The latest government report on sexually transmitted diseases shows increases in gonorrhea and syphilis, while chlamydia rates are mostly flat. It also indicates that teens and young adults are disproportionately affected and that young women may bear the heaviest burden from STDs.

Parents and doctors may be missing opportunities to address some of the issues that arise concerning sex, including STDs, as they work with teens, according to Dr. Stewart Alexander, an associate professor of medicine at Duke University.

The report from the Centers for Disease Control and Prevention says nearly 20 million new sexually transmitted infections occur nationwide, half among young people ages 15-24. Data show that gonorrhea rose 4.1 percent between 2011 and 2012, while primary and secondary syphilis increased 11.1 percent. That increase was solely among men, especially gay and bisexual men. Congenital syphilis, on the other hand, decreased 10 percent and chlamydia remained relatively stable, up just .7 percent.

“Each of these infections is a serious potential threat to an individual's immediate and long-term health and wellbeing. In addition to increasing a person's risk for HIV infection, STDs can lead to severe reproductive health complications, such as infertility and ectopic pregnancy,” the report said.

“While STDs threaten the health and wellbeing of millions of Americans overall, young people bear the greatest burden of all three STDs,” it noted. “Youth aged 15-24 have the highest rates of chlamydia and gonorrhea and those aged 20-24 have the highest rates of syphilis. The health consequences can be particularly serious for young women. CDC estimates that 24,000 women become infertile each year due to undiagnosed/untreated STDs.”

In December, JAMA Pediatrics published a study Alexander was involved in that showed doctors miss the chance to talk to young people about sex-related issues. In high numbers, he noted, doctors are not asking teens about anything to do with sex. “For one-third, there's no discussion, not even a mention asking if they're dating.”

He said the study was intended to look at how doctors counsel young patients to make good choices, but found little counseling on the topic. And because parents don't usually leave the room, when doctors do talk to older teens, any conversation about sex is “very parental and kids usually don't open up. But even when parents leave the room, kids still don't open up.”

The conversations doctors do have with kids tend to be “lectury and pop quizzy,” Alexander said. When physicians do try to engage youths, the youths are often unresponsive.

Meanwhile, experts said parents often avoid the uncomfortable topic as well, so kids are often left to find information — often wrong — from other kids. And they may miss entirely messages that would help them avoid sexually transmitted diseases and also what they need to know about effective treatment.

The stakes are high for kids, who are often making life-altering choices without really considering what long-term consequences might be.

“Here's what happens if kids learn their information from their friends and from the internet,” Alexander said. “They don't get factual information. Boys' perception of sex is very pornographic. All these kids are googling stuff and there are all those free porn sites. They don't get accurate reflection. And it is a missed opportunity for doctors to take care of patients.”

He also noted that parents sometimes bring two kids in to see the doctor at the same time, which might be efficient, but does not foster frank discussion, either.

The importance of having conversations about sex with youths is incalculable, and if adults start those talks in early adolescence, Alexander noted, “maybe the first conversations are awkward, but you build foundations for future conversation.”

Bill Albert, spokesman for The National Campaign to Prevent Teen and Unplanned Pregnancy, a national group based in Washington, D.C., recently noted that teens do appear to be making better choices regarding sex. He said positive peer influence and better decisions are among the key factors explaining why fewer teens are giving birth, having abortions or getting pregnant in the first place.

Albert said surveys of teens indicate that fewer teens are sexually active. Both the National Survey of Family Growth and the Youth Risk Behavior Survey got the same responses. Those surveys aren't perfect, Albert told the Deseret News, but they are designed to encourage youths to answer honestly.

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