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Effort To Wipe Out Sexually Transmitted Diseases Targets Adolescents

Sexually transmitted diseases, which affect millions of adolescents, are the nation's hidden epidemics, and a national campaign is needed to wipe them out, a report by the Institute of Medicine says.

The panel of scientists and health experts who conducted the study recommends that school districts provide age-appropriate health services to young people, including education, access to condoms, and clinical services to help prevent, diagnose, and treat STDs.

Of the 10 most frequently reported diseases in the United States, five are sexually transmitted. One-fourth of the 12 million cases that are reported annually occur among adolescents, the report says.

Teenagers are at the greatest risk for STDs, it says, because they are more likely than adults to engage in high-risk sexual behaviors. By the 12th grade, nearly 70 percent of teenagers have had sex. And one-fourth of all students, according to data from a survey included in the report, said that they have engaged in sexual activity with more than four partners. The risk is exacerbated by the fact that young girls tend to be particularly susceptible to cervical infections and that teenagers often lack access to health care, says the report that the institute, an arm of the congressionally chartered National Academy of Sciences, released last month.

STDs, infectious organisms transmitted through sexual contact, include syphilis, gonorrhea, chlamydia, hepatitis B, and AIDS. If left untreated, they can cause infertility, cancer, miscarriages, liver failure, and even death.

"Even though all these STDs are preventable, the U.S. has the highest rate of curable STDs of any developed country," said William T. Butler, the chancellor of Baylor College of Medicine in Houston and a lead author of the study.

The success of STD-prevention programs depends on the ability to change public awareness and behavior patterns over time, especially among young people, the report says.It calls on the federal government to launch a campaign to promote healthy sexual behaviors and increase spending on prevention.

Learning To Avoid Steroids

Schools that draft coaches onto their drug-abuse-prevention teams can help steer athletes away from using steroids, a study published in the Nov. 20 issue of the Journal of the American Medical Association says.

Researchers at the federal government's National Institute on Drug Abuse studied 1,500 football players from 31 high schools in the Portland, Ore., area. Seven hundred of the athletes had participated in the ATLAS program created by Oregon Health Sciences University and financed through a NIDA grant; the other 800 football players did not participate.

The Adolescents Training and Learning to Avoid Steroids program consists of seven 50-minute classes led by coaches and student-athletes. The sessions focus on the medical and psychological effects of steroids, sports nutrition, and strength training as an alternative to steroid use. In the classes, students also act out strategies to learn how to respond to people who offer them the muscle-building drugs. They also have seven hourlong weight-room training sessions.

Compared with the athletes who were not enrolled, those in the ATLAS program were better informed about the drugs and less inclined than they had been previously to use steroids--synthetic derivatives of the male hormone, testosterone, which increases lean-muscle mass and stamina. Previous studies have shown that steroid use is associated with stunted growth, high blood pressure, and tumors among adolescents.

Fewer Children Born With HIV

The number of U.S. children born with HIV has dropped 27 percent in the past few years--from 905 cases in 1992 to 663 last year, according to a study published in the Nov. 22 issue of the Morbidity and Mortality Weekly Report.

Because the number of HIV-infected women who gave birth during that period was stable, researchers at the federal Centers for Disease Control and Prevention in Atlanta theorize that the sharp decline reflects the fact that more women are voluntarily testing their unborn children and using a new drug therapy that has been shown to prevent prenatal transmission of the virus that causes AIDS. In 1994, the federal government endorsed the use of zidovudine therapy, which has been shown to reduce the chances of transmission of HIV from mother to fetus by two-thirds.

The report found that the largest annual decline in children born with the virus was among non-Hispanic white infants, who registered a 39 percent reduction from 1992 to 1995. The number of children born with HIV dropped 26 percent among blacks and 25 percent among Hispanics during the same period, the study found.

Modifying the Air Bag

The National Highway Traffic Safety Administration has announced a plan to preserve the safety benefit of automobile air bags while minimizing the danger to children and small adults.

Last month's notice came weeks after new NHTSA figures showed that 28 children had been killed in crashes involving passenger-side air bags since 1993. ("Health Update," Nov. 6, 1996.)

In a statement last month, the agency said it plans to draft warning labels for car manufacturers to educate consumers about the possible perils. It also proposed that air bags in new cars be deflated slightly to reduce their force on impact and that cutoff switches be installed so drivers can disable the air bags when a child is in the passenger seat.

--JESSICA PORTNER jportner@epe.org

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