Sexually Transmitted Diseases

Dear Lisa,

In teaching my teenage son about sexually transmitted diseases and the wisdom in abstinence, he thinks the answer to everything is just wear a condom. I tried to explain to him that condoms are not always full proof. I want to give him the correct information. What are the chances of getting a sexually transmitted disease when wearing a condom? Do condoms protect you from all sexually transmitted diseases?

“Are condoms full proof?”

Dear “Are condoms full proof”,

It is important to teach our teenagers about Sexually Transmitted Diseases (STDs) because many of them become sexually active during middle and late adolescence. Boys and girls ages 15 to 19 years old have extraordinarily high rates of sexually transmitted diseases. (1) For example, more than 2.8 million cases of Chlamydia occur annually in the United States, mainly among 15-24 year olds. (2) In the United States, 6% of all 12 -19 year olds carry the Herpes Simplex Virus antibodies that indicate either active or latent infection. (3)

The good thing about your son’s response is that he understands the importance of condom use. The use of male condoms can help prevent STDs, particularly HIV, Chlamydia, Gonorrhea, and Trichomoniasis because they are transmitted by fluids on mucosal surfaces. The bad thing is that your son doesn’t understand that certain STD’s are transmitted by skin to skin contact, such as Herpes simplex virus, Human Papillomavirus, genital warts and Syphilis. These diseases are less effectively prevented by male condoms. (4)

Many teenagers (as well as adults) think that if they wear a condom that they are 100% protected. Unfortunately this is not the case. For skin to skin infections, such as Herpes, the transmission can still occur if a male is wearing a condom. Condoms do not cover the thighs, the scrotum, perineal area or the base of the penile shaft. These areas come into contact with the female’s labia majora or thighs and the herpes virus can be transmitted between those areas. (5) The interesting thing about Herpes in particular is that viral shedding, or spread of the disease can occur in the absence of any lesions. A recent study utilizing daily analysis of skin swabs revealed that a newly infected person can shed Herpes Simplex 2 Virus up to 40% of the time regardless of the presence of active lesions. (5)

A dilemma occurs when a teenager realizes that condoms do not protect them from all STD’s. Some may feel that they shouldn’t wear a condom at all since they don’t work. This is where education comes into play. Although condoms may not be 100% full proof, they will help prevent the transmission of some STDs. Since STDs typically occur together, there is a greater chance that a partner with Herpes for example also has HIV or Chlamydia. Therefore it would be important to protect yourself from the other STDs even if you don’t think the condom will protect you from Herpes.

Sexual activity is risky business. Besides the concern about STDs, teenagers involved with sexual activity put themselves at risk for an unwanted pregnancy as well as the responsibility and the strong emotional aspects of such a relationship. Therefore your initial advice supporting abstinence is a very wise decision.

References:
(1) Fortenberry, J. Sexually Transmitted Infections. Pediatric Annals. 2005;34(10):803-810.
(2) Weinstock, H., Berman, S., Cates, W. Sexually Transmitted diseases among American youth: incidence and prevalence estimates, 2000. Perspect Sex Reprod Health. 2004;36: 6-10.
(3) Fleming D., McQuillan, G. , Johnson, R. Herpes Simplex Virus type 2 in the United States l976 to l994. N Engl J Med. L997;337:1105-1111.
(4) Davidson, M. Sexually Transmitted Infections. Clinician Reviews. 2004;14(6):56-60.
(5) Reitman, D. Update on Sexually Transmitted Diseases: Herpes Simplex Virus Type 2 Infections. Consultant for Pediatricians. 2006; April:238-243.


Lisa Kelly R.N., P.N.P., C.
Certified Pediatric Nurse Practitioner

Advice For Teenagers