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Experts Debate Merits of School-Based Testing for STDs

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Alarmingly, the Pediatrics study found that, of those infected with gonorrhea or chlamydia, 90% had no symptoms. Indeed, adolescents are more likely than adults to have no symptoms of STD infection, according to the American Academy of Pediatrics' Committee on Adolescents, which also reports that of the 20 million cases of STDs reported each year, one-third occur in school-aged youth. As many as one in four adolescents contracts an STD before graduating from high school.

The authors concluded that incorporating STD screening into schools might help this hard-to-reach population. And based on the drop in chlamydia infection in boys, they say STD screening programs in schools may aid STD prevention efforts.

Hicks writes that another thorny issue related to STD testing in schools is having to document teen-agers' complete sexual history. He says the health care worker who takes the sexual history has an "enormous burden to bear" regarding the reporting of events such as rape, incest, abuse, prostitution, and under-age sex.

But Farley says a detailed sexual history is unnecessary for most teen-agers undergoing STD testing. In his program, only teens who test positive for an STD have a more detailed sexual history taken, which includes identification of sex partners and making attempts to get them treated -- as well as counseling on safe sex and birth control.

He says his program has not encountered any cases of non-consensual sex or abuse, but admits that it is a concern when implementing these types of programs nationwide. "Some sort of reasonable policy needs to be put in place that balances out all the issues," Farley tells WebMD. But issues of what to do with sensitive information and how to report it through the proper channels should not prevent implementation of STD screening programs for teen-agers, he adds.

"Without programs such as this, we have many, many students out there with infectious diseases that are serious -- and [that] potentially increase their risk of HIV infection. So dealing with issues that involve a percentage of those students, perhaps a small percentage, shouldn't prevent us from implementing a program that has an overall big health benefit," Farley says.

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