Talking to Your Pediatrician About STD Testing

Pediatricians routine screen sexually active teens for STIs, including chlamydia and HIV.
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That your child may have a sexually transmitted disease (STD) likely isn't the first thing that your pediatrician thinks about when your child, even if he or she is a teenager, comes in for a visit.

According to the CDC, "Despite the prevalence of STDs among adolescents, providers frequently fail to inquire about sexual behavior, assess risk for STDs, provide counseling on risk reduction, and screen for asymptomatic infection during clinical encounters."

Unfortunately, that is often a mistake.

STD Statistics

STDs are common among teens and young adults. In fact, sexually active teens and young adults between the ages of 15 and 24 account for nearly half of all new STDs (about 19 million infections) each year.

In 2006, for older teens (15 to 19 years old), there were:

  • 293,392 cases of chlamydia in girls
  • 58,820 cases of chlamydia in boys
  • 66,405 cases of gonorrhea in girls
  • 30,119 cases of gonorrhea in boys
  • 233 cases of syphilis in girls
  • 332 cases of syphilis in boys

Altogether, it is estimated that 1 in 4 teen girls has a sexually transmitted disease. In addition to chlamydia (about 4 percent of teen girls), gonorrhea, and syphilis, these STDs include human papillomavirus (HPV - about 18 percent of teen girls), herpes simplex virus, and trichomoniasis.

STD Testing

In addition to testing teens with STD symptoms, such as sores, discharge, ulcers, pain with urination, etc., experts recommend:

  • Annual chlamydia screening for sexually active women
  • HIV screening for all teens (beginning at age 13) at least once, unless there is a very low rate of HIV in their patients, and then annually if they have high-risk behaviors or again when your pediatrician thinks it is necessary

So why don't more pediatricians test teens for STDs?

Most likely because they think it involves doing a pelvic exam and using swabs, which many pediatricians don't have much experience with.

Pediatricians don't always discuss sex with their teen patients.

These may also be reasons that teens don't bring up the fact that they may have an STD and need to be tested.

There is a quick an easy test for chlamydia and gonorrhea that can be done without a pelvic exam and without swabs. It simply involves the teen urinating in a cup and the pediatrician's office sending the urine sample to a lab to test for these STDs. This nucleic acid amplification test (NAAT) can also be done on an endocervical swab if a pelvic exam is done on women or an intraurethral swab on a man.

Testing for syphilis is usually from a swab from a sore or a blood test. Testing for other STDs, including HIV and hepatitis B, is from blood tests.

Talking to your Doctor About Testing

Does your pediatrician talk to your teen about STDs, teen pregnancy, birth control, abstinence, or any other topics that many parents, doctors, and teens sometimes find difficult?

If you are not sure, you might call before your teen's next visit and find out, especially if you know or suspect that your child is sexually active. That will help ensure that your pediatrician knows to screen to your teen for STDs.

Giving your pediatrician some time alone with your teen to ask questions in private might also help to make it more likely that they discover if your teen is sexually active and needs STD testing.

Although many pediatricians continue to see older teens, especially if they are still in school, some aren't in a ready mindset to think about teen pregnancy or STDs or simply aren't equipped to handle these issues. Others have an active teen practice, do pelvic exams, and are ready to handle all teen issues.

If your pediatrician doesn't screen teens for STDs and your child is sexually active, then it might be time to switch to one that does. Seeing a pediatrician that specializes in adolescents or a family doctor might also be good ideas. Sexually active girls should also see a gynecologist, keeping in mind that the American College of Obstetricians and Gynecologists recommends that all girls have their first visit to the gynecologist when they are between 13 and 15 years old.

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Article Sources
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  • CDC. Sexually Transmitted Diseases Treatment Guidelines 2006
  • CDC. STD Surveillance 2006. Special Focus Profiles. Adolescents and Young Adults.
  • MMWR. Screening Tests To Detect Chlamydia trachomatis and Neisseria gonorrhoeae Infections - 2002. October 18, 2002 / 51(RR15), 1-27
  • Revised Recommendations for HIV Testing of Adults, Adolescents, and Pregnant Women in Health-Care Settings - MMWR September 22, 2006