STDs: Screening, therapy, and long-term implications for the adolescent patient.

Teenagers are at higher risk for sexually transmitted diseases (STDs) than any other age group, for a variety of reasons. The risk for exposure to STDs among adolescents is determined by sociodemographic, environmental, psychosocial, behavioral and biologic factors. These factors are complex, interrelated, and often poorly understood by health professionals caring for adolescents. Infections of young adults have their most serious consequences later in life. There is a need for youth to change their behaviors now to avoid future sequelae. These sequelae include PID, tubal infertility, ectopic pregnancy, genital neoplasia, AIDS, and neurologic complications. Educational and prevention strategies are essential for decreasing the high incidence of STDs in adolescents. Not all STDs are readily cured by antibiotics, and because many adolescents are asymptomatic, many STDs initially go undetected and untreated. There is a need for innovative psychosocial and behavioral prevention programs to be developed and implemented to reach all adolescents. Such programs should provide immediate, sustained, and cost-effective care that will effect a positive change in adolescents' knowledge, attitudes, and perceptions, and prevent or modify behaviors that place them at risk. Prevention efforts need to address the entire spectrum of STD care, including behavioral, clinical, educational, and promotional activities. Use of role playing, peer-led rehearsal of simulated risky situations, didactics, and skills building are important, as is a theoretical approach (Social Learning Theory, the Health Belief Model, Value Expectancy Theory, and principles of behavior change counseling).