American schoolgirls and Asian prostitutes: what’s the difference?

One in four teenaged girls in the United States has a sexually transmitted infection, according to anew study from CDC.

Only half of those girls are sexually active. Among those who have ever had sex, STI rates are 40%. We don’t know how that compares with past rates in the United States, because this kind of study hasn’t been done before on adolescent girls in the US. That’s in part because the government expects them all to keep their legs crossed until marriage (something they are demonstrably not doing). But those rates on infection look pretty much the same as the STI rates we see among women who sell sex for a living in several countries in Asia and elsewhere.

Black girls in the States have even higher rates. The CDC abstract doesn’t tell us how sexual activity differs by race, or what STI rates are among sexually active black girls. But since it is 48% among all African-American teens (including those who have never had sex, compared with 20% among white and Hispanic girls) we can assume it is higher than we see in many groups of sex workers in Asia.

I consider STI rates of over 40% to be an appalling indictment of our prevention efforts among professional women who have sex with several different men every week. Now we’re seeing the same rates among teenagers in American households. What does that say about the success of the abstinence-only programmes pushed by the Bush administration?

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This post was published on 12/03/08 in Good sex and bad, Science, The sex trade.

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  1. Comment by Chris B, 17/03/08, 12:19:

    “But those rates on infection look pretty much the same as the STI rates we see among women who sell sex for a living in several countries in Asia and elsewhere.”

    Are you comparing like with like here? Most of the infections the CDC is counting are things are less serious infections like HPV. Is it possible that your figures for Asian prostitutes are of acute infections like HIV, syphilis and the like?

    Just wondering.

  2. Comment by elizabeth, 17/03/08, 01:36:

    You’re quite right about apples and oranges. By far the largest proportion of STIs in the CDC study was HPV, which we don’t test for among sex workers. Rates of the things that are tested for in both populations (chlamydia, trichomonas and occasionally HSV2) were far lower among schoolgirls than they typically are among sex workers. (US teen rates 4%, 3% and 2% respectively, against for example 25% chlamydia among Indonesian sex workers and between 3 and 8% in most sites in India, and 9% trich in Indonesia, with HSV2 rates in India mostly above 50%.) The CDC study did not test for gonorrhea, syphilis or HIV, which we do regularly test for among sex workers, and are also found at high rates.

    While we’re on the data, what we choose to test for varies for many reasons, not always related to the perceived “seriousness” of the infections. You imply that syphilis, which is curable, is more serious than HPV, which is not. I’d be interested in other people’s perspectives on that.

    Thank you for picking me up on this; I was putting rhetoric before data and am suitably ashamed of myself. Though I’m afraid it still doesn’t alter the central point, which is that the current approach to STI prevention among teenagers in the United States does not appear to be working very well, and that it is failing young black women in particular.

  3. Comment by Mike, 17/04/08, 03:40:

    Your data is ridiculous.
    Do you really think half (48%) of black teens in the US and 1 in every 4 teens in general has had an STD? I don’t know where it came from (If the CDC says this, they should check their facts), but I must say it seems a little far-fetched. Unless UTI’s and mononucleosis is erroneously included.

    Elizabeth responds: The data, published by CDC, are from a large national household survey. They don’t include HSV-1, but they do cover human papiloma vius, which accounts for the majority of infections.

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