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Cautions for and from teens

Safer-sex campaign makes use of peers on Facebook, YouTube, cable

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By Stephen Smith
Globe Staff / August 4, 2009

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Alarmed by the rampant spread of sexually transmitted germs among Boston teenagers, city disease trackers will unveil a safer-sex campaign today that aims to talk to adolescents via their preferred modes of communication: Facebook, YouTube, and cable channels.

Rising rates of chlamydia, an often silent disease that can cause infertility in women, illustrate the scope of the challenge. In 2007, 1,383 Boston youths between 15 and 19 years old were diagnosed with chlamydia, a 70 percent increase since 1999. The overall rate of the infection in Boston is more than double the national average.

It is evidence, specialists speculated, of teenagers’ casual attitudes about sex, parents’ shifting attention to other children’s health concerns, and improved screening by physicians. Doctors said they regularly encounter patients who are barely old enough to drive and yet suffer the consequences of unprotected sexual activity.

Boston’s health agency had $100,000 for campaigns related to communicable diseases, but specialists grew so concerned about the incidence of sexually acquired diseases among teenagers that they decided to devote the entire amount to the new campaign. Chlamydia and gonorrhea, another disease transmitted through sexual activity, are more common among Boston adolescents than any other age group.

While those diseases can be treated effectively, swiftly, and cheaply with standard antibiotics, physicians fear that their spread could be a harbinger of another sexually spread disease that is vastly more expensive to treat and has the potential to kill.

“These chlamydia cases and gonorrhea cases, they’re our future HIV cases unless we intervene,’’ said Dr. Anita Barry, top disease specialist at the Boston Public Health Commission.

In the new campaign, teenagers will do much of the talking. They are the stars, and the inspiration, for a video that provides the ABCs of what teens and doctors call STIs, sexually transmitted infections.

“They told us, ‘We don’t want some old 40-year-old woman telling us about sex and STIs,’ ’’ said Margaux Joffe, multimedia coordinator at the Public Health Commission. “We laughed, but it makes sense. You may not trust the advice of an adult as much as you would someone in your peer group.’’

The video will be aired on the favorite cable haunts of teens: MTV, FX, and BET. Chosen from 10 submitted in a contest, the video shows teenagers in a classroom learning about safe sex, including the importance of condoms and of being screened for sexual diseases so they will not unwittingly spread them. The video does not discuss abstaining from sex.

There will also be ads plastered on mass transit and blaring from the radio.

On Facebook, teenagers can anonymously post questions about sexual health that will be answered by disease specialists. On YouTube, they can watch videos related to the campaign, including the other nine submitted in the contest.

And teams of teenagers will sweep across the city, performing street theater on the dangers posed by the infections.

“Having a multilevel approach to address the issue for youths is a great strategy,’’ said Dr. Mark Schuster, chief of general pediatrics at Children’s Hospital Boston, who was not involved in the design of the campaign. “If you just have a program in the school, the kids can be interested and learn from it, but they need it in other settings, too. It’s really important to reach youths and parents in multiple ways.’’

That’s because the rise in sexually transmitted diseases is a reflection of multiple forces.

Today’s teenagers, for example, no longer live in the shadow of AIDS in the same way their forerunners did, so protecting themselves no longer seems quite as important. A city study released earlier this year found that 56 percent of Boston public high school students report that they have had sex, and 24 percent of the sexually active students said they have had more than six partners. They may say, “ ‘Hey, I may get HIV, but it’s treatable and I’m going to live,’ ’’ said Dr. Lydia Shrier, an adolescent medicine specialist at Children’s. “It’s not a death sentence to them.’’

Their parents may now be more obsessed with obesity and its consequences than about sexually transmitted germs, said Schuster.

Dr. Stephen Boswell, a veteran tracker of such germs, cautioned that some of the reported increase in sexually transmitted diseases in teenagers may reflect better screening. “Docs have been pressed for many years to screen much more carefully kids at younger and younger ages,’’ said Boswell, president of Fenway Health.

But Dr. Alfred DeMaria, the state epidemiologist, said that he believes the germs are actually spreading more widely.

Stephen Smith can be reached at stsmith@globe.com.

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