For some time, the nation’s health leaders have been asking all doctors in the US to screen adolescents for sexually transmitted diseases (STD).

Why is that?  Well, it turns out that STD’s are very common, and they often cause no symptoms.  But in people with STD’s and no symptoms, the germs can spread easily to other partners, and in the person with the silent STD, terrible life long harm can occur.  Finally, most STD’s can now be treated, to prevent serious harm.

So STD’s fulfill the key criteria that would justify screening, that is, testing someone who feels fine:

• STD’s are common
• Most people with STD’s have no idea they are infected
• If they go untreated, lifelong damage can occur and the germs can spread
• Treatments are readily available to prevent harm and spread

What STD’s should be screened?

There are many STD’s, but only 3 are currently being recommended for screening: Chlamydia, gonorrhea (GC), and HIV/AIDS (HIV).

Chlamydia

Believe it or not, chalmydia is incredibly common.  About 3 million Americans get infected with it every year, and those Americans are mostly 15-24 years old.  About one in 6-10 adolescent girls and young women are infected with Chlamydia.

It can cause a painful discharge from the vagina and/or urethera, and even severe pelvic pain, but most men and women with chalmydia never know they are infected.

If a male or female is infected, and they have unprotected sex, about 70% of the time their partner will get infected, so it’s sexually very contagious.

Now, here’s the problem, symptoms or not, untreated chlamydia scars the fallopian tubes leaving women infertile the rest of their lives.  One bout of untreated chlamydia leaves about 8% of those infected infertile.  After two bouts that numbers pops up to 18%.  It also can greatly increase the chance of an ectopic pregnancy, the fertilized egg landing outside the uterus, a very dangerous situation.

So this germ causes a tremendous amount of suffering, and for no reason.  With good screening, the infections can be found and easily treated, preserving fertility, stopping spread, and preventing ectopic pregnancies.
Screening is done by simply giving a urine sample, which goes to the lab.  Insurers are obligated to cover this service on any recent plan.

Gonorrhea– a very similar story to chlamydia.

HIV

This is of course the dread AIDS virus.  It is far, far less common than the very common chalmydia.  But it is devastating.  Left untreated, the immune system can be lethally destroyed and the virus can spread.  Treated, the infection can be lived with and contained.

The screen for HIV is by a swab of the mouth, the virus lives in saliva.

Our New Screening Process

At Advanced Pediatrics, we are embracing the new recommendations for STD screening for adolescents for all the reasons noted.

To that end here is our recommendation, as with any recommended medical process, parents of course can say no thanks:

1. Every adolescent will be asked to give a urine sample to test for chalmydia and GC at age 16.
2. Every adolescent will be asked to allow a swab of their mouth to be sent screen for HIV at age 16.
3. From age 15 up, every sexually active adolescent will be asked to give a urine sample to test for chalmydia and GC and a mouth swab to test for HIV annually.

We also see the benefit of our adolescents experiencing some sense that the fact that these germs are around is a very real fact, and to think carefully about taking steps to avoid infection.

BOTTOM LINES

1. Some STD’s are very, very common, like chlamydia and GC, they cause grievous harm without anyone knowing they have the infection, and spread easily.
2. Treatment for chlamydia and GC is simple and prevents terrible harms and further spread.
3. HIV, though rare, can be so devastating, and current treatments can save lives.
4. Therefore, Advanced Pediatrics is going to start recommending that all adolescents at age 16 be screened once for chlamydia, GC and HIV by simply giving a urine sample and allowing a mouth swab.  And that all adolescents sexually active do so yearly.

There really should be no difference between an infection that is STD and any other, if harm can be prevented, let’s do so.

To your health,
Dr. Arthur Lavin