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As a young father, even though I was a doctor, I can remember the awkward feeling I experienced, particularly with my daughter, when I initiated “the sex talk” as my three children entered puberty. I’m sure I was not alone in this reaction; many parents who read this will say, “Yeah, me too.” But that talk is a critically important part of good parenting, perhaps even more important today because of a rise in sexually transmitted diseases (STDs) in the U.S.
A recent report from the Centers for Disease Control and Prevention (CDC) notes that the combined cases of gonorrhea, chlamydia and syphilis have risen in the United States for the fifth consecutive year. A total 2.4 million STD infections were diagnosed and reported in the U.S. last year, the most ever since monitoring began, and tend to be highest among adolescents and young adults. The CDC estimates that one in four sexually active adolescent girls has an STD and that young people 15 to 24 years old acquire half of all new STD cases. The World Health Organization provides an even more alarming statistic, stating that one million STDs are diagnosed every day.
It is likely that these numbers are an underestimation since many STD infections go undiagnosed and unreported. The implications are critical because STDs can result in congenital syphilis, which can cause infant death when the mother infects the fetus through the placenta. Cases of congenital syphilis have more than doubled since 2013, with 1,306 cases reported to the CDC, and contributing to 94 infant deaths. Other outcomes of STDs include infertility and drug-resistant gonorrhea, a growing threat worldwide, along with increased health care costs and decreased quality of life.
Chlamydia infection is the most common STD, with about 1.8 million cases reported to the CDC last year, the greatest numbers occurring in Alaska and Washington, D.C. The second most common STD is gonorrhea, with over half a million reported cases, most commonly found in Mississippi and Washington, D.C. More than 100,000 cases of syphilis were reported, most common in Nevada and, again, Washington, D.C.
The reasons for this increase in STDs are likely multifactorial, including increased diagnosis and reporting because of more easily available testing services for screening; decreased use of condoms; and reduced funding for sex education, clinics and prevention.
There is some good news, however. The reported chancroid cases, herpes simplex virus infections, and human papillomavirus or HPV-related complications such as genital warts have decreased, perhaps due in part to availability of an HPV vaccine. In fact, developing a vaccine to prevent infections with syphilis, gonorrhea, and chlamydia would be a real medical breakthrough.
What can you do? Petitioning the U.S. government to allocate increased funding for sex education, clinics, screening, and prevention programs is one approach to this alarming STD epidemic. However, prevention can and should begin in the home with parents talking to their children about the basics of sex education and sexual relationships, being attentive to their needs, and listening to their issues.
Awkward or not, “the sex talk” must be a critical part of their early education. Be honest and direct, and invite a continuing discussion, not just a one-time talk. Sometimes it may be easier if both parents discuss this together. Topics such as “How will I know when I’m ready for sex,” “What if my boyfriend or girlfriend wants to have sex and I don’t,” “How do I handle peer pressure to have sex,” and “How do I protect against pregnancy and STDs,” are just some of the important subjects parents need to discuss. Multiple articles by experts from such places as the Mayo Clinic and the CDC are available to help guide parents through this challenging interaction.
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