer one has been sexually active, the more likely they are to rely on an oral contraceptive, which only protects against unwanted pregnancy, and not against disease (Donald, 1994).

• The AIDS epidemic in South Africa is of major concern.
• In South Africa, It is expected that by the year 2010, twenty-five percent of the population will be infected with AIDS alone, half of which will be under twenty-five years of age (Cherian, 1998).
• In a study of street youth, it was found that no boys had ever heard of HIV and did not know how the disease was transmitted.

• Adolescents in South Africa do not have as much information regarding AIDS and other sexually transmitted diseases than adolescents in other cultures.  This has led to a lot of misconceptions about STDs in this country.

Pregnancy

 Getting pregnant is a direct consequence of having unprotected sexual intercourse. When a woman becomes pregnant she must consider her options of carrying the pregnancy to full term or to have an abortion.  Coming to this decision can be very difficult emotionally and physically.

 It may be stereotypical, but it is often thought that girls who become pregnant at an early age have lower levels of education.  This may actually be a consequence of becoming pregnant, rather than a cause (Diaz de Leon, 1996).  If a young girl becomes pregnant and decides to have her baby, she must leave school at some point in order to care for her child.

Sexually Transmitted Diseases: Definitions, Symptoms, and Treatments

Introduction to STDs

Acquired Immunodeficiency Syndrome (AIDS): AIDS is transmitted through sexual intercourse or through bodily fluids such as semen and vaginal fluid.  It can also be transmitted through dirty needles.  Symptoms of AIDS include enlarged lymph nodes, chronic diarrhea, weight loss, fever, and fatigue, however it is not unusual to have no symptoms of AIDS, while it is in its dormant stage.  When active, this disease attacks the immune system, making a person susceptible to infection (Kilby, 1986).  Since the body cannot properly fight off disease, when a person gets an infection, it can be lethal.  It is common for an AIDS victim to catch a life-threatening pneumonia.  At this time, there is no cure for AIDS, only the cancers and associated illnesses can be treated.  There are, however, treatments that can prolong life, but the damage done to the immune system cannot be reversed.

Herpes Simplex Virus: Herpes is transmitted through direct contact of infected areas, which is usually in the genital area.  It can be a painful disease that can have recurring attacks throughout the lifetime. Herpes is incurable, but the transmission of it can be avoided.  To avoid spreading the disease, one should not have sexual intercourse during an attack and should not resume sexual activity until seventy-two hours after the lesions has disappeared (Kilby, 1986).

Chlamydial Infections:  Chlamydia is an infection that is difficult to diagnose.  It is a parasite, therefore, medically, a cell culture must be done to make a proper diagnosis.  It is also difficult to detect because most women and some men show no symptoms to the disease.  If anything, women may experience painful urination,  abdominal pain, abnormal vaginal discharge, or deep pelvic pain during sexual intercourse.  Symptoms found in men include painful urination and milky urethral discharge.   Luckily, there is a treatment for this disease, tetracycline (Kilby, 1986).  Preventions for this disease include abstinence, being in a monogamous relationship, and using barrier contraception, such as condoms or diaphragms.

More information about chlamydial infections
 

Gonorrhea:  Gonorrhea is a bacterial disease which is transmitted through sexual contact.  Symptoms in men include discomfort, burning urination, and a thick urethral discharge that is green or yellow in color.  Around half of the women infected with gonorrhea show no symptoms, but it is possible for them to have abnormal vaginal discharge or burning during urination.  Fortunately, gonorrhea can be treated by antibiotics (Kilby, 1986).

More information about Gonorrhea
 

Syphilis:  Syphilis is passed from an infected person to an uninfected person through sexual intercourse.  It is most likely to occur in persons between the ages of twenty to twenty-four.  There are four stages to syphilis: primary, secondary, latent, and late syphilis.  The primary phase is an incubation period lasting about twenty-one days.  During the secondary phase, a rash appears and the lymph nodes enlarge.  The latent phase has no symptoms and can last for many years.  In the late syphilis stage, illnesses build in the skin and bones.  If left untreated, the aorta can dilate and an aneurysm can rupture, causing death.  Penicillin is the usual treatment for syphilis, however treatment can vary depending on the stage of the disease (Kilby, 1986).

Viral Hepatitis:  There are three types of viral hepatitis:  hepatitis A, hepatitis B, and non-A, non-B hepatitis.  Hepatitis A is called infectious hepatitis, and is excreted in feces.  Hepatitis B is found in bodily fluids.  Blood containing hepatitis B is very infectious, whereas other fluids in the body may only be mildly infectious.  Non-A, non-B hepatitis is usually transmitted through blood transfusion. Hepatitis B is the most common type of hepatitis.  Hepatitis passes through three stages, the first of which is an incubation stage.  The symptoms of the second stage can include a lack of appetite, nausea, vomiting, headache, and fatigue.  The third stage is the jaundice stage, which only occurs in about one out of every four patients.  This can lead to permanent liver damage (Kilby, 1986).  The best way to prevent hepatitis is by getting immunizations.

Nongonococcal Urethritis:  Nongonococcal Urethritis is an infection of the urethra, usually in men, that is sexually transmitted.  Symptoms of this include burning urination, urethral discharge, and urgent need to urinate.  Although tetracycline is the drug of choice for treatment of Nongonococcal Urethritis, treatments can vary depending on the specific organism that is causing the disease (Kilby, 1986).

Pelvic Inflammatory Disease: Pelvic inflammatory disease is caused by bacteria that infects the cervix and moves upward into the uterus and fallopian tubes.  This usually occurs in women ages fifteen to twenty.  It is uncommon in women who are not sexually active and women taking oral contraceptives.  Symptoms include deep pain during penetration, nausea, intermenstrual bleeding, and pain during urination.  Pelvic inflammatory disease can be treated with oral antibiotics.
 
 
 
 

References
 

 Akande, A., Moore, S., Rosenthal, D., Smith, A. M. A., & de Visser, R. (1998). Australian and South African undergraduates’ HIV-related knowledge, attitudes, and behaviors. Archives of Sexual Behavior, 27(3), 279-294.

 Cherian, L., Cherian, V., & Peltzer, K. (1998). AIDS awareness of secondary school pupils in the northern province of South Africa. Psychological Reports, 83(3), 955-958.

 Diaz de Leon, J., Huerta-Franco, R., & Malacara, J. M. (1996). Knowlege and attitudes toward sexuality in adolescents and their association with the family and other factors. Adolescence, 31(121), 179-191.

 Donald, M., Dunne, M., Lucke, J., O’Toole, B., & Raphael, B. (1994). Determinants of condom use by Australian secondary school students. Journal of Adolescent Health, 15(6), 503-510.

 Griffiths, J., & Kassirer, A. (1997). The effectiveness of “the responsible sexuality program”: a brief high school sexual education intervention. Journal of Sex Education and Therapy, 22(2), 5-10.

 Kilby, D. (1986). Manual of Safe Sex. Ontario: B. C. Decker.

 Moore, S. M., & Rosenthal, D. A. (1992). Australian adolescents’ perception fo health-related risks. Journal of Adolescent Research, 7(2), 177-191.

 Richter, L. M., & Swart-Kruger, J. (1997). AIDS-related knowledge, attitudes and behaviour among South African street youth: reflections on power, sexuality and the autonomous self. Social Science and Medicine, 45(6), 957-966.