Researchers at Magee-Womens Research Institute found undiagnosed sexually transmitted diseases in 18 percent of teenage girls who provided vaginal samples they collected themselves during a two-year study. The researchers, who are affiliated with the University of Pittsburgh, reported their findings in the June issue of Sexually Transmitted Diseases, the journal of the Sexually Transmitted Diseases Association. Also known as venereal diseases, sexually transmitted diseases (STDs) include a variety of infections such as chlamydia, gonorrhea, syphilis, trichomoniasis and genital herpes. Chlamydia is the most common sexually transmitted disease in the United States, affecting an estimated 13 percent of women.
"The study is significant because it shows that a self-testing option can be very valuable in detecting previously undiagnosed STDs in an adolescent population," said primary study author Harold Wiesenfeld, M.D., an assistant professor of obstetrics, gynecology and reproductive sciences at the University of Pittsburgh School of Medicine.
He is also a physician in the departments of gynecology and infectious diseases at Magee-Womens Hospital of UPMC Health System.
"Nearly 13 percent of women had never previously had a gynecological exam tested positive for an STD, and 51 percent of infected students would not have pursued STD testing by traditional gynecological examination," wrote Dr. Wiesenfeld.
Two hundred and twenty-eight female students aged 15 to 19 took part in the study through school-based health clinics at two Pittsburgh-area high schools in 1997 and 1998. Students were instructed on how to collect vaginal swabs, which were then tested in labs at the Magee-Womens Research Institute. Disease rates identified were trichomoniasis, 10 percent; chlamydia, 8 percent; and gonorrhea, 2 percent. Trichomoniasis can cause painful inflammation, itching and vaginal discharge. A bacterial infection, gonorrhea is one of the most common infectious diseases in the world.
Untreated STDs can result in loss of fertility, and, in some cases, have extreme long-term consequences including heart valve inflammation and arthritis. Pelvic inflammatory disease, which is often a complication of infection, is a major cause of infertility, ectopic pregnancy and chronic pelvic pain. Trichomoniasis has been associated with pregnancy complications such as premature fetal membrane rupture. In addition, the link between STD infection and HIV transmission is becoming ever more apparent.
"Self-collection of vaginal swabs was almost uniformly reported as easy to perform, and preferable to gynecological examination," the authors wrote. "Nearly all stated that they would undergo testing at frequent intervals if self-testing was available."
"Symptoms of some sexually transmitted diseases are often unclear, or even absent," noted senior study author Richard Sweet, M.D., the Lawrence Milton McCall Professor and chairman of the university's department of obstetrics, gynecology and reproductive sciences. "In fact, most of these girls came to the health clinics for other reasons entirely, like a sports injury or a headache."
