Long before girls make the very adult decision to become sexually active, a routine vaccine that recently became available can protect them from becoming infected with the human papillomavirus (HPV) — one of the most common sexually transmitted diseases (STDs) in the world and a leading cause of cervical cancer and genital warts. Yet only 1 in 4 girls in the United States is getting the immunization, according to the first government survey of the vaccine's use.
Looking at immunization information about nearly 3,000 teens, the Centers for Disease Control and Prevention (CDC) found that just a quarter of teen girls are getting the recommended HPV vaccine (called Gardasil). The vaccine is recommended for girls 11 to 12 years old, and a "catch-up immunization" is recommended for 13- to 18-year-olds girls who haven't gotten it yet.
The vaccine is given in a series of three shots over a 6-month period and protects girls from four types of HPV. And that's huge, considering that the STD actually affects more than half of sexually active people at some point in their lives — about 6.2 million people each year, in fact. And, according to the CDC, about half of those infected are just 14 to 24 years old.
More on HPV
Girls may contract HPV in their teenage or young adult years through intimate sexual contact and then develop cervical cancer years later. HPV can sometimes also lead to genital warts, but often there are no physical signs of infection. When symptoms do crop up, genital warts may be painless, flesh-colored growths or bumps (that may appear in and around the vagina, anus, or on the cervix in females and on the penis, scrotum, groin, or thigh in males).
Although men infected with HPV can also be at higher risk for cancer of the penis and the anus, the HPV vaccine isn't recommended for boys yet, although immunization experts are considering it.
Like most STDs, HPV infections and genital warts can only be prevented for certain by not having sex or by having sex only with one uninfected partner. Condoms do offer some protection against HPV, but they can't completely prevent infections because the warts can be outside of the area protected by the condom. Spermicidal foams, creams, and jellies have not been proven to protect against HPV and genital warts.
So, even if your daughter isn't sexually active and may not be for a long time, the HPV vaccine has the best chance of protecting her against infection if the series of shots is given before she becomes intimate with anyone. If you have any questions about the vaccine, and whether it's appropriate for your daughter, talk with your doctor.
What This Means to You
Before kids and teens decide to engage in any kind of sexual activity, they need to understand its many adult consequences. So it's important to talk to your kids before they're already in the heat of the moment and it's too late. Consider that it only takes one instance of unprotected sex for your child to become one of the nearly 1 million teenage girls in the United States who have babies every year or the 1 in 4 (an estimated 3.2 million) teenage girls in the United States with an STD.
So, it's wise to establish an ongoing dialogue about sexual development, decision-making, and values as kids grow instead of waiting to have "the talk" in one big, potentially awkward summit.
Many schools start sex education in the fifth or sixth grade, but it's best to gradually begin the conversation long before this, when kids already may be starting to go through some of the emotional and physical changes of puberty. This can help them feel far more prepared when their bodies and brains start maturing and they begin experiencing new and often confusing feelings. Plus, they'll feel more comfortable coming to you with questions.
Whenever you decide to discuss sex with your kids, here are some things to keep in mind:
- Seize the opportunity to have natural, in-context "teachable moments" early on.
- Approach discussions about sexuality like you would any other health topic — as a normal part of the human experience.
- Try to openly address the issue, without getting too emotional or preachy.
- Answer questions as honestly as you can, keeping kids' ages and maturity in mind. You can always start with less detail and add more as they become more curious. If you don't know an answer, say you'll find out or look up the answer together.
- Give the facts, but also give them a sense of where you stand. Explain your values and why you feel that way.
- If your kids are in sex-ed classes in school, talk to the teacher about ways to coordinate discussions at home with the school's lesson plans.
- Set the record straight. Although sexually active teens may be more worried about having a baby than getting an STD, they need to realize that:
- You can't get pregnant if you have oral sex, but you can get an STD like gonorrhea, chlamydia, syphilis, warts, herpes, or HIV.
- Some STDs (like genital warts and herpes) also can spread through intimate skin-to-skin contact without actual vaginal or anal penetration.
- A latex condom is an absolute must for anyone who decides to have vaginal or oral sex. But only complete and consistent abstinence can totally prevent pregnancy and protect against all STDs.
If your teen is (or even might be) sexually active, schedule regular full physical exams, which can include STD screening for boys and girls, and a Pap smear plus the HPV vaccine for girls.
Whether your kids are far from being sexually active or already in an intimate relationship, help them comprehend how their decisions today really can have a long-lasting effect on their lives now and far into the future.
And although it may feel awkward, having these discussions doesn't mean your child will then want to have sex. In fact, studies have proven that informed teens are not more likely to have sex, but they are more likely to practice safe sex if they do decide to become sexually active.
Reviewed by: Steven Dowshen, MD
Date reviewed: October 2008
Source: "Vaccination Coverage Among Adolescents Aged 13–17 Years — United States, 2007," Morbidity and Mortality Weekly Report (MMWR), Oct. 10, 2008.