STD study hits home with teen girls in Hampton Roads

A 17-year-old Norfolk girl said she and her friends were quick to tell one another when they lost their virginity.

At 16, she was one of the last in her circle to have sex.

They've been slower to share stories about sexually transmitted diseases.

She learned she had chlamydia - a pelvic infection that can cause infertility - after a test at Planned Parenthood of Southeastern Virginia last month.

"I was shocked. For some reason, I felt like it couldn't be me. This opened my eyes."

She is not surprised by a report released earlier this week by the Centers for Disease Control and Prevention that estimates one in four American teen girls has at least one of a group of common sexually transmitted diseases.

The problem is worrisome in the eastern region of Virginia - which includes Hampton Roads - because STD rates tend to be higher than average here. In 2006, the eastern region had the highest rates in the state for chlamydia, gonorrhea and syphilis.

Forty-one percent of the state's chlamydia cases that year were reported in the eastern region, even though the region makes up 24 percent of Virginia's population.

Rates of chlamydia infection are particularly high among girls in their teens and early 20s, said Elaine Martin, who directs community services in the Virginia Department of Health's disease prevention division.

She said the developing nature of young girls' cervixes increases their risk of contracting that disease once exposed.

State health statistics show that 2,620 girls ages 13 through 19 in the eastern region were diagnosed with chlamydia in 2007. That compares with 528 boys in the same age range.

The CDC study examined test results from 838 girls ages 14 through 19, selected at random from a national government health survey in 2003 and 2004. Four infections were tracked: human papillomavirus, or HPV, which can cause cervical cancer and affected 18 percent of girls studied; chlamydia, which affected 4 percent; trichomoniasis, 2.5 percent; and genital herpes, 2 percent.

The study also found that infection rates were higher among black girls, nearly half of whom had an STD, compared with 20 percent among white and Mexican American girls.

Martin said it's difficult to compare the CDC statistics to Virginia's figures because health care providers are not required to report HPV, herpes and trichomoniasis to the Health Department.

Because of that, state numbers of teen STDs will seem smaller than reality.

Another barrier to a true picture of sexually transmitted disease is that many people who contract STDs do not have symptoms. That means they can spread the disease without realizing it.

It's estimated that 70 to 80 percent of girls and women with chlamydia show no symptoms. Left untreated, it can cause infertility problems.

HPV is another disease that often doesn't have any symptoms. When the law goes into effect in October, Virginia will become the first state to require sixth-grade girls to receive HPV vaccines unless their parents opt out.

Kathleen Raney, a nurse midwife and lead clinician at Planned Parenthood of Southeastern Virginia, said the CDC statistics reflect what her agency sees.

In fact, she believes the local numbers could be higher. Raney said adolescents often turn to the agency because they're afraid or embarrassed to go to their family doctors.

Some of the teens she sees with STDs didn't realize they could be infected from oral or anal sex. Some thought birth control would protect them from everything. Some in same-sex relationships thought that since there was no danger of getting pregnant, there was nothing else to worry about.

"I've had young women who are diagnosed with herpes say, 'I have never had sex.' I ask them, 'Have you had heavy petting? Because herpes is a contact sport.' "

Teens also are afraid to tell their parents they are having sex, she said, but they don't have transportation or money to seek out reproductive care or screening on their own.

Some come to Planned Parenthood on the bus; others get rides from older sisters, aunts and friends.

And there's another factor behind high rates of sexually transmitted diseases: the teen brain.

"They think, 'It's not going to happen to me. I'm infallible. It won't happen until I'm 25.' But STDs do not care what age you are. Or what gender you are, or whether you're gay or not."

They also do not care if you've had sex only one time.

Dr. Joel Brenner, director of adolescent medicine at Children's Hospital of The King's Daughters, said teens often stop going to the doctor for checkups during their adolescent years.

Those who do get checkups are not generally screened for STDs unless they tell the doctor they're sexually active. Some teens aren't forthcoming with the information, and some family practice doctors and pediatricians might be reluctant to press the issue.

But "it's just as important as asking about safety issues, diet and everything else," Brenner said. "Just because you don't ask doesn't mean it isn't happening."

He said sports physicals would be an ideal opportunity for screening; it's not currently done in school-based exams.

Dr. Glenda Karp, a pediatrician with Tidewater Children's Associates for more than two decades, asks parents to leave the room when she examines teens, so she can talk frankly about sexual activity. Still, she imagines some teens skirt the truth, which is why she believes universal screening is the answer.

"If everyone were screened, we could find and treat the infections earlier."

Adults in the general public might have been surprised by the CDC's report of high infection rates among adolescents, but many teen girls were not.

On Thursday, a group of girls who gathered at a Portsmouth home said teen sexuality is all around them, and not just in the media.

The nine girls ranged from 10 to 17 years old and attend schools in Chesapeake, Portsmouth and Norfolk.

They talked about having pregnant classmates in middle school, and about friends who refer to diseases simply as "the burning." The girls regularly overhear hallway bragging about sexual exploits.

"You hear girls say, 'You did it with him? I did it with him, too,' " said 17-year-old Rayvin Cook of Portsmouth.

Fourteen-year-old Danielle Moore of Portsmouth said some people look down on girls who aren't sexually active. "They'll say, 'Oh, you're a virgin, I'm not going to mess with you.' "

The girls say that they've learned about sexually transmitted diseases in family life classes at school but that many teens ignore the risk or think it won't happen to them.

These girls come together twice a week to talk about sex education issues at the home of Saran Bell-Day.

The Portsmouth woman used to work as a health educator for a community services board and now has an organization called Youth Against Drugs and Disease.

Bell-Day, who was a teen mother herself, says she thinks it's important not only to educate young girls about the facts and risks of sex, but also to give them a place to talk about self-esteem, emotions, peer pressure and whatever else is on their minds.

She tries to drill home this advice:

"Love yourself. Respect yourself. Protect yourself."

The 17-year-old Norfolk girl who is being treated for chlamydia said she, too, learned about sexual diseases and how to protect herself in family life classes in her public school, but somehow, she didn't think it would happen to her.

"I knew the possible consequences of my actions, but I didn't pay attention. It's not like something you can see."

She's had three sexual partners during the past year but didn't use protection.

The boy she believes infected her was "someone I would never think would have anything."

A friend told her she should go to Planned Parenthood for screening to make sure she didn't have a disease. She put it off for a while because she was afraid.

Finally, she asked her sister-in-law to take her. "I thought, 'I got a tattoo, I can do this too.' "

She said she feels fortunate that she wasn't diagnosed with something more serious, like HIV. It served as a serious wake-up call for her.

Her advice for other girls:

"We need to apply what we know," she said. "Be careful, be safe, it can happen to you."

Elizabeth Simpson, (757) 446-2635, elizabeth.simpson@pilotonline.com