Safe Teen Relationships

Q & A with John Douglas, M.D., Centers for Disease Control and Prevention.

Dr. John Douglas is the Chief Medical Officer of the CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention (NCHHSTP).

His responsibilities include developing and directing CDC’s national STD prevention programs. Dr. Douglas received his undergraduate degree from Davidson College and his medical degree from Harvard Medical School. He is a leading authority on the prevention and management of STDs. He’s also father of a teen and offers advice for how to talk to teens about safe sex and STDs.

BSBW: What are important things for young people, especially young women, to know about getting tested?

John Douglas: First of all you don’t have to have symptoms to need a test. So you shouldn’t wait if you’ve been in a risk situation for symptoms to develop to be tested. Two, young people ought to be as assertive as possible with their health care providers about "Are you doing testing and what kind of testing are you doing?" Because there’s often an assumption, especially among women that if they’re having any sort of genital examination, such as a pap smear that everything’s being done and everything’s being taken care of and that’s not the case.

STD testing requires - it can be easily done at the same time of these genital tests or pap smears but it requires a doctor to do that specifically. Now the prevention take on or the testing take on that …we’re really trying to get the public to understand is that chlamydia testing in young women is one of the most important things that they can do to protect their health.

We’ve been recommending annual testing for chlamydia in women under the age of 26 who are sexually active for the past ten years. And we know it’s a complicated situation. We know that young people don’t know they need the test, which is why we’re so happy to find ways to get this information out there. And we know that when young women ask their doctors, I’d like a chlamydia test. Are you doing a chlamydia test today? Can we be sure I get a chlamydia test? It’s more likely to get done.

BSBW: What is important for young men to know about STD testing?

John Douglas: STD testing for men is a little bit of a different situation. Men can have the infection without having symptoms. But more commonly they do have it.

So for men we largely recommend if you’re developing signs or symptoms in your genital tract, such as a discharge from your penis, such as sores on your penis they could suggest an infection. That’s the time to go in and be seen.

BSBW: What are some common misconceptions about STDs?

John Douglas: Don’t assume that if you don’t have symptoms you don’t have an infection. Two, don’t assume that if the person you are planning or already having sex with has been sexually active with other people but looks healthy, looks clean, talks a good line, don’t make the presumption that they don’t have a sexually transmitted infection either.

Misconception number three don’t assume because you’ve been to a doctor and even had a genital assessment that you’ve had an STD test done. You’ve got to ask. There are a lot of things that busy physicians need to do and if they’re not being prompted or reminded in some circumstances about the need to do STD testing it may not happen.

And then finally the biggest misconception is this notion of stereotype and stigma. It’s only the people that really mess around a lot. It’s only the people that are irresponsible. It’s only the people that are being careless that get an STD, absolutely not the case.

BSBW: What are important vaccinations young people and parents should know about?

John Douglas: Everybody ought to get a Hepatitis B vaccine. That’s now being done very generally in young adolescents and is more or less being taken care of by the broad immunization programs. There’s a new vaccine for Human Papilloma Virus, HPV infection.

BSBW: Why is it so hard for parents to talk to their young sons and daughters about sex and its possible consequences?

John Douglas: We like to look at it. We like to use it to market but we don’t do a very good job of talking about it. And I think parentally speaking point number one is realize, yes, we’re all starting with a level of discomfort. I tried six months ago to have a conversation with my 14-year old son about sex. He had a new girlfriend and the answer I got was dad I don’t want to do the talk, not now.

And you know as America’s STD professional at CDC that sort of set me back a little bit. And I had to confer with my wife. And one of the things she pointed out to me is pick your time. Pick your battle and don’t give up after one for right. And a month later in a different circumstance we brought it up again and actually had a different conversation. So I mean I would feel like I should be prepared as any parent but I didn’t get it right the first time and I had to go back again and talk.

I think we need to pay attention to our kid’s cues. You know sometimes they will alert us by asking questions that may seem awkward or embarrassing and we may not want to really talk about it, but cherish those moments. When they come up try to take advantage of them. And try to realize that by meeting your kid where they’re at you’re much more likely to be able to engage in the kind of dialogue that you’d like to take part in.