Sexually transmitted diseases in adolescents: what's new?

Sexually transmitted diseases (STDs) are an important cause of morbidity and, potentially, mortality for adolescents in the United States. Each year, 2.5 million teenagers in this country will contract an STD. An understanding of recent advances in risk factors, epidemiology, diagnosis, and treatment of these important infections is vital for clinicians providing care for adolescents.

To identify topics for review, a MEDLINE search for the years 1993 to 1997 was conducted, using the general term sexually transmitted diseases. Separate searches were performed for individual infections, including chlamydia, gonorrhea, herpes simplex virus (HSV), human papillomavirus (HPV), human immunodeficiency virus (HIV), and Trichomonas vaginalis. Relevant publications addressing risk factors for STD acquisition, as well as the epidemiology, diagnosis, and treatment of these infections were reviewed.

Information derived from the search that was considered relevant and important for the care of adolescents is presented. Risk factors for STD acquisition, including sexual activity, condom use, and substance use are discussed. Recent information about the epidemiology of bacterial (eg, chlamydia, gonorrhea), viral (eg, HSV, HPV, HIV), and protozoal (T vaginalis) infections is presented. Novel diagnostic techniques and advances in treatment of specific infections are reviewed.

Sexually transmitted diseases represent a significant health problem for adolescents in the United States. Recent advances in the area of diagnosis likely will lead to enhanced recognition of infected individuals, particularly those who lack symptoms. In addition, new drugs and novel approaches to therapy have simplified treatment and may lead to enhanced compliance.