The past several years have brought positive changes in teen sexual practices. Teen pregnancy rates are at an all-time low and fewer teens are sexually active than in the recent past. One increasingly serious issue, however, is the rise in STD rates. Those teens who are sexually active are more likely to contract an STD and are unlikely to get tested and receive treatment.
Why is there such a gap between, for example, teen pregnancy and STD rates? A combination of abstinence-only sex education, which is proven to be ineffective, and limited access to testing facilities have increased the likelihood of infection. Additionally, teens are engaging in a wider array of sexual behaviors and may not use protection during those activities.
In order to reduce STD rates and improve teen health, providers need to find alternative ways to reach young patients, improve education, and reduce costs so that care is accessible. For many young people, traditional pediatric care and clinics just aren’t working.
Transforming “The Talk”
For many teens, the bulk of their sex education comes from a cursory parental talk and troves of misinformation from their peers. That’s why physicians need to be trained to spot opportunities for honest and informative sex ed that addresses their present concerns.
Annual exams and sports physicals are an ideal time to ask questions about sexual activity, but there’s no guarantee that teens will answer you honestly. One way to increase the chances they’ll communicate is by making sure parents have left the room and asking open-ended questions. Be prepared for hypotheticals, questions posed as stories about friends as opposed to personal scenarios. The key is to be armed with facts and statistics to counter all of the false information teens get from their peers.
Finally, when it comes to primary care, doctors should consider offering teens the option of speaking with other providers within the practice. While continuity of care is a great thing, many teens see their pediatricians as proxies for their parents; they’ve been treated by them their whole lives. Seeing a different provider can help them open up about their experiences and concerns.
Another way to encourage teens to seek STD testing is by communicating with them about appropriate testing timelines. For example, Milwaukee recently experienced a cluster of HIV and syphilis infections and even teens who are aware that they require STD testing may not understand the testing windows for different infections. According to the Health Testing Centers, individuals who have had unprotected sex should be tested 2-3 weeks after the encounter and then again after three months. HIV, in particular, can take up to 3 months to appear on tests, but teens tend to take one “all clear” as the final verdict.
When discussing testing timelines with young patients, it’s important to set up accessible follow-up appointments. Teens are not known for their follow-through; if they need to go to an inaccessible doctors office or need a parent to pay for an appointment, they’re even less likely to get additional tests.
To bridge the gap between affordable, accessible STD care and current options, healthcare providers need to tune in to what teens themselves are saying. And one common request is for the widespread use of mobile health units. When young people have access to mobile health units at school or other community events and don’t have to miss class or contact a parent to receive sexual health care, they’re more likely to get regularly tested and receive follow-up care. With mobile health units, teens are empowered to make their own healthcare decisions.
Not only are mobile health care units easier for teens to access than traditional office visits, most recognize that these community care services are more affordable than traditional office visits. Teens frequently express that cost is one of the primary barriers to STD testing. Many don’t have jobs and if they don’t want to discuss their sexual behaviors with parents, then they similarly can’t ask for the money for testing. It’s a significant barrier, but hospitals are incentivized to provide these services because it reduces long-term care costs.
Teen STD rates have been on the rise for several years running and if we want to reverse course, doctors need to take action now. It’s time to listen to patient feedback and meet teens where they are. That could be outside their schools or community centers, at sporting events or town fairs. When STD testing is affordable and easy to access, teens are more than happy to undergo testing. They’ve been proactive about pregnancy. Give them the tools to take on STDs as well.