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POSTED: Thursday, October 10, 2013, 5:30 AM
Filed Under: Child Abuse | Rima Himelstein | Sex

Recently, I became the doctor of a 17-year-old girl who had been raped.  She told me that right after the rape, she was scared and told her mother.  Her mother immediately took her to the ER.  Following medical guidelines, the ER doctor gave her emergency contraception and treated her empirically for sexually transmitted infections (STIs). My patient told the ER doctor what had happened and even told him that she knew the person. But she refused to tell anyone, including her mother and the police, his name. Like most teenagers who have been victims of sexual assault, my patient chose not to disclose the name of the perpetrator. 

Is it really rare? No. Sexual assault, which is a crime of violence and aggression, includes sexual behaviors ranging from unwanted touching to dating violence to rape.  Sexual assault includes situations in which the victim cannot consent because of intoxication, inability to understand the consequences, or misperceptions because of age or level of cognitive development. Sexual assault is not really rare at all; in fact, it’s all too common. 

The most recent and rigorous studies have found that approximately 27.5% of college women — more than one in four — reported experiences that met the legal criteria for rape. Researchers also found that among female rape victims surveyed, more than half (54%) were under age 18; 32.4% were 12–17; and 21.6% were under age 12 at time of victimization. Studies have also indicated that alcohol is often involved.

POSTED: Tuesday, September 24, 2013, 5:30 AM
Filed Under: Janet Rosenzweig | Sex | Tips

Today's guest blogger is Janet Rosenzweig, MS, PhD, MPA, the national consultant for child sexual abuse prevention for Prevent Child Abuse America and the author of The Sex-Wise Parent. For more information, read her blog , follow @JanetRosenzweig on Twitter or contact to schedule a program for your school or community group.

No matter how much discipline we try to exert over our bodies, in some ways they're just going to do what they're going to do. We breathe, we have reflexes, when we're scared our bodies make ready to fight or flee.  And anyone who has ever diapered a boy baby has probably seen a tiny erection, a reflexive physical reaction.

It is absurd to think that a baby's genital feelings are sexual -- babies have no concept of sexuality and just naturally respond to anything that feels good. Human bodies are wired to react to many types of stimulation without conscious decision -- like getting goose bumps, or blinking. These types of bodily responses, including physical arousal of the genitalia, are called autonomic responses. They are governed by the autonomic nervous system and not conscious choice.

POSTED: Thursday, August 29, 2013, 5:30 AM
Filed Under: Janet Rosenzweig | Sex

Today's guest blogger is Janet Rosenzweig, MS, PhD, MPA, a national consultant for child sexual abuse prevention for Prevent Child Abuse America and the author of The Sex-Wise Parent. For more information, read her blog or contact to schedule a program for your school or community group.

Most of us pay no attention to the weather unless something extraordinary happens — a horrible storm, or a gloriously sunny day in the middle of winter. Likewise, most people pay no attention to the sexual climate in the places they spend their time each day until something doesn’t feel right. Maybe the jokes are just a little bit too risqué, displays of affection are too intense, or questionable photos are hanging over a colleague’s desk; something just feels creepy. A lot of adults relate this concept to their workplace, but few of us recognize that it also applies to our kids’ schools.

Kids spend most of their waking hours in school, and schools each have their own climate or “social feel".  A school’s “culture” would be its policies, procedures, rules and regulations, while school “climate” refers to how it actually feels to be in a school. This is a difficult concept for people who have spent time in few schools, but the differences can be vast. Researchers use variations in school climate to predict outcomes like academic achievement, rates of bullying, and sexual health and safety.

POSTED: Wednesday, May 15, 2013, 6:00 AM
Filed Under: Growing Pains | Rima Himelstein | Sex

Most of my teenage patients have one hand attached to their cell phones during their medical visits. Sometimes they’re answering their parents’ texts about what time they will be done, and sometimes they’re texting their partners to tell them they have chlamydia.

Given that texting has entered exam rooms in my office, I was not surprised to read the results from the 2011 Pew Internet & American Life Project. Pew surveyed 799 U.S. teens 12 to 17 years of age and their parents; they carried out focus groups with 57 teens. Here is what they found:

  • 75 percent text and 63 percent say they text every day.
  • Texting is trending up: the median number of texts rose from 50 per day in 2009 to 60 per day in 2011.
  • Older girls text the most, with a median of 100 texts a day—more than 3,000 texts a month!—compared with 50 texts per day for boys their age.

And then there are hyper-texters. One in 5 teens are “hyper-texters,” texting more than 120 times a day.  Hyper-texters are more likely to have sex, engage in binge drinking, use illegal drugs or be in a physical fight than teens who text less. 

POSTED: Thursday, March 7, 2013, 6:00 AM

Adolescents have sex, whether parents want to face it or not. Teens need to know that one serious consequence of having sex is acquiring sexually transmitted diseases. To make matters worse, some STDs aren’t easily treatable anymore.

Condoms help prevent STDs, but they are often not used (especially for oral sex) and therefore, these diseases can be easily spread. Fifty years ago, plain penicillin and sulfa would treat syphilis, gonorrhea and chlamydia, but mutating germs and the overuse of antibiotics have increasing diminished the effectiveness of these drugs.

The CDC recently announced the increasing presence of multidrug resistant gonorrhea in the United States. There are over 300,000 cases per year in the US. Some of the highest reported rates of infection are among sexually active teenagers in the US. Up to 12 percent of sexually active high school males have gonorrhea or chlamydia, and about 16 percent of sexually active females have either STD.

POSTED: Monday, December 17, 2012, 1:03 PM

By Rima Himelstein

One of my patients drove home from college to see me because she was “just not feeling well.” About a month earlier she had a sore throat, which got better, and then came back again. And she needed to sleep a lot− 16 hours a day and she was still exhausted! When I examined her, I found her to have swollen glands behind her neck. Her “Monospot,” a test used to diagnose infectious mononucleosis, was positive.

Infectious mononucleosis, unaffectionately known as “mono,” is a contagious illness that causes sore throat and other symptoms. A person of almost any age can get mono but it is more common and often more severe in high-school and college-age people. About 85% of mono is caused by the Epstein-Barr virus (EBV) and the other 15% by other viruses such as cytomegalovirus (CMV). 

POSTED: Tuesday, October 23, 2012, 4:59 PM
Does your teen know the risks of trich? Trich itself is not a life-threatening illness, and it is easy to treat. But it shows that someone is having unprotected sex and is taking big risks.

by Rima Himelstein, M.D.

Heard about “trich”? Trichomoniasis is one of the most common sexually transmitted diseases (STDs). It is caused by Trichomonas vaginalis, a type of tiny parasite. When I find the infection in my patients, I often show them the trich under the microscope. Seeing the infection can be the key to getting teens to change their risky behaviors -- sometimes being spooked changes teens’ behaviors.

It’s a creepy infection, which is easily spread. Trich is passed from one person to another through unprotected sexual contact. Both females and males can get this infection.   And because the organism can survive for about one and a half hours on a wet sponge, transmission can possibly occur through shared washcloths, communal bathing, or during routine child care.

POSTED: Tuesday, October 16, 2012, 2:04 PM
Filed Under: Sex | Vaccines and Medications
The researchers note that teen sexual activity carries a high risk for HPV infection -- an argument in favor of saying yes to the vaccine. One in three sexually-active 14- to 19-year-olds is infected with at least one HPV strain and 12% carry one of the four strains most likely to cause cervical cancer if a girl’s immune system doesn’t wipe it out. A good reason to say yes to this vaccine. And to the opportunity for a frank talk about sex. (AP Photo)

Even the most pro-vaccine parent-- like me -- stops and wonders when the pediatrician asks about the HPV vaccine for a preteen or barely teen-aged daughter. The vaccine’s benefits are clear and compelling; it’s proven to cut risk for a lingering infection with human papilloma virus strains most likely to cause cervical cancer. But in explaining the vaccine to your child, even if you use it as another chance to talk about values and expectations and physical and emotional health, are you still crossing a line -- and subtly saying “OK, the truth is I know you’re going to be sexually active sooner rather than later and it’s OK by me”?

Now, a new study from the Kaiser Permanent Center for Health Research-Southeast says girls who receive the HPV vaccine aren’t more sexually active -- at least in the first three years after their shots. Researchers tracked 1,398 girls for 3 years starting at age 11 or 12; 493 had received the HPV vaccine and 905 did not. They didn’t directly ask the girls about sexually activity. Instead, they looked at how many in each group came back to their doctor’s office within three years with a medical need that was a sign of sexual activity -- like a request for birth control, for a pregnancy test or for a check for a sexually-transmitted disease like chlamydia.

The result: The researchers conclude that the HPV vaccine wasn’t a “license for early sex.” Nearly equal numbers of girls in each group came in with health needs related to sex. The numbers aren’t exactly equal, however. The girls in the HPV vaccine group were slightly more likely to ask about birth control, chlamydia checks or pregnancy testing. But their chances for actually having chlamydia or being pregnant were nearly equal to those of the non-vaccinated girls -- in fact, they were a tiny, tiny bit lower. The researchers say the differences in numbers are so small that they’re insignificant -- and show that HPV-vaccinated girls are no more likely to be sexually active early.  “In our analysis,HPV vaccination at ages 11 through12 did not increase the likelihood ofseeking medical attention for outcomesrelated to sexual activity with upto 3 years of follow-up,” they soberly state.

About this blog
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
Stephen Aronoff, M.D., M.B.A. Temple University Hospital
Christopher C. Chang, M.D., Ph.D Nemours/Alfred I. duPont Hospital for Children, Jefferson Medical Colg
Mario Cruz, M.D St. Christopher’s Hospital for Children, Drexel University College of Medicine
Katherine K. Dahlsgaard, Ph.D. Lead Psychologist - The Anxiety Behaviors Clinic, CHOP
Gary A. Emmett, M.D. Director of Hospital Pediatrics at TJU Hospital & Pediatrics Professor at Thomas Jefferson Univ.
Lauren Falini Bariatric exercise physiologist, Nemours/Alfred I. duPont Hospital for Children
Hazel Guinto-Ocampo, M.D. Nemours duPont Pediatrics/Bryn Mawr Hospital
Rima Himelstein, M.D. Crozer-Keystone Health System
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, RD Children's Hospital of Philadelphia
W. Douglas Tynan, Ph.D. Nemours/Alfred I. duPont Hospital for Children, Jefferson Medical Colg
Flaura Koplin Winston, MD, PhD Scientific Director of the Children’s Hospital of Philadelphia’s Center for Injury Research and Prevention
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