It's undeniable: the emotional, physical and psychological satisfactions from sex are beyond compare with almost every other activity we share with another person. The problem is nature has a way of balancing things out. For every pleasure, there is a pain.A recent study by the Centers for Disease Control (CDC) proclaimed that roughly one in four adolescent women in the United States has a sexually transmitted infection (STI). Of the 838 women ages 14-19 surveyed, 26 percent had one or more common STIs, including, but not limited to, human papillomavirus (HPV), chlamydia and trichomoniasis. While these numbers have been widely reported by the media, how do they hold up in our own back yard?

Census figures show that as of 2006 there were 10,386 women between the ages of 15 and 19 living in Santa Cruz County. Using the CDC's "one in four" theory, one could surmise that roughly 2,600 of them have an STI.

In fact, the numbers appear to be much lower than that--although health officials caution that it may be more a matter of underreporting than of having a healthier-than-average populace.

California law requires every health care provider to report cases of certain communicable diseases to the county. Santa Cruz County's 2006 STD data report, released in May 2007, shows 134 cases of chlamydia, 10 cases of gonorrhea and no cases of syphilis reported for females between the ages of 15 and 19. That's a grand total of 144--a far cry from 2,600.

However, the data sets are nowhere near comparable. The age ranges are slightly different (15 to 19 for the Santa Cruz figures, 14 to 19 for the CDC figures). More importantly, the CDC and the county gathered information on different diseases. Santa Cruz County does not collect trichomoniasis and HPV statistics because they aren't required by state law; syphilis was not included in the CDC study. Neither collects figures on HIV.

Paula Haller, STD Controller for Santa Cruz County, says experts just assume the number of reported cases represents a fraction of the reality.

"So many people have an STD, but we just don't know about them. If you look at our 2006 number, some people think you could multiply that by four and get the accurate number of people who have [STIs] in Santa Cruz County. ... A lot of people aren't aware of the urine test [used by the county], so they're afraid it's an invasive test. Some people aren't aware of the confidentiality, or some providers don't ask the right question. There are a lot of reasons that people don't get tested."

One of the biggest advantages of the CDC study is that it randomly selected a cross-section of young women and initiated both a questionnaire and medical exam, so people who were either unaware of an infection or unwilling to get tested were covered in the results.

Haller believes what's important to take away from the CDC's one-in-four finding is not fear but an understanding that STI screening should be a vital aspect of health care. Still, it's hard to not be scared by the numbers. Perhaps solace can be found in the fact that an STI is an infection, and as such there are ways to prevent and combat it. And you're not in the fight alone. For over 90 years, Planned Parenthood has provided a comprehensive approach to sexual health.

"For us, we're concerned about teen safety and making sure we can provide the tools available so that young people can make good judgment calls about sexual activity and being safe," explains Buu Thai. As public affairs director of Planned Parenthood Mar Monte Coastal Region, Thai believes information and testing are the best tools to fight the spread of STIs.

"When we go to a school, or in our clinics, we advocate comprehensive sex education--age-appropriate and medically accurate information. I know there have been other reports about abstinence-only, and we feel that abstinence-only is only one aspect, and it's not going to deter young people from having sex. So we err on the side of providing the comprehensive picture." In any given year, the Westside Planned Parenthood will see approximately 22,000 to 25,000 patients. "We talk to them about symptoms and provide visuals as a way of education, not as a scare tactic but to let them know what the symptoms are."

Even with education and precautions, it's still possible to contract an STI. Planned Parenthood and health care providers can offer not only education and testing but treatment for patients with an STI. In California it's also legal for a health care provider to issue partner-delivered treatment, meaning a clinician can write a prescription for a patient's partner. Another tool, Inspot.com, is designed to electronically and anonymously allow you to notify any past bed mates if you've tested positive for an STI.

STIs continue to be a major factor in our sex lives. Luckily there are just as many organizations out there with resources to help people play safe. Nature is an equalizer, but it isn't malevolent in its design.

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