Razor burn, moles and other STDs

Adolescents today face unprecedented challenges. Although I gratefully enjoy the innocence of my young boys, who are just now entering the public-school system, my work makes me painfully aware of the challenges our teens must confront. My time on staff at the Buncombe County Health Center’s STD and family-planning clinics, as well as my current work in urgent care, have shown me that many of our teens aren’t adequately prepared to make good choices that will protect both their emotional and physical health long term.

How many times have I examined a high-school girl with “razor burn” that turned out to be an outbreak of herpes? How many times have I explained to an anxious young man that the new “moles” he had were actually genital warts? And every time, without exception, I face a bewildered teen who’s shocked and horrified that he or she could have contracted a sexually transmitted disease.

The statistics are startling. According to the Centers for Disease Control and Prevention’s 2007 Youth Risk Behavior Surveillance System survey, almost 50 percent of American teens are sexually active in high school, and 9 percent of North Carolina teens say they had sex for the first time before age 13. In other words, roughly one out of every 10 kids in this state is having sex before they’re even in high school.

The challenges these kids face are real, concrete and immediate. As a result, talking about STDs is no longer the sole domain of lascivious people with sketchy pasts who visit dens of iniquity. Having nonmedical professionals teach a class or two using vague terms is no longer enough.

Our adolescents are experiencing an epidemic of STDs—both viral and bacterial—that can have lifelong impacts, including chronic pelvic pain and infertility. When one in three girls will contract HPV (the virus responsible for cervical cancer and genital warts) with their sexual debut and one in five sexually active people are currently infected with herpes, the odds are clearly against these young people.

And then there are the other struggles our teens face: Eating disorders, unintended pregnancy, unprecedented rates of obesity and inactivity, dating violence and abusive relationships have all become distressingly familiar. In the 2007 survey, one in 10 teen respondents reported having been hit, slapped or intentionally physically hurt by a boyfriend or girlfriend. And 20 percent of 10th-grade females admitted to having fasted for 24 hours or taken diet pills to lose weight. Ask your teens if they know someone facing one of these problems and they may or may not share the truth. But being in the trenches, I can tell you firsthand: These kids are dealing with some pretty tough stuff.

I applaud all the churches and synagogues that have active youth groups; same goes for team sports, scouts and other extracurricular activities aimed at youth. But the truth is, the kids who go to church and attend private schools wind up in my office too. So what can we do to help teens navigate these fearsome obstacles?

First off, we need to give them a solid, objective foundation, using an evidence-based, hard-facts approach that includes openly discussing taboo subjects and unpopular problems. Arming our teens with knowledge will empower them to make good choices. At the very least, it will enable them to recognize and begin to correct mistakes they may already have made.

As a family doctor in this community, I have taken a personal interest in helping educate local teens. And next month, together with several community partners, we are staging an event that will give teen girls and their moms an opportunity to hear the latest on such critical topics as STDs, unintended pregnancy, dating violence, healthy eating, exercise and stress relief. “Living the Healthy Life: Playin’ it Safe for Teen Girls and their Moms” will include a health fair, breakfast and lunch, plus many giveaways, as well as displays by community partners (see box, “Straight Talk”). Led by female family doctors and ob-gyns from the community, we have created an amazing lineup to facilitate some of these difficult conversations and take the next step in empowering our teens—and their moms—with essential knowledge.

My hope is that this will be the first in a series of community-supported conversations that engage our teens and answer their questions in nonjudgmental fashion. If you are the parent, teacher or neighbor of an 8th- to 10th-grade girl, I hope you’ll encourage them to attend an event that’s guaranteed to be fun, informative—and a definite step in the right direction. And if you have a special interest or could contribute to our event, I welcome your comments and suggestions!

[Dr. Shannon Dowler is a family physician in Asheville with a special interest in adolescent and public health. She can be reached at shdowler@gmail.com.]