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Every Seventh Student

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If you are a junior high or high school teacher, the health of your students is under attack from a deadly combination of ignorance and illness. One in seven of your students will contract a sexually transmitted disease by the time he or she is 20. Most of these infected adolescents will contract one or more of the relatively common STD's. But AIDS, the newest such disease, is also spreading with frightening speed among teenagers.

Most of your students know little about these diseases, and almost half say they have no one--peer or adult--they can turn to for advice and help. Teachers and schools must do much, much more to combat the ignorance and isolation that help spread STD's. In order to protect the physical and emotional health of our young people, the silence about these diseases must end.

Grim statistics show that the spread of STD's among teenagers is epidemic. Each year, two and a half million teenagers contract one or more of the relatively common STD's: chlamydia, gonorrhea, genital herpes, syphilis, hepatitis, or genital warts. This high incidence of STD's is also an ominous warning sign for what could become an AIDS epidemic among teenagers. The Centers for Disease Control reports a 43 percent increase between July 1988 and July 1989 in the number of teenagers with AIDS. Although only 447 teenagers were actually diagnosed with AIDS as of the end of November 1989, many more are believed to be infected with HIV, the AIDS-causing virus. According to Karen Hein, director of the adolescent AIDS program at Montefiore Medical Center in New York, the rapid spread of the AIDS virus among heterosexuals that some health experts predicted is now occurring among teens in the United States.

There are two reasons why teachers should be especially concerned. Most fundamentally, healthy students learn better. A student who is afflicted with an STD or is preoccupied with notifying a sexual partner about an infection cannot possibly apply himself or herself in the classroom. Moreover, although many people believe that information about sexuality is much more accurate and available than it was 20 or 30 years ago, much of the STD problem is due to ignorance. In the words of Faye Wattleton, president of Planned Parenthood Federation, teenagers are both sexually active and sexually illiterate.

The National Adolescent Student Health Survey, a study of the views of 11,000 students conducted in 1987 by the American School Health Association, the Association for the Advancement of Health Education, and the Society for Public Health Education, reveals many misconceptions among teenagers about STD's:

Fifty-one percent mistakenly believed, or were not sure whether, washing after sex would prevent AIDS.

Fifty-five percent thought that taking birth control pills prevented STD's.

Thirty percent did not know that most people contract STD's by having sex.

Twenty-five percent did not know that using a condom was an effective method to avoid disease.

Thirty-three percent did not know that a sore on the sex organs is a common early sign of STD's.

The survey also reveals that embarrassment and access to care are barriers that prevent students from seeking help:

Thirty-eight percent would not know where to go to be treated.

Forty-four percent would be embarrassed to ask a doctor what is wrong.

Seventy-nine percent mistakenly believed, or were unsure whether, clinics require permission from parents before they can treat anyone under the age of 18 for STD's.

Forty-nine percent of students would find it hard to pay for treatment.

Thirty-nine percent did not have an adult they could turn to for assistance if they thought they had an STD.

Forty-six percent did not have a friend they could turn to for assistance if they thought they had an STD.

Schools and teachers could make a difference. Primary health care clinics staffed by public health clinicians should be set up on school grounds, where most adolescents spend most of their day. These clinics would make it easy for adolescents to get care for and information about STD's. An alternative would be to strengthen the links between schools and community health care facilities. At a minimum, the school should work with community agencies to develop a guide to community health services and make it part of a student manual that is distributed annually. Schools could provide social support by organizing peer counseling groups to address sexuality issues and STD's, as well as other problems that plague adolescents, such as low self-esteem, substance abuse, and suicide.

Schools should also devote more time to education about family life and sexuality. In most states that require health education, students attend health classes only for one semester in junior high school and one semester in high school. This is not enough time to provide STD education and cover all the other health topics that must be taught.

Fighting the STD threat is not just the responsibility of the school nurse or the health teacher. All teachers must take part. Health behavior is much more likely to change when information is provided through multiple channels.

In discussing STD's, educators in all disciplines should emphasize the virtues of abstinence. However, discussing only abstinence neglects those high school students--at least half the teenage population--who are already sexually active. Therefore, educators must stress the importance of condoms to prevent sexually transmitted diseases, including HIV infection. Teachers should also discuss the importance of preventive medical care so infection can be detected early. This is particularly important for female students since approximately 80 percent of them show no symptoms when they contract such STD's as chlamydia and gonorrhea. If left undetected, these diseases can cause sterility.

There are many ways for teachers to raise the STD issue in class. An adolescent guest speaker who had contracted a disease could be invited to the classroom. Teachers of art, English, and music could help students produce stories or comics or songs that address adolescent health in general and STD's in particular. With the assistance of the drama teacher, student groups could be organized to produce theatrical productions that focus on adolescent sexuality and sexual health. Teachers of social studies could have students research important figures in history who are believed to have had STD's. Math teachers could have students work out statistics on contracting such diseases.

Clearly, teachers and schools want to avoid controversy. Because of this, they too often steer clear of any discussion of sexuality and STD's. But teachers owe it to their students to address these topics. Their health and their very lives may depend on it.

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