CONTENTS
Chapters
- Growing Numbers, Diverse Needs
- Growth, Change, and Risk
- Programs for Young Adults
- Evaluation Findings
- Winning Support from the Community and
Young Adults
HIGHLIGHTS
Included with this issue:
Population Reports is published by the Population
Information Program, Center for Communication Programs, The
Johns Hopkins School of Public Health, 111 Market Place, Suite 310, Baltimore, Maryland
21202-4012, USA
Volume XXIII, Number 3
October, 1995 |
Millions of young adults around the world become infected with STDs
every year (394). Among all age groups in the US, for example, girls ages
15 to 19 have the highest incidence of gonorrhea among females, and boys
ages 15 to 19 have the second-highest incidence among males (498). (See
Population Reports, Controlling Sexually Transmitted Diseases, L-9, June
1993.) Furthermore, at least half—up to 6 million—of the people infected
with HIV are younger than age 25 (394). Of the one million cases of AIDS
worldwide, the high incidence among people now in their 20s indicates that
many contracted HIV infection before reaching age 20. Transmission patterns
in both developing and developed countries indicate that young women are the
group facing the highest risk for HIV infection through heterosexual contact
(92). In a recent study in Zimbabwe, for example, 30% of pregnant girls ages
15 to 19 were HIV-positive (508).
Young adults are particularly vulnerable to STDs because:
- Most know little about STDs, even if they are sexually active (8,
303). Even when they visit family planning clinics, young people
may not receive information about STDs. In the South African study
the youth volunteers seeking condoms were counseled about AIDS in
only 1 of 48 clinic visits (5).
- Even when they know about STDs, young adults use condoms inconsistently (146,
175) (see Chapter 1.7, Young Adults
and Contraceptive Use).
- The earlier people become sexually active, the more likely they are
to change sexual partners and thus face a greater risk of exposure
to STDs.
- STD pathogens can more easily penetrate the cervical mucus of young
women than that of older women. The cervix of a young woman is more
susceptible to gonorrheal and chlamydial infection as well as to the
sexually transmitted human papilloma virus (HPV), which causes
cervical cancer (64, 312, 340, 341).
- Young adults may be even more reluctant than adults to seek treatment for
STDs because their sexual activity is frowned upon. Also, young people
may not know that they have a disease. They may be too embarrassed to
go to a clinic, have no access to a clinic, or be unable to afford services.
Many go instead to unqualified traditional healers or obtain antibiotics
from pharmacies or drug hawkers without proper diagnosis. Improper and
especially incomplete treatment of STDs may mask symptoms without completely
curing the disease, making it more likely that STDs will be transmitted
to others and that complications such as infertility will occur (185).
- Throughout the developing world millions of adolescents live or work
on the street, and many sell sex to make a living, increasing their
exposure to STDs (38, 60, 163, 225, 403,
404, 420).
- Young people may be forced into sex or otherwise have little power
in sexual relationships to negotiate condom use, particularly if
their sexual partner is older (324)—a double risk since older men
are more likely to be infected (76). In some areas adult men seeking
uninfected short-term sex partners increasingly pursue young women
(305, 352, 484).
Untreated STDs can cause infertility in both men and women as well
as other devastating consequences for young women and their children. In
women STDs, especially gonorrhea and chlamydial infection, can cause pelvic
inflammatory disease (PID), leading to irreversible damage to the fallopian
tubes and thus infertility (65, 286, 411, 521, 541). Even a single episode
of PID increases the risk of ectopic pregnancy, a condition that can kill
from sudden and severe internal bleeding when the out-of-place pregnancy
ruptures the fallopian tube. PID also can lead to chronic pelvic pain, pain
during coitus, menstrual irregularities, and repeat episodes of PID (64).
Infertility is particularly tragic for young women in cultures where
children are women's primary means to social status (293, 541).
In pregnant women STDs can affect the infant's health as well as the
mother's. STDs contribute to premature births and low birth weight (90, 286).
Syphilis and genital herpes infection can cause spontaneous abortion, stillbirth,
or perinatal death (117). Gonorrhea and chlamydial infection may
spread to a baby's eyes during birth, damaging vision if not treated (184,
419). |
