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Pelvic Inflammation Puts Girls at Risk for Repeat STIs

Behavioral counseling needs to go beyond merely urging safe sex practices, study says

THURSDAY, Nov. 13 (HealthDay News) -- Teenage girls treated for pelvic inflammatory disease (PID) become highly vulnerable to sexually transmitted infections (STIs), sometimes just weeks or months after treatment, researchers at Johns Hopkins Children's Center report.

The findings, according to the researchers, suggest that treating PID "with a prescription and a brochure" isn't enough to change behavior and prevent future repeat infections, which can increase the risk of chronic pelvic pain, ectopic (outside the uterus) pregnancies and infertility.

"Because our findings show PID is not a single isolated incident, doctors should look for ways to change behaviors in girls and not just treat the acute clinical episode. We are talking counseling, we are talking strict follow-up, and, most importantly, we need to develop new strategies that actually work," lead investigator Dr. Maria Trent, a pediatrician and adolescent medicine specialist, said in a Hopkins news release.

The four-year study included 80 Baltimore inner-city girls, ages 15 to 21, who were diagnosed with PID and returned for follow-up. Of those girls, 27 (34 percent) were diagnosed with at least one STI over a six-month period. And of those 27, eight (30 percent) had at least two STIs in the follow-up period.

The findings were published in the November issue of the journal Archives of Pediatrics & Adolescent Medicine.

This study included girls in Baltimore, but teenage girls across the United States probably face similar problems associated with inner-city life and have behaviors that put them at high risk for repeat STIs, the researchers said.

The best times for counseling these girls may be at the time of diagnosis or when they return for the prescribed repeat PID screening within 72 hours. This counseling needs to go beyond simply urging them to practice safe sex or to abstain from sex, the researchers added.

"What we think we need is individually tailored counseling by a clinical provider that is done after an in-depth interview with each patient to determine what aspects of her behavior put her at risk and must change," Trent said.

More information

The U.S. National Women's Health Information Center has more about pelvic inflammatory disease.

-- Robert Preidt

SOURCE: Johns Hopkins Medical Institutions, news release, Nov. 3, 2008

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