SAN FRANCISCO: Teens Exhibit Low Birth Rates, High STD Rates
Although the birth rate among San Francisco teens is lower than the statewide average, they have STD rates higher than any other age group in the city, according to a recent report by the San Francisco Department of Public Health (San Francisco Department of Public Health release, 1/23). According to the report based on 1997 data, "A Snapshot of Adolescent Health in San Francisco," 6% of all San Francisco high school students, or 16% of sexually active students, reported either having been pregnant or having gotten someone pregnant, resulting in a birth rate of 17.5 per 1,000 females ages 10-19, compared to the state rate of 27.7 per 1,000 females of the same age. More than 90% of teen births were to minority females, with the largest figures among Latinas (46%) and African Americans (28%). Pregnant adolescents were less likely than older women to receive prenatal care during the first trimester, with 65% of pregnant teens ages 12-15 receiving such care, compared with 87% of women over age 20. According to the report, 87% of middle school students and 68% of high school students said they had never engaged in sexual intercourse. But 45% of sexually active middle school students have had at least three partners and 27% of sexually active high school students have had four or more partners. Sixty-one percent of middle schoolers and 60% of high schoolers used condoms the last time they had sex. For both middle school and high school students, males were more likely than females to have had sex.
Teen Births, STDs
According to the report, teenagers had higher rates of STDs than older San Francisco residents. Although cases of chlamydia and gonorrhea have declined steadily from 1994 to 1997, teens ages 14-20 have rates of both infections that are higher than those of other age groups in the city. Among that group, there were 825 cases of chlamydia and 182 cases of gonorrhea in 1997. According to the report, gonorrhea rates are "1.3 times higher and chlamydia rates are three times higher among adolescent females than males." Overall, African-American teenagers exhibited the highest STD rates, with Native Americans, Latinos, whites and Asian/Pacific Islanders trailing.
HIV/AIDS
Because the delay between HIV infection and the development of AIDS symptoms is about 10 years or longer, the majority of individuals diagnosed with AIDS who are between the ages of 20 and 29 years are thought to have become infected as teenagers. Consequently, the researchers estimated that 15% of 29-year-old San Francisco men who had had sex with men but did not inject drugs HIV-positive in 1997. In 1998, 1% of young adults ages 12-24 tested positive for HIV at the San Francisco Department of Public Health City STD Clinic. Additionally, as of last May, 3,147 individuals ages 13-29 have been diagnosed with AIDS, representing 12% of all AIDS cases in the city and 1.2% of the city's population under age 30. From statistics through last April, the largest category of HIV transmission for individuals ages 13-19 was men having sex with men (49%); heterosexual transmission accounted for 10% of HIV cases. For individuals ages 20-29, men having sex with men was also the highest mode of transmission (72%); heterosexual transmission accounted for 2% of cases.
What Now?
The authors conclude, "We know that many of the health problems experienced during adolescence are related to preventable risk- taking behaviors. By creating and promoting programs and policies that address healthy youth growth and development and family support and education, San Francisco can begin to build a healthier community." To obtain a copy of the report, visit the San Francisco Department of Health Web site, at www.dph.sf.ca .us (Duh/Shalwitz, "A Snapshot of Adolescent Health," 11/99).