Study shows girls unaware of STIs

Over half of America’s teenagers have sex before college. According to a recent study, however, many sexually active adolescent females do not know the basics of sexually transmitted infections (STIs) until the dangers become real.

In a paper published in the Journal of Adolescent Health, researchers from Carnegie Mellon and the Children’s Hospital of Pittsburgh wrote that sexually active girls aged from 14 to 18 years who have previously contracted STIs knew more about them than girls who had not.

Over a period of six months, the researchers gave four tests on basic STI facts, covering eight different infections. The results showed that, aside from HIV/AIDS, the sample of 300 Pittsburgh girls knew relatively little about the STIs if they did not have previous experience with them.

This indicates that girls going into a sexual situation may be completely unaware of the risks they take, leading to potentially ruinous consequences.

Some STIs cause increased cancer susceptibility or infertility, and the study found that many do not even know basic facts about infections other than HIV/AIDS.

“Most people who have an STI don’t realize that they have it,” said Julie Downs, the lead author of the study and a research faculty member of the Department of Social and Decision Sciences. “They don’t realize that if their condition is not treated, they can give it to their partners.”

In addition to not knowing about STI symptoms, almost none of the 300 girls had gone to a doctor for gynecological tests.

Downs and Pamela Murray, chief of the Division of Adolescent Medicine at the Children’s Hospital of Pittsburgh and co-author of the study, agree that many social prejudices prevent girls from openly discussing topics about sex with friends and family.

Downs added that this inhibits girls from receiving free tests and information from local clinics.
“In other countries, there are fewer stigmas about sexuality and sexual behaviors. Discussions are public,” Murray said. “Here there is a lot of privacy and modesty.”

Aside from encouraging a look at societal stigmas, the study also raises issues about sexual education. The girls in the study knew a good amount about HIV/AIDS but not about the other STIs.

“A lot of girls ... are not worried about other diseases because they think, ‘Oh, it’s not HIV,’ ” Downs said.

Wändi Bruine de Bruin, a research faculty member of the Department of Social and Decision Sciences and co-author of the study, pointed out that in Pittsburgh, teenage girls are statistically more likely to contract an STI other than HIV/AIDS. In fact, no girl who had HIV/AIDS participated in the study.
“Schools place more emphasis on HIV education because it is more of a threat and [the education] is in more demand,” Bruine de Bruin said.

At Schenley High School in Oakland, students must meet the Pennsylvania requirement of two health courses, each totaling one semester. Health instructors Judy Vida and James Trent teach co-ed courses of about 150 students every semester.

Both instructors noted their curricula emphasize every condition and preventive measure their students will need. Their classes stress abstinence over other preventive measures and show explicit pictures of the infections.

Trent said that he has two lesson units of equal length for STIs — one deals exclusively with HIV/AIDS and the other covers all the rest of the STIs.

“I think we do an excellent job. I don’t think one of these kids can go out not knowing about all of the [STIs],” Vida said.

“People choose to do scare tactics,” Murray said regarding explicit pictures of STI symptoms. “I’m not sure what [the students] learn from that.”

According to Bruine de Bruin, many schools favor abstinence-only education.

“The problem is that lot of these curricula do not include other ways to prevent negative outcomes,” said Downs, questioning the traditional exclusive primacy of abstinence as a preventive measure embraced by such schools as Schenley.

“Wanting kids to be abstinent is one thing,” Downs said. “Getting them to be abstinent [requires] telling them about other things.”

Bruine de Bruin emphasized the need for more behavioral training in sexual education because research supports learning through role-playing.

However, she finds room for concern in the many curricula that have not been altered to reflect new research.

At Schenley High, Trent noted their health program has not changed much in the 23 years that he has taught at the school.

The Carnegie Mellon study also tested the efficacy of virtual negotiation situations where girls choose possible actions in situations through a DVD simulation. According to Bruine de Bruin, these simulations helped girls make better decisions in dealing with men and with peer pressure.

“Girls think that others are having more sex than they really are and that it’s okay,” said Amanda Cooper, a Carnegie Mellon physician and assistant professor of medicine at the Shadyside Medical Center. “However, studies show that [these estimates] are wrong.”

“We work really hard to educate our patients,” said Carnegie Mellon health educator Kristine Cecchetti.
“College is a time that girls explore their sexuality and they open themselves up to problems.”

Health Services offers STI testing for all students.