In your opinion, what are some of the most urgent issues related to adolescent and young adult health? Young people have to work through a broad range of issues as they move from childhood to adulthood. They may have to deal with changes to their bodies and their feelings and they may be thinking about having their first relationship or having sex. Young people may also be exploring their identities in terms of their sexuality or gender identity. They may want more independence from their families, and their friends may play a more important part in their lives. Some may also want to experiment with alcohol and other drugs. Although growing up can be an exciting time, it can also be confusing and challenging. Research shows confident young people who feel supported by their families and friends are more likely to safely negotiate issues like these. However, it is important to remember adolescence is generally a time for experimenting with risky behaviours, even with good parenting and role modelling. Teenagers and alcohol Alcohol is one of the most widely used drugs in Australia. According to recent surveys, around 40 per cent of young people aged 12-17 have had a full serve of alcohol and around 60 per cent of year 10-12 students have drunk alcohol at least once. For young people, alcohol use is associated with a range of health risks, including: · unsafe sex · unwanted sex · unintended pregnancy · drink-driving and road accidents · violence and aggressive behaviour · criminal activity. Teenagers and body image Young people are at risk of developing a negative body image, where they dislike the way they look. The related health problems for young people can include: · crash dieting and malnourishment · eating disorders, including anorexia and bulimia nervosa · obesity · steroid use (to build muscle mass). Teenagers and bullying Estimates suggest around one in six children are bullied every few weeks or more in Australia. Young people are bullied by their peers for many reasons, including: · the way they look (for example, if they are overweight) · resisting pressure to conform · their cultural or socioeconomic background or religion · their academic achievements · their sexual orientation or behaviour · being ‘the new kid’ at school. Teenagers and smoking Despite widespread media campaigns, tobacco smoking is still popular among young people in Australia, especially young women, though the number of young people who smoke cigarettes is decreasing. · Smoking tobacco increases people’s risk of: · cancers of the lung, throat and mouth · reduced lung function · asthma and other respiratory problems · damaged senses of smell and taste · heart disease, major heart attack and stroke. Teenagers and family life Young people can face issues relating to family life, including: · relationship problems between family members · family violence · abuse, including neglect and physical, sexual or emotional abuse · separation and divorce. For some young peopl.

1. In your opinion, what are some of the most urgent issues related to adolescent and young adult
health?
Young people have to work through a broad range of issues as they move from childhood to
adulthood. They may have to deal with changes to their bodies and their feelings and they may
be thinking about having their first relationship or having sex.
Young people may also be exploring their identities in terms of their sexuality or gender identity.
They may want more independence from their families, and their friends may play a more
important part in their lives. Some may also want to experiment with alcohol and other drugs.
Although growing up can be an exciting time, it can also be confusing and challenging. Research
shows confident young people who feel supported by their families and friends are more likely to
safely negotiate issues like these. However, it is important to remember adolescence is generally
a time for experimenting with risky behaviours, even with good parenting and role modelling.
Teenagers and alcohol
Alcohol is one of the most widely used drugs in Australia. According to recent surveys, around
40 per cent of young people aged 12-17 have had a full serve of alcohol and around 60 per cent
of year 10-12 students have drunk alcohol at least once.
For young people, alcohol use is associated with a range of health risks, including:
· unsafe sex
· unwanted sex
· unintended pregnancy
· drink-driving and road accidents
· violence and aggressive behaviour
· criminal activity.
Teenagers and body image
Young people are at risk of developing a negative body image, where they dislike the way they
look.
The related health problems for young people can include:
· crash dieting and malnourishment
· eating disorders, including anorexia and bulimia nervosa
· obesity
· steroid use (to build muscle mass).
Teenagers and bullying
Estimates suggest around one in six children are bullied every few weeks or more in Australia.
Young people are bullied by their peers for many reasons, including:
· the way they look (for example, if they are overweight)

2. · resisting pressure to conform
· their cultural or socioeconomic background or religion
· their academic achievements
· their sexual orientation or behaviour
· being ‘the new kid’ at school.
Teenagers and smoking
Despite widespread media campaigns, tobacco smoking is still popular among young people in
Australia, especially young women, though the number of young people who smoke cigarettes is
decreasing.
· Smoking tobacco increases people’s risk of:
· cancers of the lung, throat and mouth
· reduced lung function
· asthma and other respiratory problems
· damaged senses of smell and taste
· heart disease, major heart attack and stroke.
Teenagers and family life
Young people can face issues relating to family life, including:
· relationship problems between family members
· family violence
· abuse, including neglect and physical, sexual or emotional abuse
· separation and divorce.
For some young people, a change in family circumstances can be positive. For example, if there
has been a lot of conflict in a family, separation may be a better option.
Teenagers and illicit drugs
Marijuana (Cannabis sativa) is an illicit drug commonly used by young people. Around 17 per
cent of year 10-12 students and around 14 per cent of 14-19 year olds have used cannabis at least
once. Other commonly used illicit drugs include hallucinogens, amphetamines, cocaine and
ecstasy, with very small percentages of 12 to 17 year olds having used one of these at least once.
It is often assumed that young people turn to illicit drugs to ease depression or anxiety, but most
try drugs simply for fun. Young men are more likely than young women to experiment with
illicit drugs. Those who smoke tobacco and drink alcohol are also more likely to try illicit drugs
than those who do not.
Teenagers and media
Media, including print, television, film and online, can negatively affect young people in many
ways, including:
· exposing them to extreme violence, which can desensitise them to reality

3. · supporting the cultural ideal that only thin is beautiful, which promotes body image
problems
· reinforcing the importance of money, consumerism and status symbols.
Teenagers and suicide
After car accidents, suicide is the most common cause of death among young people in
Australia. Research shows more young women than young men attempt suicide, but young men
are far more likely to take their own lives.
In the past 10 years, the suicide rate for males aged 15 to 24 years has dropped considerably.
However, young men living in rural and remote areas are more likely than those living in the city
to take their own lives.
Teenagers and sexual relationships
Young people need access to comprehensive, factual information about sexuality to safely
negotiate adult relationships.
The issues young people may be confronted with include:
· safer sex
· contraception
· sexually transmissible infections (STIs)
· unplanned pregnancy
· peer pressure
· cultural definitions of gender roles and sexual orientation.
Teenagers and pregnancy
South Australian figures show around three per cent of young women aged 15 to 19 years
became pregnant in 2011. Of these, around 50 per cent had an abortion.
Pregnancy can be a positive time for a young woman, but she may be confronted with issues
such as:
· emotional distress
· isolation or a lack of understanding and support from family and friends
· complications during pregnancy and birth
· financial pressures.
Why are we seeing an increase in adolescent suicide and mental health conditions (e.g.,
depression, anxiety)?
Many troubling and difficult situations can make a teen consider suicide. The same emotional
states that make adults vulnerable to considering suicide also apply to adolescents. Those with
good support networks (e.g., among family and peers, or extracurricular sport, social, or religious
associations) are likely to have an outlet to help them deal with their feelings. Others without
such networks are more susceptible during their emotional changes, and may feel that they're all

4. alone in times of trouble.
Apart from the normal pressures of teen life, specific circumstances can contribute to an
adolescent's consideration of suicide. It's especially difficult when adolescents are confronted
with problems that are out of their control, such as:
Many suicides are committed by people who are depressed. Depression is a mental health
disorder. It causes chemical imbalances in the brain, which can lead to despondency, lethargy, or
general apathy towards life. Almost half of 14- and 15-year-olds have reported feeling some
symptoms of depression, which makes coping with the extensive stresses of adolescence all the
more difficult. Symptoms of depression in youth are often overlooked or passed off as being
typical "adolescent turmoil."
Another serious problem that can lead teens to suicide - or aid in their plans to end their lives - is
the easy access many of them have to firearms, drugs, alcohol, and motor vehicles. For the
general population, about 30% of suicides involve firearms. Of all firearm-related deaths that
occur, about 80% are suicides.
Warning signs and risk factors
Suicidal tendencies don't just appear out of the blue: People usually display a number of
warning signs when things seem so wrong in their lives that they've simply given up hope.
Because adolescence is such a turbulent time, it may be difficult to distinguish the signs that lead
to suicide from the changing, sometimes uncertain but otherwise normal behaviour of teens.
Behaviour changes to watch for are:
Though many suicidal teens appear depressed or downcast, others hide their problems
underneath a disguise of excess energy. If an adolescent starts displaying uncharacteristic
agitation and hyperactivity, it may also signal the existence of an underlying problem. This
restlessness may take the form of confrontational or aggressive behaviour.
More obvious signs that an adolescent may be suicidal include low self-esteem and self-
deprecating remarks. Some teens come right out and talk or write about their suicidal thoughts -
this should be taken seriously, and not ignored with the hope that it's a passing phase. Any
previous attempts at suicide are loud and clear cries for help, which demand responses before
it's too late.
As a society, how do we address these issues?
It's essential that you take suicidal behaviour or previous attempts seriously - and get assistance
quickly.Aside from professional treatment, a suicidal teen needs to know there are people who
care, and who are available to talk to. Good support means listening to what's troubling
somebody without passing judgment on his or her feelings. A person should be reassured that
there are always solutions to problems or ways other than suicide for coping with them. Giving
an adolescent the chance to open up and talk about his or her feelings will help relieve some of

5. the distress of those intense emotions, and make that person feel less alone.
Don't hesitate to bring up the subject of suicide, and to ask direct questions. Somebody who
hasn't considered ending their life isn't going to adopt the idea simply because the possibility
has been raised. On the other hand, for individuals who are thinking about suicide, your concern
will only be reassuring. At the same time, people can take the opportunity to open up about their
distress.
Some parents may find that their adolescent child resists their advances and isn't willing to
confide in them. When teens insist their parents just "don't understand," it might be a good idea
to suggest they talk to a more objective or emotionally neutral person. This can include other
family members, religious leaders, a school counsellor, a coach, or a trusted doctor.
Restricting access to firearms and ammunition is also an important preventive measure. Weapons
kept in the home increase the risk that suicide attempts will be successful, by giving a suicidal
adolescent the means to take their own life.
Getting treatment
It is very important to seek professional help for the adolescent who may be suicidal. Guidance
counsellors at schools or counsellors at crisis centres can help ensure that a distressed teen
receives the needed assistance.
As the vast majority of adolescents who commit suicide have depressive symptoms, recognition
and evaluation of clinical depression - a treatable medical condition - is essential. Physicians,
including psychiatrists, provide both one-on-one counselling and medical treatment for the
biochemical causes of depression.
Psychological counselling will help a teen develop effective mechanisms for coping with
problems. These will be of value long after adolescence has ended, when a person has to face
many of the stresses routinely encountered during adulthood.
Why are STDs among teenagers at an all-time high? Is this a major public health concern?
Sexually transmitted diseases (STDs) are a major health problem affecting mostly young people,
not only in developing, but also in developed countries.
Over the period 1985-1996, a general decrease of gonorrhoea, syphilis and chlamydia infections
was noted in developed countries, both in the general population and among adolescents. From
the mid-1990s however, increases in the diagnoses of sexually transmitted diseases, in particular
syphilis, gonorrhoea and chlamydia have been reported in several European countries, especially
among teenagers 16-19 years old.
The problem with most STDs is that they can occur symptom-free and can thus be passed on
unaware during unprotected sexual intercourse. On an individual level, complications can
include pelvic inflammatory diseases and possibly lead to ectopic pregnancies and infertility.
Female adolescents are likely to have a higher risk of contracting an STD than their male

6. counterparts as their partners are generally older and hence more likely to be infected.
The declining age of first sexual intercourse has been proffered as one possible explanation for
the increase in numbers of STDs. According to data from different European countries, the
average age of first sexual intercourse has decreased over the last three decades, with increasing
proportions of adolescents reporting sexual activity before the age of 16 years. An early onset of
sexual activity not only increases the probability of having various sexual partners, it also
increases the chances of contracting a sexually transmitted infection. The risk is higher for
female adolescents as their cervical anatomic development is incomplete and especially
vulnerable to infection by certain sexually transmitted pathogens.
The reluctance of adolescents to use condoms is another possible explanation for the increase in
STDs. Some surveys of adolescents have reported that condoms were found to be difficult to use
for sexually inexperienced, detract from sensual pleasure and also embarrassing to suggest.
Condoms have also been reported to be used primarily as a protection against pregnancy, not
STD, with their use becoming irregular when other contraceptives are used. Furthermore, many
adolescents do not perceive themselves to be at risk of contracting an STD.
STDs affect persons of all racial, cultural, socioeconomic, and religious groups in the United
States. Persons of all sexual orientations and sexually active persons in all states, communities,
and social networks are at risk for STDs. These diseases are a tremendous health and economic
burden on the people of the United States. STDs predominantly affect otherwise healthy youth
and young adults, but the consequences can be lifelong. This impact is largely unrecognized by
the public and even some health care professionals. Severe complications of STDs include
cancer, reproductive health problems, neurologic diseases, and sometimes death. Women and
their infants bear a disproportionate burden of these STD-associated complications. The
committee estimates that the total annual cost associated with major STDs is approximately $10
billion, which rises to $17 billion when sexually transmitted HIV infections are included. The
large number of STD-related deaths and morbidity, and the high costs of managing STDs and
their complications, in the United States underscores the importance of effective prevention
programs for STDs. Many cases of cancer, infertility, spontaneous abortions, low birth weight,
STD-related deaths, and other STD-related conditions are clearly preventable. These data justify
investing in effective STD prevention programs to both reduce human suffering and contain
health care costs.
The impact of STDs on women's health is substantial. STDs disproportionately impact women
because women are more susceptible to infection, they are more likely to have undetected
infections, and they are more likely to have STD-related complications compared to men.
Adolescents and young adults are at greatest risk for acquiring STDs. Female adolescents appear
to be particularly susceptible to several STDs. As described in Chapter 3, adolescents and young

7. adults are also likely to lack information regarding STDs, lack health insurance, and use
intoxicating drugs; these factors significantly increase risk for STDs.
Many STDs increase an individual's risk for acquiring and transmitting HIV infection.
Therefore, reducing STDs would decrease the incidence of HIV infection in the population.
Given the strong association between certain STDs and cervical, liver, and other cancers, cancer
prevention programs need to incorporate STD prevention strategies as means for preventing such
cancers. As emerging and reemerging infections, new sexually transmitted infections appear on a
regular basis and are likely to continue to do so as long as rates of risky sexual behaviors remain
high and global economic and demographic factors continue to promote emergence of new
STDs. STDs are major international health problems, and all nations will have to contribute to
prevention efforts on a global scale.
Solution
In your opinion, what are some of the most urgent issues related to adolescent and young adult
health?
Young people have to work through a broad range of issues as they move from childhood to
adulthood. They may have to deal with changes to their bodies and their feelings and they may
be thinking about having their first relationship or having sex.
Young people may also be exploring their identities in terms of their sexuality or gender identity.
They may want more independence from their families, and their friends may play a more
important part in their lives. Some may also want to experiment with alcohol and other drugs.
Although growing up can be an exciting time, it can also be confusing and challenging. Research
shows confident young people who feel supported by their families and friends are more likely to
safely negotiate issues like these. However, it is important to remember adolescence is generally
a time for experimenting with risky behaviours, even with good parenting and role modelling.
Teenagers and alcohol
Alcohol is one of the most widely used drugs in Australia. According to recent surveys, around
40 per cent of young people aged 12-17 have had a full serve of alcohol and around 60 per cent
of year 10-12 students have drunk alcohol at least once.
For young people, alcohol use is associated with a range of health risks, including:
· unsafe sex
· unwanted sex
· unintended pregnancy
· drink-driving and road accidents
· violence and aggressive behaviour

8. · criminal activity.
Teenagers and body image
Young people are at risk of developing a negative body image, where they dislike the way they
look.
The related health problems for young people can include:
· crash dieting and malnourishment
· eating disorders, including anorexia and bulimia nervosa
· obesity
· steroid use (to build muscle mass).
Teenagers and bullying
Estimates suggest around one in six children are bullied every few weeks or more in Australia.
Young people are bullied by their peers for many reasons, including:
· the way they look (for example, if they are overweight)
· resisting pressure to conform
· their cultural or socioeconomic background or religion
· their academic achievements
· their sexual orientation or behaviour
· being ‘the new kid’ at school.
Teenagers and smoking
Despite widespread media campaigns, tobacco smoking is still popular among young people in
Australia, especially young women, though the number of young people who smoke cigarettes is
decreasing.
· Smoking tobacco increases people’s risk of:
· cancers of the lung, throat and mouth
· reduced lung function
· asthma and other respiratory problems
· damaged senses of smell and taste
· heart disease, major heart attack and stroke.
Teenagers and family life
Young people can face issues relating to family life, including:
· relationship problems between family members
· family violence
· abuse, including neglect and physical, sexual or emotional abuse
· separation and divorce.
For some young people, a change in family circumstances can be positive. For example, if there
has been a lot of conflict in a family, separation may be a better option.

9. Teenagers and illicit drugs
Marijuana (Cannabis sativa) is an illicit drug commonly used by young people. Around 17 per
cent of year 10-12 students and around 14 per cent of 14-19 year olds have used cannabis at least
once. Other commonly used illicit drugs include hallucinogens, amphetamines, cocaine and
ecstasy, with very small percentages of 12 to 17 year olds having used one of these at least once.
It is often assumed that young people turn to illicit drugs to ease depression or anxiety, but most
try drugs simply for fun. Young men are more likely than young women to experiment with
illicit drugs. Those who smoke tobacco and drink alcohol are also more likely to try illicit drugs
than those who do not.
Teenagers and media
Media, including print, television, film and online, can negatively affect young people in many
ways, including:
· exposing them to extreme violence, which can desensitise them to reality
· supporting the cultural ideal that only thin is beautiful, which promotes body image
problems
· reinforcing the importance of money, consumerism and status symbols.
Teenagers and suicide
After car accidents, suicide is the most common cause of death among young people in
Australia. Research shows more young women than young men attempt suicide, but young men
are far more likely to take their own lives.
In the past 10 years, the suicide rate for males aged 15 to 24 years has dropped considerably.
However, young men living in rural and remote areas are more likely than those living in the city
to take their own lives.
Teenagers and sexual relationships
Young people need access to comprehensive, factual information about sexuality to safely
negotiate adult relationships.
The issues young people may be confronted with include:
· safer sex
· contraception
· sexually transmissible infections (STIs)
· unplanned pregnancy
· peer pressure
· cultural definitions of gender roles and sexual orientation.
Teenagers and pregnancy
South Australian figures show around three per cent of young women aged 15 to 19 years
became pregnant in 2011. Of these, around 50 per cent had an abortion.

10. Pregnancy can be a positive time for a young woman, but she may be confronted with issues
such as:
· emotional distress
· isolation or a lack of understanding and support from family and friends
· complications during pregnancy and birth
· financial pressures.
Why are we seeing an increase in adolescent suicide and mental health conditions (e.g.,
depression, anxiety)?
Many troubling and difficult situations can make a teen consider suicide. The same emotional
states that make adults vulnerable to considering suicide also apply to adolescents. Those with
good support networks (e.g., among family and peers, or extracurricular sport, social, or religious
associations) are likely to have an outlet to help them deal with their feelings. Others without
such networks are more susceptible during their emotional changes, and may feel that they're all
alone in times of trouble.
Apart from the normal pressures of teen life, specific circumstances can contribute to an
adolescent's consideration of suicide. It's especially difficult when adolescents are confronted
with problems that are out of their control, such as:
Many suicides are committed by people who are depressed. Depression is a mental health
disorder. It causes chemical imbalances in the brain, which can lead to despondency, lethargy, or
general apathy towards life. Almost half of 14- and 15-year-olds have reported feeling some
symptoms of depression, which makes coping with the extensive stresses of adolescence all the
more difficult. Symptoms of depression in youth are often overlooked or passed off as being
typical "adolescent turmoil."
Another serious problem that can lead teens to suicide - or aid in their plans to end their lives - is
the easy access many of them have to firearms, drugs, alcohol, and motor vehicles. For the
general population, about 30% of suicides involve firearms. Of all firearm-related deaths that
occur, about 80% are suicides.
Warning signs and risk factors
Suicidal tendencies don't just appear out of the blue: People usually display a number of
warning signs when things seem so wrong in their lives that they've simply given up hope.
Because adolescence is such a turbulent time, it may be difficult to distinguish the signs that lead
to suicide from the changing, sometimes uncertain but otherwise normal behaviour of teens.
Behaviour changes to watch for are:
Though many suicidal teens appear depressed or downcast, others hide their problems
underneath a disguise of excess energy. If an adolescent starts displaying uncharacteristic
agitation and hyperactivity, it may also signal the existence of an underlying problem. This

11. restlessness may take the form of confrontational or aggressive behaviour.
More obvious signs that an adolescent may be suicidal include low self-esteem and self-
deprecating remarks. Some teens come right out and talk or write about their suicidal thoughts -
this should be taken seriously, and not ignored with the hope that it's a passing phase. Any
previous attempts at suicide are loud and clear cries for help, which demand responses before
it's too late.
As a society, how do we address these issues?
It's essential that you take suicidal behaviour or previous attempts seriously - and get assistance
quickly.Aside from professional treatment, a suicidal teen needs to know there are people who
care, and who are available to talk to. Good support means listening to what's troubling
somebody without passing judgment on his or her feelings. A person should be reassured that
there are always solutions to problems or ways other than suicide for coping with them. Giving
an adolescent the chance to open up and talk about his or her feelings will help relieve some of
the distress of those intense emotions, and make that person feel less alone.
Don't hesitate to bring up the subject of suicide, and to ask direct questions. Somebody who
hasn't considered ending their life isn't going to adopt the idea simply because the possibility
has been raised. On the other hand, for individuals who are thinking about suicide, your concern
will only be reassuring. At the same time, people can take the opportunity to open up about their
distress.
Some parents may find that their adolescent child resists their advances and isn't willing to
confide in them. When teens insist their parents just "don't understand," it might be a good idea
to suggest they talk to a more objective or emotionally neutral person. This can include other
family members, religious leaders, a school counsellor, a coach, or a trusted doctor.
Restricting access to firearms and ammunition is also an important preventive measure. Weapons
kept in the home increase the risk that suicide attempts will be successful, by giving a suicidal
adolescent the means to take their own life.
Getting treatment
It is very important to seek professional help for the adolescent who may be suicidal. Guidance
counsellors at schools or counsellors at crisis centres can help ensure that a distressed teen
receives the needed assistance.
As the vast majority of adolescents who commit suicide have depressive symptoms, recognition
and evaluation of clinical depression - a treatable medical condition - is essential. Physicians,
including psychiatrists, provide both one-on-one counselling and medical treatment for the
biochemical causes of depression.
Psychological counselling will help a teen develop effective mechanisms for coping with
problems. These will be of value long after adolescence has ended, when a person has to face

12. many of the stresses routinely encountered during adulthood.
Why are STDs among teenagers at an all-time high? Is this a major public health concern?
Sexually transmitted diseases (STDs) are a major health problem affecting mostly young people,
not only in developing, but also in developed countries.
Over the period 1985-1996, a general decrease of gonorrhoea, syphilis and chlamydia infections
was noted in developed countries, both in the general population and among adolescents. From
the mid-1990s however, increases in the diagnoses of sexually transmitted diseases, in particular
syphilis, gonorrhoea and chlamydia have been reported in several European countries, especially
among teenagers 16-19 years old.
The problem with most STDs is that they can occur symptom-free and can thus be passed on
unaware during unprotected sexual intercourse. On an individual level, complications can
include pelvic inflammatory diseases and possibly lead to ectopic pregnancies and infertility.
Female adolescents are likely to have a higher risk of contracting an STD than their male
counterparts as their partners are generally older and hence more likely to be infected.
The declining age of first sexual intercourse has been proffered as one possible explanation for
the increase in numbers of STDs. According to data from different European countries, the
average age of first sexual intercourse has decreased over the last three decades, with increasing
proportions of adolescents reporting sexual activity before the age of 16 years. An early onset of
sexual activity not only increases the probability of having various sexual partners, it also
increases the chances of contracting a sexually transmitted infection. The risk is higher for
female adolescents as their cervical anatomic development is incomplete and especially
vulnerable to infection by certain sexually transmitted pathogens.
The reluctance of adolescents to use condoms is another possible explanation for the increase in
STDs. Some surveys of adolescents have reported that condoms were found to be difficult to use
for sexually inexperienced, detract from sensual pleasure and also embarrassing to suggest.
Condoms have also been reported to be used primarily as a protection against pregnancy, not
STD, with their use becoming irregular when other contraceptives are used. Furthermore, many
adolescents do not perceive themselves to be at risk of contracting an STD.
STDs affect persons of all racial, cultural, socioeconomic, and religious groups in the United
States. Persons of all sexual orientations and sexually active persons in all states, communities,
and social networks are at risk for STDs. These diseases are a tremendous health and economic
burden on the people of the United States. STDs predominantly affect otherwise healthy youth
and young adults, but the consequences can be lifelong. This impact is largely unrecognized by
the public and even some health care professionals. Severe complications of STDs include
cancer, reproductive health problems, neurologic diseases, and sometimes death. Women and
their infants bear a disproportionate burden of these STD-associated complications. The

13. committee estimates that the total annual cost associated with major STDs is approximately $10
billion, which rises to $17 billion when sexually transmitted HIV infections are included. The
large number of STD-related deaths and morbidity, and the high costs of managing STDs and
their complications, in the United States underscores the importance of effective prevention
programs for STDs. Many cases of cancer, infertility, spontaneous abortions, low birth weight,
STD-related deaths, and other STD-related conditions are clearly preventable. These data justify
investing in effective STD prevention programs to both reduce human suffering and contain
health care costs.
The impact of STDs on women's health is substantial. STDs disproportionately impact women
because women are more susceptible to infection, they are more likely to have undetected
infections, and they are more likely to have STD-related complications compared to men.
Adolescents and young adults are at greatest risk for acquiring STDs. Female adolescents appear
to be particularly susceptible to several STDs. As described in Chapter 3, adolescents and young
adults are also likely to lack information regarding STDs, lack health insurance, and use
intoxicating drugs; these factors significantly increase risk for STDs.
Many STDs increase an individual's risk for acquiring and transmitting HIV infection.
Therefore, reducing STDs would decrease the incidence of HIV infection in the population.
Given the strong association between certain STDs and cervical, liver, and other cancers, cancer
prevention programs need to incorporate STD prevention strategies as means for preventing such
cancers. As emerging and reemerging infections, new sexually transmitted infections appear on a
regular basis and are likely to continue to do so as long as rates of risky sexual behaviors remain
high and global economic and demographic factors continue to promote emergence of new
STDs. STDs are major international health problems, and all nations will have to contribute to
prevention efforts on a global scale.