PEOPLE AND SEXUALLY TRANSMITTED DISEASES
ABOUT YOUNG PEOPLE
are more than 1.5 billion young people (between the ages
of 10 and 24) in the world today; 85% of them live in
developing countries. Between 1970 and 2025, the urban
adolescent (between the ages of 10 and 19) population in
developing countries will grow by 600%.
least developed countries, only 13% of the girls and 22%
of the boys enroll for secondary education.
5 out of every 10 unemployed are young people; in some
developing countries it is 8 out of 10.
million adolescents between the ages of 10 and 14 are
vast majority, sexual relations begin in adolescence.
sexual relations increase risks of unwanted pregnancy
and early childbirth, as well as unsafe abortion and
sexually transmitted diseases (STD) including HIV/AIDS.
knowledge and access to contraceptives as well as
vulnerability to sexual abuse puts adolescents at
highest risk of unwanted pregnancy.
developing countries, maternal mortality in girls under
18 is two to five times higher than in women from 18 to
more than 10% of all births are to women 15 to 19 years
abortions are estimated between 1 and 4.4 million per
year, most of which are unsafe because they are
performed illegally and under hazardous circumstances by
year more than one out of 20 adolescents contracts a
curable STD, not including viral infections.
PEOPLE AND HIV/AIDS
evidence that new HIV infections in the younger age
groups continue to rise as the overall proportion of
people living with HIV/AIDS falls.
more than half of all new HIV infections are among the
15 - 24 age group.
parts of the world, the majority of new infections are
in young people between the ages of 15 and 24, sometimes
younger. In one study in Zambia, over 12% of the 15 and
16 year-olds seen at antenatal clinics were already
infected with HIV.
appear to be especially vulnerable to infection.
Although statistics from Uganda show that, in some
areas, infection rates among teenage girls have dropped
50% from 1990, incidence rates are still six times
higher than in boys of the same age.
Africa, the proportion of pregnant 15 to 19 year-olds
infected with HIV rose to 13% in 1996 from around half
that level just two years ago. In Botswana, the
infection rate stood at 28% for the same group in 1997.
people may know of the risks of unprotected sex but feel
AIDS could not possibly happen to them. In Malawi, most
young men and women know how AIDS is transmitted and how
it can be prevented. However, many feel invulnerable to
the virus. Some 90% of teenage boys said they were at no
risk or at minimal risk of infection, even though nearly
half of them reported at least one casual sex partner
over the last year, and condom use was low.
GREATER RISKS OF STD INFECTION
is a normal part of adolescent development which also
exposes them to health risks. Young people=s sexual
relations are often unplanned, sporadic and, sometimes,
the result of pressure or force.
relations typically occur before adolescents have gained
experience and skills in self-protection, before they
have acquired adequate information about STDs, and
before they can get access to health services and
supplies (such as condoms).
girls are especially vulnerable for physiological,
social and economic reasons.
infection during adolescence is more likely to result in
pelvic inflammatory disease and as a consequence, lead
to infection such as chlamydia during adolescence is
more likely to result in cancer of the cervix.
and embarrassment associated with STD can impair
psychological development and attitudes towards
sexuality later in life.
diagnosis of STD infection is more problematic during
adolescence: the STD may be asymptomatic, especially in
young women; even if adolescents know about existing
services, they are often reluctant to seek help for
diagnosis and treatment.
often have difficulty complying with treatment because
it may be lengthy (such as in the case of chlamydia),
painful (venereal warts) and sometimes they need to
conceal medication so that the STD is not revealed to
estimated 333 million new STDs that occur in the world
every year, at least 111 million occur in young people
under 25 years of age.
transmitted diseases (STDs) are among the most common
causes of illness in the world and have far-reaching
health, social and economic consequences. In addition to
their sheer magnitude, STDs are a major public health
problem for two additional reasons:serious
complications, and the fact they facilitate transmission
described in the 16th century. In industrialized
countries, syphilis apparently declined during the
latter half of the 19th century. In these same
countries, however, there was a sharp rise in incidence
after the First World War, but following the Second
World War the incidence again fell rapidly, coinciding
with the availability of improved diagnostic tests and
antibiotics. In some developed countries (France, USA),
syphilis began to rise again in the 1960s and has been
increasing steadily in some industrialized and
developing countries since then.
is the classic example of an STD which can be
successfully controlled by public health measures: a
simple to use and highly sensitive diagnostic test is
available, as is a highly effective antibiotic to which
resistance has not developed. If untreated, however,
syphilis may lead to nerve damage, arterial wall damage,
and mental disorientation, and eventually to death.
generally observed that the incidence of syphilis, as
reported by the number of cases treated each year, is
highest among the 15 to 30 years-old group and among
people with the greatest sexual activity, and that
incidence decreases with age. Based on reports of new
cases of syphilis treated in Chile in 1993, for example,
the highest incidence was among the 20-24 age group,
followed by the 25-29 age group. The 15 to 24 years-old
group represented 40% of all cases.
it was estimated that there were approximately 12
million new cases of syphilis among adults worldwide,
with the greatest number of cases occurring in South and
South-East Asia, followed by sub-Saharan Africa.
is a common adult disease, though a significant
proportion of those with infection (up to 80% among
women and 10% among men) are asymptomatic, that is, they
do not have symptoms and therefore they are neither
aware of the need for treatment nor of the risk of
transmitting the disease to others.
men usually have symptoms and seek treatment
spontaneously. Women frequently have only minor symptoms
or are asymptomatic, so detection of infection depends
mainly on screening by culture which is costly and
requires relatively sophisticated facilities. Few
countries operate regular screening programmes and
therefore gonorrhoea reporting seldom reflects true
levels of infection.
it was estimated that there were approximately 62
million new cases of gonorrhoea among adults worldwide,
with the greatest number found in South and South-East
Asia, followed by sub-Saharan Africa.
untreated, the disease could lead to blindness and
research in Western and Central Africa revealed an
infertility belt. Up to 45% of women over the age of 45
years have been unable to conceive in that area, due in
large part to STD-induced infertility among young women.
like gonorrhoea, is a common adult disease which has
asymptomatic rates in women similar to those for
gonorrhoea, but higher rates of asymptomatic infection
for men. Like gonorrhoea, chlamydia can lead to pelvic
inflammatory disease and infertility. Diagnosis of
chlamydia infection is costly and it is not generally
available in laboratories in developing countries. Even
in industrialized countries, laboratory testing is not
universally available. Since many infections are neither
detected nor treated, prevalence rates are high.
estimated in 1995 that 89 million new adult chlamydia
infections occurred in the world with the greatest
numbers in South and South-East Asia, followed by
developed laboratory tests have, however, made screening
programmes for chlamydia infection possible in some
industrialized countries. Rates of infection among women
attending family planning clinics from 1989 to 1993 in
the United States of America, for example, have been
shown to vary from 4.5% to 8.5%.
is one of
the most common STDs. It causes symptoms in
approximately 50% of infected women. In men, infection
is usually of short duration but men easily transmit the
parasite responsible for the disease to their partners.
in Malawi and in former Zaire have shown association of
the disease with HIV seroconversion in women. These
findings, along with high prevalence of the disease
worldwide, call for greater attention to this medical
condition, for which diagnosis is simple and treatment
rates among African women attending antenatal clinics
range from 12% in Kenya to 47% in Botswana.
170 million new cases of trichomoniasis were estimated
to occur in the world in 1995.
estimates of chancroid were made using the
methodology developed for other STDs. Poor understanding
of the epidemiology and natural history of the disease
and the absence of a good test make it difficult to
estimate prevalence and duration of infection.
genital ulcers produced by chancroid are a major risk
factor for HIV transmission, and the incidence of
chancroid varies greatly between countries and regions.
For example, in Swaziland and Kenya, 44% and 62%
respectively of genital ulcers were diagnosed as
chancroid in STD clinics in 1980. In western Algeria ,
chancroid is the most common STD observed and the
primary cause of genital ulcer disease. In India, in
1989, chancroid represented 26% of all reported STDs. In
most industrialized countries chancroid has become a