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Sexually transmitted infections: Overview of issues specific to adolescents

J Dennis Fortenberry, MD, MS
Section Editors
Sheldon L Kaplan, MD
Diane Blake, MD
Deputy Editor
Mary M Torchia, MD


Adolescence is a heterogeneous developmental period in terms of sexual behavior and risk of acquiring sexually transmitted infections (STIs). Early adolescence begins during the first years of the second decade and is marked by rapid physical growth and attainment of secondary sex characteristics. Middle adolescence begins at approximately age 14 years, ends around age 17 to 18 years, and is marked by maturation of the reproductive systems and achievement of adult physical stature. Increased sexual interest and noncoital sexual behaviors are characteristic of middle adolescence.

The average age of first coitus is approximately 16 years among American adolescents, but the age is lower in certain populations, such as inner city youth. Late adolescence ends with the transition into young adulthood and is associated with high levels of sexual activity and acquisition of STIs.

This topic will focus on aspects of STIs that are particularly relevant in adolescents. Details about clinical manifestations, diagnosis, and treatment of individual infections are discussed separately. (See appropriate topic reviews.)


Cross-sectional data from the 2003-2004 National Health and Nutrition Examination Survey (NHANES) indicate 24 percent of female adolescents aged 14 to 19 years had laboratory evidence of at least one of the following STDs: human papillomavirus (HPV, 18 percent), Chlamydia trachomatis (4 percent), Trichomonas vaginalis (3 percent), herpes simplex virus type 2 (HSV-2, 2 percent), or Neisseria gonorrhoeae (1 percent) [1]. Among girls who reported ever having had sex, 40 percent had laboratory evidence of one of the four STIs, predominantly HPV (30 percent) and chlamydia (7 percent).

The acquisition of genital gonorrhea decreased among adolescent females (age 15 to 19 years) between 2013 and 2014 (459.2 and 430.5 cases per 100,000, respectively) [2,3]. Genital chlamydia rates among 15- to 19-year-old women were considerably higher, at 2,941.0 cases per 100,000 in 2014.


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Literature review current through: Sep 2016. | This topic last updated: Jul 19, 2016.
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