Will cutting back on teen Pap tests result in more STDs?

Teen girls can skip Pap tests, according to new guidelines that say women should start cervical cancer screening at age 21. But some experts are concerned that rates of sexually transmitted diseases or unplanned pregnancies could increase without the Pap test to prompt a doctor’s visit.

As it stands, as many as one in four U.S. teenage girls has had an STD at some point in her life, often soon after she becomes sexually active, according to research published this week in Pediatrics.

“I am concerned that without the recommendation for young women to get Pap smears early on, they will lose important opportunities to seek advice and to learn about their health — particularly their sexual health — at a time in their lives when they need it most,” says Kimberly Spector, an adolescent-health educator in Los Angeles, California. “Regardless of the tests performed during a gynecologist visit, the conversation regarding sexual health risks and preventative measures can be very informative and empowering for young patients.”

In the past, women were told to start Pap tests, which can detect abnormal cells in the cervix, three years after becoming sexually active or at age 21 — whichever came first. However, these abnormal cells often go away on their own, particularly in young women. If they don’t, such cells grow so slowly that catching them at age 21 is still early enough to remove them before they become cancerous. And catching them sooner could lead to unnecessary tests and treatments that sometimes damage the cervix, increasing the risk for a premature birth later in life.

The new guidelines still recommend that girls who are under 21 see a gynecologist; they just don’t need Pap tests, according to the American College of Obstetricians and Gynecologists. The fear, however, is that some teens may misinterpret the new rules and miss out on important discussions about contraception and protection against STDs such as gonorrhea, bacterial vaginosis, chlamydia, and human papillomavirus.

“If women hear that they no longer need Pap tests annually or until they are 21, perhaps they wouldn’t seek any preventive health care, and whether this results in decreased screening and identification of chlamydia and other STDs remains to be determined, but it is concerning,” says Harold Wiesenfeld, M.D., the director of the division of reproductive infectious diseases at the University of Pittsburgh School of Medicine, in Pennsylvania.

Many STDs, including chlamydia and gonorrhea, have no symptoms. “Unless screened, young women will remain undiagnosed, untreated, and at risk for complications, including pelvic inflammatory disease, which results in infertility,” says Wiesenfeld, who is also an associate investigator at Magee-Womens Research Institute, in Pittsburgh. “[Still] the Pap test is not the 100 percent trigger to do chlamydia screening,” he says. “We need to do a better job about STD screening overall.”

Teens who are sexually active should use contraception and take steps (such as using condoms) to prevent STDs, even if they don’t need Pap tests, says Alina Salganicoff, Ph.D., the vice president and director of women’s health policy for the Henry J. Kaiser Family Foundation, an advocacy group based in Menlo Park, California.

“We are going to have to pay special attention to how we educate our adolescent patients about contraception and STD prevention,” she says.

However, most experts agree that Pap tests are indeed unnecessary for younger women and that the new guidelines will not put them at risk. Most also agree that the new guidelines are not an effort to limit care.

“I do not fear the consequences because these guidelines are well thought out and give us a great opportunity to focus on who is at risk for cervical cancer,” says Bobbie Gostout, M.D., the chair of the department of obstetrics and gynecology at the Mayo Clinic, in Rochester, Minnesota.

“Cervical cancer screening is very important, but we are getting smarter at screening,” she says. “We are backing off from screening those that have less to gain from it.” The cervical guidelines, which recommend that sexually active teens still be counseled and tested for STDs (although a pelvic exam might not be necessary), “hit it right,” she says.

Teens who have received human papillomavirus vaccines, such as Gardasil, are protected against several HPV strains that are linked to many, but not all, cervical cancers and to genital warts. These types of vaccines may eventually reduce cervical cancer rates even further (rates have been dropping since the 1970s), although experts say the impact won’t be seen for 10 to 15 years. Therefore, girls and women given the HPV shot need to have Pap tests starting at age 21 and every two years after that, just like those who haven’t had the shot.

The Centers for Disease Control and Prevention has added Gardasil to its routine childhood vaccine schedule. It recommends that Gardasil, which is administered in three doses, be given to all girls ages 11 and 12, and even for girls as young as 9, with catch-up doses for girls and women ages 13 to 26 who haven’t been vaccinated.

“We know that the HPV types targeted by the new vaccine are linked to cervical cancers that tend to occur five years earlier than cervical cancers caused by other HPV types,” Gostout says. “So once adolescents are well vaccinated against HPV, we should have even more confidence in eliminating Pap tests in younger women.”

“We are now rolling out the vaccine, and clearly the first group that will experience broader protection is young women,” agrees the Kaiser Family Foundation’s Salganicoff. “The HPV vaccine is a really important step that young women can take in terms of protecting themselves against HPV and subsequent cervical cancer.”

Ideally, teens should have an HPV shot and see a gynecologist for counseling about STDs before they become sexually active, experts say. HPV vaccines don’t protect women who have already been infected with the virus.

“Ideally, women need to establish a relationship with a reproductive health provider before they become sexually active,” Wiesenfeld says.

Source: CNN

Tiger Mistress Want STD Test

SEXY socialite and Tiger Woods mistress Rachel Uchitel plans to be screened for sexually transmitted diseases, it was claimed last night.

Curvy Rachel told pals she would undergo tests after a string of girls — including TWO porn stars — said they had also slept with the superstar golfer.

It is understood New Yorker Rachel wants to see doctors after claims Tiger had unprotected sex, said US website TMZ.

The reports said: “Rachel Uchitel has flipped out after learning how many women now claim to have had unprotected sex with Tiger and she is telling friends she will get screened for sexually transmitted diseases.”

It is also claimed Tiger had promised Rachel he would DITCH wife Elin for her.

He apparently bombarded her with emails before the car crash that led to his exposure as a love cheat, a magazine said.

One allegedly declares it “kills” him they are apart. He adds: “I want you to lay next to me, lay on me or where ever you want to lay.”

Referring to his wife in another he says: “It guts me to think I’ve fallen for the wrong one.”

Rachel, 34, – who insisted yesterday “I am not a whore” – has signed a magazine deal.

She said: “People have called me a homewrecker, gold-digger, tramp, whore. I make mistakes, but I’m not those things.”

Meanwhile 300 sexy phone texts and voicemails between Woods and cocktail waitress Jaimee Grubbs also surfaced.

In one he promises to “wear” out the 24-year-old, who claims they had a 31-month affair.

In another he asks her to take a “dirty” photo of herself and send it. When she tells him she is busy at work he begs: “Go to the bathroom and take it.”

Source: TheSun

CDC: STD Rates Up in Boys, Teens Need Better Sex Education

U.S. teens are getting sex education, but most are not learning about birth control from their parents, new government data showed on Thursday.

And rates of infection with sexually transmitted diseases reflect this — the annual rate of AIDS diagnoses for boys aged 15 to 19 years has nearly doubled in the past 10 years, and rates of syphilis are also up.

The numbers show that U.S. youth need better sex education, the U.S. Centers for Disease Control and Prevention said.

The new administration of President Barack Obama has been dropping some of the more controversial policies of the former Bush government, including an emphasis on abstinence-only education.

“The data presented in this report indicate that many young persons in the United States engage in sexual risk behavior and experience negative reproductive health outcomes,” the CDC wrote in its weekly report on death and disease.

For its report, the CDC compiled data from many different studies of hundreds of thousands of children and young adults aged 10 to 25. Some of the findings:

* Among 18 and 19-year-olds, 49.8 percent of girls and just 35 percent of boys had talked with a parent about methods of birth control.

* More than 80 percent of boys and girls said they had received formal instruction before age 18 on how to say no to sex.

* Nearly 70 percent of teen girls and 66 percent of boys had received instruction on methods of birth control.

* Thirty percent of girls aged 15 to 17 reported they had engaged in sex; this rose to 70.6 of girls aged 18 to 19.

* For boys, 31.6 of those aged 15 to 17 had ever had sex; 64.7 percent of those aged 18 to 19.

* Nearly 10 percent of young women aged 18 to 24 said their first intercourse was involuntary.

* Infections with the human immune deficiency virus that causes AIDS rose among boys aged 15 to 19 from 1.3 cases per 100,000 in 1997 to 2.5 cases in 2006.

* Syphilis rates for females aged 15 to 19 rose from 1.5 cases per 100,000 in 2004 to 2.2 cases per 100,000 in 2006 after having plunged between 1997 and 2005.

Source: Fox News

Risks: 5 Pathogens Linked to Risk for Stroke

Hepatitis C rate high in trucker study

A New Mexico survey of long-haul truckers showed high rates of hepatitis C, but many infected were unaware they had it.

The state health department’s research is the first nationwide effort to examine infection rates and high risk behaviors among truckers.

The researchers examined sexually transmitted infections, HIV and hepatitis B and hepatitis C virus prevalence and risk behaviors among 652 truck drivers at 11 New Mexico truck stops. While 8.5 percent of truckers tested positive for hepatitis C, only one trucker tested positive for HIV, one for gonorrhea and one for syphilis.

Eleven percent of drivers had injected drugs at least once, which researchers believe is what most likely accounted for the high rate of hepatitis C.

Dr. Steve Jenison, medical director for New Mexico’s health department’s Infectious Diseases Bureau, conducted the research from 2004-2006.

“We know from other international studies that long-haul truck drivers in some countries have high rates of sexually transmitted diseases including HIV, but we wanted to learn if that was true in the United States,” Jenison said. “We also learned from the study that some of the truck drivers who were hepatitis C positive also engaged in risky behavior such as binge drinking, which puts them at higher risk for complications if they have hepatitis C,”

Drivers should consider hepatitis C testing and seek medical help if they have the disease, especially if they ever injected drugs or received blood transfusions prior to 1992.

“Despite the low measured prevalence of sexually transmitted infections in the study, many drivers reported sexual behaviors that would place them at risk for acquiring these infections, including HIV,” he said. “Truck drivers who have contact with casual partners or commercial sex workers while on the road should follow safer sex practices including consistent condom use.”

The American Journal of Public Health published the study Sept. 17. The study was done in collaboration with the U.S. Centers for Disease Control and Prevention through a cooperative agreement with the Association for Prevention Teaching and Research.