STD and contraception in adolescents.

The prevalence of sexually transmitted diseases (STDs) in adolescents is poorly documented, as published studies consider single diseases or subgroups of adolescents. To obtain a broader view we examined STDs in unselected adolescent boys and girls at two contrasting genitourinary medicine (GUM) clinics, a large one at St Thomas's Hospital in inner London, which serves commuters and an inner city population, the other a smaller one at Swansea in south Wales, which serves a mixed urban and rural population. Contraception was also assessed in the girls. The STDs in adolescents were compared with the total diagnoses in patients of all ages attending the two GUM clinics, and with total diagnoses in all patients attending GUM clinics in England and Wales. The most striking finding was that all adolescents had at least one infection, whereas 18% of diagnoses in patients of all ages were of no infection. This contrasts with results of previous studies of selected groups, which suggested that the prevalence of STDs is similar in adults and adolescents. The percentages of infections, other than herpes at both clinics and trichomoniasis at Swansea, were higher in adolescents than in patients of all ages. High incidences of pelvic inflammatory disease in London and genital warts at Swansea suggest future problems. Only 66% of adolescent girls practised contraception, and only 8% stated that condoms were used. All people caring for adolescents should consider whether they are sexually active and, if they are, whether they need contraceptive advice or referral to a GUM clinic.