IU School of Medicine Establishes Nation's First Adolescent Sexually Transmitted Disease Center

INDIANAPOLIS -- The Indiana University School of Medicine is the recipient of a $7 million National Institutes of Health grant creating the nation's only sexually transmitted disease center focusing solely on adolescents.

Donald Orr, M.D., said the long term goals of the newly established Mid-America Adolescent Sexually Transmitted Disease Cooperative Research Center is to understand what adolescents and parents can do to increase protection and decrease risk for sexually transmitted infection in teens. Dr. Orr is the director of the Section of Adolescent Medicine at IU School of Medicine and principal investigator for the five-year study funded through the National Institute of Allergy and Infectious Disease, a division of the NIH.

Last year the National Institute of Medicine identified sexually transmitted diseases (STD) as a hidden epidemic. There were 14 million reported STD cases in the United States in 1995 and 3 million of those cases were in adolescents. Health care costs that year for STD treatment totaled $8 million. In the U.S., 65 percent of all reported STD cases occur in individuals between the ages of 15 and 24 years.

Dr. Orr, who is a pediatrician at James Whitcomb Riley Hospital for Children, began his research into sexually transmitted diseases in adolescents 15 years ago with funding provided by the Riley Memorial Association. The NIH grant, which moved the IU Department of Pediatrics into the top 15 pediatric departments nationwide for NIH funding, will allow Dr. Orr and his colleagues to expand their research efforts.

"Adolescents are targeted because they are at highest risk of any age group," said Dr. Orr. "That is a result of a combination of factors including biological, social and behavioral issues, including the fact that teens are becoming sexually active at an earlier age."

In Marion County, Indiana, which includes Indianapolis, the average age of first sexual intercourse for youths with STD infection is 13 years for males and 14 years for females. The neighborhoods in which youths live place some at higher risk for contagion, Dr. Orr explained.

"Adolescents who live in suburbs are proportionately at less risk for gonorrhea or HIV and more at risk for chlamydia and human papilloma virus, which can cause cervical cancer," he said. "Adolescents in the inner city are at higher risk for all STDs."

However, even within neighborhoods where adolescents are at risk, not all teens who are sexually active get sexually transmitted diseases. That is one of the primary issues to be examined by Dr. Orr and his colleagues. Two factors are believed to be involved: behavioral issues such as the use of condoms and partner selection, and biological factors related to the way the organisms infect the body and the body's natural barriers to infection.

Within the next few months, 600 girls between the ages of 14 and 16 and their mothers will be enrolled in the study. The teens, who may or may not be sexually active, will receive regular checkups and education on behavioral issues. The teens will be followed for a 27-month period to obtain behavioral and biological data to determine why some at-risk adolescents become infected and some do not. The mothers will not be involved in the clinical aspect of the study; they will receive the educational materials on the behavioral issues.

The study will focus on four sexually transmitted diseases: chlamydia, gonorrhea, trichomonas and human papillomavirus. Chlamydia and gonorrhea, along with some other sexually transmitted diseases, place individuals at greater risk for contracting HIV.

Involved in the study will be researchers from the IU School of Medicine, Northwestern University, Louisiana State University and the University of Iowa.

The IU School of Medicine also is home to the Midwest Sexually Transmitted Disease Cooperative Research Center, which focuses on research and treatment of adults with sexually transmitted diseases.

Contact: Mary Hardin
317-274-7722
mhardin@iupui.edu
or Ellen Gullett
317-274-7722
egullett@iupui.edu

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