Thursday, November 26, 2015

Teens' sexual health: 8 common myths

At least half of teens are having sex by the time they graduate high school, and their behavior is sometimes based on myths, which puts them at a high risk for sexually transmitted infections (STIs) and pregnancy. Here are eight myths that you should talk to your teen about.

Teens’ sexual health: 8 common myths


Can we talk?  While most of us agree it would be best for our teenagers to wait until they are older to have sex, at least half are having sex by the time they graduate high school.  And what’s more troubling is that their behavior is sometimes based on myths, which puts them at a high risk for sexually transmitted infections (STIs) and pregnancy.  Here are eight of the myths that I hear most often from my teenage patients and how I respond:

1. Myth: STIs and pregnancy won’t happen to me.

My response: You are normal to believe “it won’t happen to me” because it is a normal part of adolescence (the “personal fable”) to feel that way.  But STIs and pregnancy can happen to you.

2. Myth: I know I don’t have an STI.  I was tested and my partner was tested.

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My response: That’s great that you both got tested, and you should continue to get tested at least once a year. But there are certain common STIs that we don’t routinely test for in teenagers, like human papilloma virus (HPV) and herpes.

3. Myth: I feel fine – I know I don’t have an STI.

My response: Most people with STIs (and who spread STIs) don’t know they have an infection because they don’t have any symptoms.  Teens have high rates of STIs and, again, most are without symptoms. Estimates suggest that young people aged 15–24 years acquire nearly half of all new STIs. For some STIs, such as Chlamydia, adolescent females are especially at risk. 

4. Myth: I don’t need contraception because I had PID before.

My response: Untreated STIs in a female can spread to PID (pelvic inflammatory disease), a serious infection of the uterus, fallopian tubes and ovaries. One of the complications of PID is infertility. The percentage of women who experience infertility due to PID is proportional to the number of episodes of PID that they have experienced. So even if you have had PID before, most likely you can still get pregnant.

5. Myth: If the condom breaks, I just put another one on.

My response: Pre-ejaculation fluid contains sperm so this is not a reliable method of contraception.

6. Myth: I won’t get pregnant; I use condoms ... sometimes.

My response: It only takes one time to result in a pregnancy. Of the 22 million 15- to 19-year-olds in the United States, three million did not use a condom the last time they had sex.

7. Myth: I use two condoms at one time for extra protection.

My response: I like that you want to be as careful as possible, but in this case, two is not better than one. This can actually increase the friction between the condoms and make them more likely to tear. Other condom errors can occur as well.  A recent review of 50 articles from 14 countries looked at the frequency of various condom use errors and problems including:

  • Timing issues: late application of condoms after intercourse began or early removal of condom followed by unprotected intercourse
  • Technical issues: not leaving space at the tip, not squeezing air from the tip before use, putting the condom on inside out and having to flip it over, not using water-based lubricant and incorrect withdrawal
  • Condom problems: breakage, slippage, leakage and problems with fit

8. Myth:  I won’t get a girl pregnant because I pull out.

My response: Pulling out or “coitus interruptus” is not a reliable method of birth control because pre-ejaculation fluid contains sperm. Also, pulling out does not provide protection from STIs.

Here’s an interesting link between texting and safer sex. A recent study looked at texting and sexual behavior among 176 sexually active high school students to find out about their use of technology to communicate with partners about condoms, birth control, STIs, HIV/AIDS, pregnancy, and sexual limits. Rates of consistent condom use were three times higher among youth using technology to discuss condoms and birth control. 

My advice: 

  • Teens: go ahead and text (just not while driving!) if it helps keep you safe.
  • Teachers, doctors, and, yes, even parents, need to participate in correcting sexual health myths.
  • Try directing teens to an educational website to learn about correct condom use.
  • Female teens may like to visit this website for more information on young women's sexual health.
  • Male teens may like to visit this website for more information on young men’s sexual health.
  • For teenagers, the use of dual methods — combining a hormonal method of birth control  and condoms — is a more effective approach to preventing pregnancy and STIs than the use of one method alone.

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Adolescent Medicine Specialist at Crozer-Keystone Health System
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The Healthy Kids blog is your window into the latest news, research and advice around children's health. Learn more about our growing list of contributors here.

If you have questions about your child's health, ask them here.

Anna Nguyen Healthy Kids blog Editor
Sarah Levin Allen, Ph.D., CBIS Assistant Professor of Psychology at Philadelphia College of Osteopathic Medicine
Stephen Aronoff, M.D., M.B.A. Chair of the Department of Pediatrics at Temple University Hospital
Peter Bidey, D.O. Medical Director of Family Medicine at Philadelphia College of Osteopathic Medicine
Christopher C. Chang, MD, PhD, MBA, FAAAAI, FACAAI Associate Professor of Medicine in division of Rheumatology, Allergy and Clinical Immunology at UC Davis
Katherine K. Dahlsgaard, Ph.D. Lead Psychologist of The Anxiety Behaviors Clinic at Children's Hospital of Philadelphia
Gary A. Emmett, M.D., F.A.A.P Director of Hospital Pediatrics at TJU Hospital & Pediatrics Professor at Thomas Jefferson Univ.
Magee DeFelice, M.D. Chief of Allergy and Immunology at Nemours/Alfred I. duPont Hospital for Children
Hazel Guinto-Ocampo, M.D. Chief of Pediatric Emergency Services at Nemours duPont Pediatrics/Bryn Mawr Hospital
Rima Himelstein, M.D. Adolescent Medicine Specialist at Crozer-Keystone Health System
Jessica Kendorski, PhD, NCSP, BCBA-D Associate Professor in School Psychology/Applied Behavior Analysis at Philadelphia College of Osteopathic Medicine
Anita Kulick President & CEO, Educating Communities for Parenting
Janet Rosenzweig, MS, PhD, MPA VP for Programs & Research for Prevent Child Abuse America
Beth Wallace Smith, R.D. Registered Dietitian at Children's Hospital of Philadelphia
Emiliano Tatar, M.D. Pediatrician at Einstein Healthcare Network Roxborough Plaza
Jeanette Trella, Pharm.D Managing Director at The Poison Control Center at CHOP
W. Douglas Tynan, Ph.D., ABPP Director of Integrated Health Care for American Psychological Association
Flaura Koplin Winston, M.D., Ph.D. Scientific Director of the Children’s Hospital of Philadelphia’s Center for Injury Research and Prevention
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