Thursday, March 11, 1999

VD rate for teens soars in Tristate

---

Cincinnati leads all Ohio cities

BY TIM BONFIELD and JANET WETZEL
The Cincinnati Enquirer

        Tristate teen-agers are catching and spreading chlamydia and gonorrhea at such rapidly increasing rates that Cincinnati has soared to the top of all Ohio cities for both sexually transmitted diseases.

        Statewide, chlamydia rates have climbed 25 percent in three years. Gonorrhea rates rose 14 percent, according to reports from the Ohio Department of Health. But in Cincinnati, the rates have doubled.

        In 1996, Cincinnati was fourth among Ohio cities in per-capita chlamydia rates behind Cleveland, Youngstown and Lima. Cincinnati also was fourth in gonorrhea rates behind Dayton, Cleveland and Lima. Now, Cincinnati is in first place by large margins.

        The rising disease rates renew debates about cultural influences, parental guidance, changes in teen attitudes about sex, and whether public health agencies are doing enough teaching and testing for the highest-risk groups.

INFOGRAPHIC

Sex disease trends

        “What we're looking at is a failure of people to exercise even the most basic precautions about safe-sex practices,” said Cincinnati Health Commissioner Malcolm Adcock. “It seems to be a trend among younger people to ignore the (health) messages and place themselves at risk.”

        A closer look at the numbers reveals two trends:

        • Both diseases are most heavily concentrated among youths of high school age. Last year in Hamilton County, there were 1,870 chlamydia cases among 15- to 19-year-olds (nearly half the total number of cases). In addition, there were 14 cases in children under 10 years old.

        • Both diseases are highly concentrated among African-Americans. For chlamydia, the 1998 disease rate was 10 times higher among blacks than whites in Hamilton County. For gonorrhea, the rate was 33 times higher for blacks than whites.

Condoms aren't used
        For victims, the rising rates of sexually transmitted diseases (STDs) increase risks of infertility, cancer and other health problems. Beyond that, the trend demonstrates that many young people aren't abstaining from sex and they aren't practicing safe sex — because condoms are highly effective at preventing the spread of bacterial STDs.

        That means, today's sexually active teens are ignoring the risk of catching AIDS, which also has been spreading faster among African-American women than any other group.

        “So many young people, not just African-Americans, think they're indestructible,” said Sheila Adams, president and chief executive officer of the Urban League of Greater Cincinnati, which is working this week with several black churches on its second annual AIDS awareness and prevention campaign.

        “Our message is, "You really have to think about your life and the choices you make,'” Ms. Adams said. “We've got to keep getting that message out there.”

"A wake-up call'
        Dr. Paula Hillard, a specialist in adolescent gynecology at Children's Hospital Medical Center, said Cincinnati's rising STD rates runs counter to some national trends.

        National studies indicate that teen pregnancy rates are slowing, more sexually active teens are using condoms and more teens are delaying their first sexual intercourse. All those factors should lead to lower STD rates, but that isn't happening in Cincinnati.

        “This should be a wake-up call to all parents and physicians who take care of young people,” Dr. Hillard said.

        Dr. Hillard also said the apparently huge disparity between disease among black and white teens may not be so huge.

Statistics misleading
        While the growing STD rates among black teens is a serious public-health concern, at least it's a documented problem. Dr. Hillard offered four reasons why STD rates among middle-class and upper-class whites may be significantly underreported.

        • Many of the statistics in the state reports come from public-health clinics, which are more heavily used by low-income people, be they black or white. Those clinics often make it their mission to test young people for STDs.

        • Many middle-class white families may not be taking otherwise healthy teens for regular, thorough medical exams.

        • Many teens, white or black, may not know that Ohio law allows them to seek confidential STD testing and treatment without parental consent.

        • Even when teens see a doctor, Dr. Hillard suspects that many suburban physicians don't even question teen patients about their sexual activity much less test them for sexually transmitted diseases.

        “I think there are plenty of upper- and middle-class kids out there who are walking around with STDs who have never been tested,” Dr. Hillard said.

Teens don't fear STDs
        Outside Hamilton County, where the statistics are dominated by the city of Cincinnati, chlamydia and gonorrhea case numbers are much lower, but the rates are rising.

        In Butler County, gonorrhea rates are up 53 percent since 1996. Chlamydia rates were up slightly.

        In Clermont County, gonorrhea rates have tripled. Chlamydia rates are up 48 percent.

        In Warren County, chlamydia is up 20 percent and gonorrhea is down 18 percent.

        “There's two main reasons for getting an STD. One, you have casual promiscuous sex. And the other is you have multiple sex partners,” said Dr. John Perkins, medical director of the Middletown City Health Department. “The other real problem, in my view, is people who have their STDs diagnosed and treated all too often don't seem to realize that their sexual con tacts also have to be treated or we don't break the cycle of transmission.”

        Dennis Sayers, supervisor of the STD section of the HIV/STD Prevention Unit of the Ohio Department of Health, said he could see no clear reason why STD rates are so much higher among blacks than whites. He said young people in general seem less afraid of AIDS and other sexual diseases.

        “Previous generations saw their friends dying, and knew it was obviously very important to reduce their own risk,” Mr. Sayers said. “Now with another generation, that significance to them may be waning. Whatever impression we make on one generation, we can't give up on that because there's always a new generation coming along.”

"Shout a little louder'
        In Cincinnati, Ms. Adams and Dr. Hillard said more effort is needed to reach out to high-risk groups.

        On Sunday, the Urban League and several black churches kicked off their second annual Black Church Week of Prayer for the Healing of AIDS. A special concert at Zion Baptist Church in Avondale will be held at 7:30 p.m. Friday. A day of seminars and workshops begins at 9 a.m. Saturday at Zion.

        “Maybe we need to shout a little louder about the risks and realities of STDs,” Dr. Hillard said.

        The Cincinnati Health Department spends about $1.2 million of its $40 million annual budget on STD testing, treatment and prevention.

        More of that money is being aimed toward African-Americans, Dr. Adcock said. For example, spending on minority AIDS prevention programs has nearly tripled from $60,000 in 1997 to $177,000 this year.

A long-term battle
        Is that enough?

        Even if the health department vastly increased its spending, Dr. Adcock said, the public-health message about risky sexual behavior amounts to a whisper at a rock concert when compared to the volumes of sex messages blasting at young people from movies, television, music and music videos.

        “This isn't just a health department issue. It's a community issue,” Dr. Adcock said. “And this problem didn't appear overnight. This is a long-term battle.”

Q & A about sex and risks

---

Recycle plan: Old clothes make new life
VD rate for teens soars in Tristate
Most local school districts too 'rich' for funds
School officials find funding formula complicated
Charges toughened against driver
Driver pleads not guilty in 3 deaths
Jail officer facing sex charges was a felon
Mother sues city after cruiser hit, killed son during chase
National chain plans antiques mall in Tricounty
The meaning of Mecca
Caregivers send cry for help
Sabin Center expansion foes get hearing
Where to build jail? How about 100 miles away?
Actress proves show must go on
Chaim Soutine painting given to Cincinnati Art Museum
Technology makes cleanup of Fernald 'can't-miss' project
Tylenol overdose ends trial
Young star adapts to 'Tavern'
GOP in search mode for Lucas challenger
Church fights zoning ruling
City pushed to add snow equipment
City wants help fixing rail tracks
Cold Spring planners reject development
Court hears accounts of sex abuse of children
Court urged to alter judicial voting
Firemen's discipline undecided
Kenton Co. officials still face liability in inmate's death
Kidnap suspect charged
Lincoln Heights loses manager
Ludlow police, city battle over check
Neighbors don't want Butler jail
New charges in Covington bank robbery
'Read With Me' drive helps kids
Shirey, FOP want to keep target range
TRISTATE DIGEST