The major health concerns for many women in their 20s and 30s are avoiding sexually transmitted diseases and unintended pregnancies. Though there have been some advances in contraception, the situation involving STDs is far more troubling.
"HPV is the epidemic right now," said Dr. Margaret Polaneczky, an obstetrician-gynecologist at New York-Presbyterian Hospital in Manhattan. Her reference was to human papillomavirus, which causes genital warts, cervical cancer and other genital cancers. olaneczky and other doctors say they are seeing more young women who are having more and more sexual partners over time. It's the whole 'Sex and the City' thing," she said.
And that puts them at risk for viruses such as HPV, herpes and HIV -- none of which can be cured, only treated for their symptoms.
The federal Centers for Disease Control and Prevention says HPV is "likely the most common STD among young, sexually active people," affecting 20 million in the United States at any one time. Every year, about 5.5 million acquire an HPV infection, according to the CDC.
There are 30 known types of HPV. Most cause no problem; some cause genital warts, which are unsightly but otherwise benign. But a few types can lead to cervical cancer. The virus is undetectable in about 90% of women after two years, but studies have found that in some women the types that lead to cervical cancer can persist. Constant reinfection from multiple partners greatly increases that risk.
Herpes also is a major concern. About 45 million Americans have had herpes, the CDC says. Caused by the herpes simplex virus, the infection produces blisters in the genital area that usually disappear in two or three weeks. But the virus remains in the body for life and the sores may recur. The virus may be passed on even when the person shows no symptoms, said Dr. Judith Morris de Celis, a clinical associate professor of obstetrics and gynecology at New York University Medical Center in Manhattan.
And then there is potentially lethal HIV. In 2002, there were more than 56,000 women in the United States with either HIV or AIDS, which they had acquired through heterosexual sex, according to the CDC.
The problem is that many women think that condoms are a sure-fire protection against sexually acquired infections. lthough condoms reduce the risk of transmission, they don't eliminate it. Condoms aren't always used properly and some tear or leak. And Morris de Celis said that both HPV and herpes can be transmitted via the scrotum, which is not covered by a condom.
But doctors say that aside from abstinence, condoms remain the best way to reduce transmission of sexually acquired infections. And lacking any cures, they agreed that women need to have frank conversations with their sexual partners and their doctors.
"It really is about finding that middle ground between living a full and joyous life but also remembering you're the only one who is really responsible for your own life and health and you have to take ultimate control," said Dr. Jill Rabin, chief of ambulatory care and head of urogynecology for Long Island Jewish Medical Center.