In a fog of moral panic and hand wringing, a recent Centers for Disease Control study was released to answer the age-old question: Is our children screwing? The answer, apparently shocking, was yes. Perhaps. Well, it depends.
The general gist of the report is that over one quarter of teenage girls are infected with “a common sexually transmitted disease.” On the surface of it, this is a worrying statistic. It becomes even more so when, broken down by race, one finds that nearly half of African-American teenage girls have some form of STD. That would indicate a lot of unsafe sex and, even worse, a reversal of the trends that were seen in the late 1990s of increased condom use.
But the surface is deceiving. Of those 3.2 million girls with STDs, the clear majority of cases were Human papillomavirus – cases of which were over four times as prevalent as the next most prevalent STD. This is significant because Human papillomavirus – HPV – is not, strictly speaking, a sexually-transmitted disease. In fact, it can be transmitted by any form of skin-to-skin contact – or even by contact with a common surface such as a shared article of clothing. According to the CDC, 50% of sexually active adults will contract HPV in their lifetimes and most will never know it: 90% of HPV infections are cleared up naturally by the body. A smaller number of people may develop certain forms of cancer, the most common of which is cervical cancer; this can be prevented by a vaccine given at the age of 12.
Again, the study states that 18% of teenage girls have HPV, which is not strictly an STD. This accounts for 2.2 million of the 3.2 million girls infected in the CDC study. That would leave about 480,000 teens with Chlamydia, and about 224,000 each with Trichomoniasis and Herpes simplex virus. By my (admittedly quick) math, this means that perhaps 9% of teenage girls are, in fact, carrying “true” STDs. A too-high, number, perhaps, but certainly not anywhere near as shocking a number as one in four.
All else being equal, then, the disparity between African-American teens and White/Mexican-American teens (White and Mexican-American girls had the same infection rates in the study) would still remain, but instead of 48% of AA teens infected with STDs, it’s more like 16%. And instead of 20% of W/MA teens with STDs, it’s more like 7%. Again, too high, one might argue, but not an epidemic.
If those are a lot of numbers to throw out, it’s to make the point that the CDC stats are artificially inflated through misrepresentation of how the virus is transmitted. Human papillomavirus is often cited by social conservatives to lend credence to the argument that condoms don’t work. The reason? HPV, as we discussed, is not transmitted sexually, but rather through any skin-to-skin contact. Condoms, then, would as a matter of course be unsuccessful in preventing the spread of the virus unless one made a suit of condom-armor out of them. What is successful in preventing the most harmful aspect of HPV – cervical cancer – is an immunization given to girls around age 12. However, many states, most notably Texas, have passed laws to avoid making this immunization “opt-out” (like the MMR vaccine) rather than “opt-in”.
But does the story represent sensationalism or simply a case of mistaken STD? It has gotten much less traction than similar stories that earn the “shocking” headline, possibly as it is being overshadowed by recent events in the Presidential election. Furthermore, it is unclear what the study reveals about the ever-popular topic of teenage sexuality, if it reveals anything at all. What is apparent is that the 9% number is much, much less than the one-quarter stated in the study. And that makes for a much, much less (ahem) sexy headline.
What this study portends for policy is equally ambivalent and equally as subject to sensationalism and shifting definitions. On the one hand, the sheer number of HPV infections – STD or not – leads to the conclusion that the anti-cancer vaccine for girls is probably more necessary now than ever; accordingly, a considerable number of states either have passed, attempted to pass, or are currently adopting vaccination programs. On the other hand, there aren’t enough data to determine what these rates mean relative to widespread adoption of abstinence-only sex education policies in the last decade (specifically following the passage of Title V in 1996). Indeed, the US has always had relatively higher teenage STD rates when compared to other developed countries with similar levels of teenage sexual activity.
So it needs to be said again: while an examination of the headlines might lead to hand wringing, the study itself contains very little useful information. Certainly nothing that could reliably guide policy one way or the other. And certainly nothing shocking.