~~~~~~~Introduction~~~~~~~
Sexual promiscuity is becoming more and more prevalent in the United States. The general population is having more sex at a younger age. For example, did you know that 50% of females and 55% of males ages 15-19 are having sex? 16% of sexually active teens have had 4 or more sexual partners. 8% of all teens have engaged in sexual activity before age 13. (16% against their will). 13% of those engaging in sexual activity before age 16 have sexual partners who are over age 20.
Some factors that discourage sexual activity for teens are:
*A connection to parent and family, with parents who disapprove of teenage sexual activity and/or teenage contraception use.
*A connection to a school, where the student has a high daily attendance.
*A peer group who supports their decision to abstain from sex until marriage.
*A decision to abstain from drug or alcohol use.
~~~~~~~Sexually Transmitted Diseases~~~~~~~
There are over 25 different types of sexually transmitted diseases (STDs) and each year in the United States, nearly 4 million adolescents become infected with one or more STDs. Over 15 million sexually transmitted infections occur each year.
There are different types of STDs:
*Bacterial and Protozoal STDs: These types of STDs usuall respond to antibiotic therapy and are treatable if detected early, but damage may have already occurred.
*Viral STDs: These types of STDs are incurable, but preventable. It was estimated in 1996 that 66.3 million of the 265 million people in the United States were infected with a viral STD.
Generally,STDs affect females more severely than males. Women and infants suffer the greatest portion of STD-related complications and the incidence of STDs is greatest in women of reproductive age.
STDs can lead to pelvic inflammatory disease (PID), chronic pelvic pain, tubal pregnancy, tubal infertility, and genital cancers, as well as cause liver cancer, chronic liver disease, cirrhosis, acquired immunodeficiency syndrome (AIDS), and death.
STD infections during pregnancy can cause low birth weight, premature delivery, neonatal eye disease, congenital abnormalities and fetal death.
Perhaps the most serious fact regarding STDs is that they are often without symptoms and as a result, diagnosis and treatment is often delayed.
Human Papilloma Virus (HPV)
HPV is a viral STD that is the main cause of cervical cancer in women--90% of cervical cancer cases involve HPV.
HPV is more commonly known as "genital warts" because warts on the genital area can sometimes accompany this virus.
There are over 70 HPV viral types and 56 of those are potential cancer causing agents.
Some facts about HPV:
*90-95% of HPV infections have no symptoms
*PAP smears and close clinical observation are the most common screens for HPV; however, they are most often not visible, so they can go undetected even with yearly PAP smears
*HPV is highly contagious -- over 60% of individuals exposed will become infected. It is transmitted by skin-to-skin contact, therefore, condoms do not protect you from this virus.
* It is estimated that 5.5 million new HPV cases occur each year in the United States and that HPV now infects over 20 million people in the United States.
*There is no cure for HPV. Treatment is limited to reducing the size of visible warts and testing for cervical cancer.
Because of the way HPV behaves, it is impossible to say with any assurance when someone contracted the virus, or from whom.
Chlamydia
Chlamydia is the most common bacterial STD; there are an estimated 3 million new infections per year. 85% of individuals infected with Chlamydia do not know they have it.
Symptoms, if present, are:
*Vaginal discharge
*Fever
*Abdominal pain
Chlamydia is a leading cause of infertility, chronic pelvic pain and tubal pregnancy.
Gonorrhea
Gonorrhea is a bacterial STD that can be treated with antibiotic therapy; however, many strains of gonorrhea are developing a resistance to antibiotics.
Like Chlamydia many can have gonorrhea and not know it. Gonorrhea can lead to infertility, chronic pelvic pain, and tubal pregnancy.
Syphilis
Syphilis is a bacterial STD. If left untreated and/or undiagnosed, it can lead to:
*Brain, nervous system and cardiac problems
*Death
Herpes Simplex Virus (HSV/Genital Herpes)
This viral STD is widespread among Americans. An estimated one out of every four women and men will become infected with HSV during their lifetime.
40% of those with genital herpes have no symptoms and if symptoms are present, they are in the form of recurring painful ulcers.
Genital herpes has been associated with an increased risk of HIV infection.
Trichomonas
This protozoan STD is the most common curable STD. There are 3 million women infected annually. This STD can occur without symptoms or can be present if you have:
*Vaginal discharge
*Genital itching
*Painful urination
*Painful sexual intercourse
Trichomonas has been associated with an increased risk of HIV infection.
Human Immunodeficiency Virus (HIV)
In 1996, it was estimated that approximately 900,000 individuals in the United States were diagnosed as HIV positive. 1 out of every 300 individuals over the age of 13 is HIV positive.
Some facts about HIV:
*Persons that become HIV positive will usually develop AIDS. It is estimated that only 5 percent of those infected with HIV will live more than 10 years without developing AIDS
*There are an estimated 41,000 new HIV infections annually in the United States
*25% of HIV infections occur in women
*The greatest increase in HIV infections is in the heterosexual population
*HIV leads to AIDS and eventually death
*The size of the HIV virus is 500 times smaller than a single sperm
Who is not at Risk?
Individuals who have never been sexually involved (this is defined as having genital contact) with another individual.
How do I have sex and not get a disease?
Have sex with one partner who is not infected and remain faithful to that one partner for life.
Does the pill or any other hormone contraceptive prevent STDs?
No pill or hormone contraception protects against STDs. Some research indicates that there even may be an increased risk for contracting HIV and HPV if you use hormone contraception.
What about condoms in preventing STDs?
Latex condoms used "perfectly" (the instructions for using a condom are extensive), and assuming there are no defects in the condom, may reduce the risk of bacterial STDs; however, condoms do not reduce the risk of HPV or HSV. 2-10% of those who are using condoms "perfectly" will still potentially become infected with HIV if exposed.
If you use a condom:
*You will become pregnant 17% of the time if you do not use the condom "perfectly"
*You will become pregnant 5% of the time even if you use the condom "perfectly"
Remember--pregnancy can only occur about 2 to 3 days out of the month, whereas STDs can occur 24 hours a day, 7 days a week.
~~~~~~~Teen Pregnancy~~~~~~~
Abortion
*48% of all prenancies that occur in individuals less than 15 years of age end in abortion
*35% of all pregnancies that occur in individuals age 15-19 years of age end in abortion
Pregnancy
*12% of all births in the United States were to females age 15-19 years
*79% of all births age 15-19 are unmarried
Adoption
*Less than 10% of teens chose adoption
Characteristics of Teen Pregnancy
*No prenatal care
*Higher use of tobacco
*Low birth weight infants
*Teen mothers are less likely to receive a high-school diploma than women who postpone childbearing
*Teen mothers are more likely to live in poverty, receive welfare, and stay on welfare longer
*Teen fathers are more likely to finish fewer years of schooling, earn less income annually by the age of 27 years, and participate less in the work force than men who delay fathering until age 21 years
*Children of teen mothers are more likely to have health and learning disadvantages and to be neglected or abused. The daughters of teen mothers are more likely to become teen mothers themselves, and the sons of teen mothers are more likely to spend time in prison
Economic Cost of STDs and Pregnancy
The cost of treating the most common STDs is conservatively estimated at $17 billion annually.
Treating HPV is estimated at $3.8 billion with an additional $737 million in costs associated with HPV-related cervical cancer.
Eliminate teen pregnancy and the net gain to society is higher productivity, lower public assistance, and a savings of social service costs that would exceed $37 billion annually.
Emotional Cost of STDs and Pregnancy
The diagnosis of an STD evokes strong emotional reactions, including shame, embarrassment, anger at current or past sexual partner or partners, and/or fear of passing a STD to other partners.
Pregnancy and adoption are never easy choices. Their after-effects last a lifetime. Abortion is a surgical procedure which carries significant physical risks along with emotional side effects.
~~~~~~~Conclusion~~~~~~~
Women suffer greater physical trauma from STDs than men. An infant who has an infected mother is also at risk of contracting a disease during pregnancy and while breastfeeding.
STDs should not be taken lightly. While most are curable with antibiotics when detected, often the damage has been done. Some are not curable, but can be treated. At present, AIDS is the only STD 100% fatal to those infected.
What should I do?
If you have had sexual contact (oral, anal, vaginal, or hand): STOP.
Seek counsel from a parent or other responsible adult. There is hope and healing for you, but only if you choose to stop having sexual contact.
Anyone who is having or has had sexual intercourse should be tested. If you have symptoms of any STD listed here, or if you develop them, go see your private healthcare provider immediately. Symptoms can include ulcers or discharge in the mouth or nasal area (if you have participated in oral sex), painful urination, genital ulcers or sores, discharge from the penis or vagina, or any abnormalities anywhere you have had sexual contact with another person. Women who are experiencing abdominal pain with or without fever should also consider testing if they are sexually active.
Testing should include at least the following:
*PAP smear, and if positive, then HPV screening
*Cervical cultures for Gonorrhea and Chlamydia
*Culture of any ulcers or sores (Herpes and Syphilis)
*Vaginal swabs for Trichomonas and Bacterial Vaginosis
*Blood work for HIV, Hepatitis profile, and Syphilis
Even if by some miracle you escape physical harm from premarital or extramarital sex, there are heavy emotional consequences for sex outside of marriage (husband and wife for life). Choosing to be sexually active before marriage carries emotional damage. Many experience regret, guilt, depression, loss of self-respect, and/or loss of reputation. It is not uncommon, after unmarried sex, to be unable to trust others or to be able to commit to future relationships.
Sexually active teens become so absorbed in a sexual relationship that they neglect other aspects of their life. When sex becomes the focus of the relationship, personal development will suffer.
Sex creates an emotional bond. When the relationship breaks off, anger and resentment inevitably occur because that bond is broken. Every time you have sex, you give a part of yourself away that you can never get back.
Premarital sex may cause serious sexual problems after marriage. Unfulfilled expectations based on past relationships and flashbacks of previous relationships often interfere with a healthy marriage.
Sex can provide joy and pleasure, as well as deep hurt and pain. When protected by a safe environment -- one that is both physically and emotionally safe -- sex is at its best and most fulfilling. Time has shown that the only true safe place for sex is in a loving marriage.
Saving Sex for Marriage is Best
If you have never had sexual contact (any genital contact), do not start. The only "safe sex" physically and emotionally is saving sex for marriage (a lifetime commitment to a partner without an infection). Those who delay sex until marriage will experience freedom from unplanned pregnancy, STDs, premature marriage, side effects of condoms/contraceptives, guilt, doubt, disappointment, worry, and intensified feelings of rejection.
Additionally, those who delay sex until marriage will be free to focus their energy on establishing and accomplishing their personal goals, to enjoy being single, to develop a better understanding of friendship and to enjoy dating relationships. They will also benefit from having relationships that are faithful and honest, without the fear of sexual rejection or manipulation.
The question to ask yourself is this: Do you want your future wife or husband to have had prior sexual contact? The answer is always "no," so remember, when you are dating and are faced with the temptation to have sexual contact, you may be having sex with someone else's future husband or wife.
Abstaining from sex before marriage is always a positive decision that carries tremendous physical and emotional benefits.
~~~~~~~Websites~~~~~~~
www.pamstenzel.com
www.abstinence.net
www.medinstitute.org
www.youthdevelopment.org
~~~~~~~Bibliography~~~~~~~
Adolescent Pregnancy Facts 2000. ACOG: Washington, D.C.
Advances in Managing Genital Warts: OBG Management, June 2000
Sexual Health Today: The Medical Institute for Sexual Health 1999
Contraceptives and STDs: Alternative Approaches to Providing Dual Protection: Dialogues in Contraception; Winter 2000, Vol.6, Number 3
Sex and Character: Cole and Duran
Sex is a Choice: edited by Amanda Williams
Pam Stenzel is one of the world's foremost speakers on sexual abstinence and character issues. She powerfully tackles today's tough issues of sex with candor, insight and humor, while challenging young people to embrace the benefits of abstinence. Pam is the former Directer of the Alpha Women's Center and is the Founder of Enlighten Communications, Inc.
Keith Williams MD, FACOG is a Board Certified Obstetrician and Gynecologist. He is a graduate of The University of Tennessee College of Medicine, and has been in private practice with The Jackson Clinic PA in Jackson, TN for the past 17 years.
Enlighten Communications, Inc. wishes to express a special thanks to Dr. Keith Williams for his time, knowledge and experience that made this educational brochure possible.
