Volume 7 Review Number 12 14 November 1997 ISSN 1350-9349 Sexually transmitted diseases among teenagers in England and Wales N Connor, M Catchpole, P A Rogers, N MacDonald, C McGarrigle, I Simms, et al R173-8 CD4 cell counts of 200 × × × × × 10 6 /l or below in natural history studies and surveillance: is one enough or are two better? P J Easterbrook, L M Yu, K McLean, D Hawkins, B Gazzard R179-85 Leptospirosis in the Republic of Ireland: 1985 to 1996 M C Hogan, G Pate, S J McConkey, D O’Flanagan, C Mongan, G J Mellotte R185-9 Outbreak of cryptosporidiosis associated with a swimming pool in Andover T Sundkvist, M Dryden, R Gabb, N Soltanpoor, D Casemoor, J Stuart R190-2 Sexually transmitted diseases among teenagers in England and Wales N Connor, M Catchpole, P A Rogers, N Macdonald, CiMciGarrigle, I Simms, L Radcliffe, V Gilbart, S E Clarke, J iWebster, A Nicoll Summary A profile of sexually transmitted diseases (STDs) and HIV infections among teenagers in England and Wales was obtained from reports of newly diagnosed STDs among teenagers attending genitourinary medicine (GUM) clinics in 1995, laboratory reports of newly diagnosed HIV infections between 1985 when reporting began and the end of 1995, and the prevalence of HIV (unlinked anonymous programme) among teenagers attending genitourinary medicine clinics and antenatal clinics in 1994 and 1995. STD reports were analysed by sex, age group, and place of residence of patients – whether in the NHS Thames regions or elsewhere in England and Wales. High rates of STDs were reported in teenagers, particularly in girls. The incidences of gonorrhoea, chlamydia infection, and first attack genital wart infections were higher in teenage girls than in any other age group. Boys under 16 years of age had substantially higher rates of infection with all STDs in the Thames regions than elsewhere. Rates of gonorrhoea in teenagers of both sexes in the Thames regions were more than twice those in the rest of the country. Infection rates for genital herpes, and chlamydia in girls, were also higher in the Thames regions, although the geographical differences were less marked. The seroprevalence of HIV among heterosexual teenagers was very low. In contrast, 226 HIV infections among teenage boys had probably been acquired through sexual intercourse with other males. Unlinked anonymous testing revealed HIV antibody in 7.5% of routinely collected serology specimens taken from teenage homosexual or bisexual males attending GUM clinics in London. The high rates of STDs among teenage girls and all teenagers in the Thames regions make these groups a high priority for sexual health promotion, with special consideration given to homo/bisexual male teenagers. Detailed surveillance of risk factors for STDs, and further studies of teenage sexual behaviour will help to effectively target resources to improve the sexual health of teenagers in England and Wales. Key words: adolescent medicine – chlamydia – condylomata acuminata – demography – epidemiology – gonorrhoea – herpes genitalis – HIV – sexuallyitransmitted diseases Introduction Adolescent sexual culture in industrialised countries has changed over the past four decades. The effect of a trend towards a younger age at first intercourse but unchanging age at first marriage or partnership has resulted in an expanded ‘risk window’ during which young people may have many sexual partners 1 (figure 1). High rates of partner change and unprotected sex during this ‘risk Correspondence to: Editor CDR, PHLS Communicable Disease Surveillance Centre, 61 Colindale Avenue, London NW9 5EQ Tel: 0181 200 6868 Fax: 0181 200 7868 Telex: 8953942 Public Health Laboratory Service CDR REVIEW © 1996 Communicable Disease Review