San Francisco Chronicle; Friday, August 23, 1991
Nanette Asimov, Chronicle Staff Writer

The infection rate was 160 cases per 100,000 San Francisco teenagers ages 15 to 19 last year, compared with a national average of 27 cases per 100,000 teenagers in the same age range, according to figures from San Francisco Department of Public Health.

At a time when San Francisco public school leaders are considering offering condoms and other contraceptives to students at Balboa High School, health officials say the numbers indicate that unsafe sex is on the rise among teenagers.

Similarly high rates appear among teenagers in other large cities, such as New York, Los Angeles and Chicago.

"Something needs to be done," said Dr. Charles Wibbelsman, a pediatrician. Wibbelsman was speaking for a committee of medical experts that suggested to Superintendent Ramon Cortines yesterday that condoms be made available to students at the city's only on-campus clinic, at Balboa.

He called the situation "a serious problem throughout our school system" and said, "We're looking at a scenario that is very similar to 1981, where you had very high rates of syphilis and gonorrhea just prior to the AIDS epidemic. As medical-care providers, we need to take responsibility and prevent (teenagers) from becoming HIV statistics." HIV is the human immunodeficiency virus, which causes AIDS.

Syphilis, in particular, increases the risk for HIV infection because its symptoms include open sores, said Paul Gibson, a City Clinic director specializing in sexually transmitted diseases.

"The reason the sexually transmitted disease rates are so high is that teenagers are having unsafe sex," he said. "Teens are naturally sexually inquisitive. It's too simple to say it's ignorance, and too simple to say they refuse to have safe sex. Information alone won't stop it. You have to include condoms, give people the tools with which to protect themselves, and you have to give them skills."

Although gonorrhea infections have declined slightly among San Francisco teenagers during the past five years, the rates are still 42 percent higher than the national average, Gibson said.

His clinic compiles local figures and compares them to national data supplied by the national Centers for Disease Control in Atlanta.

After reading the four-page proposal by the School Health Advisory Committee yesterday, Superintendent Cortines said he would approve the new Balboa program only if the distribution of condoms and contraceptives were accompanied by sex education emphasizing abstinence and if the program involved parent participation.

"I cannot ignore those numbers, and we must do something to prevent them," Cortines said. "But handing out (contraceptives) across the counter won't do it. I will not be supportive of anything that does not involve the parent and that does not have a major component of abstinence."

Cortines also said the school district offers sex education too late.

"The increase in disease and teenage pregnancy, and the life- and-death issue of AIDS (means) there needs to be more than the perfunctory 10th-grade course on sex education," he said. "There needs to be an education program at the middle-school level."

As it stands, the proposal is unclear about the role of parents or when sex education should be offered. It states, however, that students "will be provided information about abstinence, effective use of condoms and other forms of birth control that is age-appropriate, language-specific, and culturally sensitive."

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CHART: SAN FRANCISCO SYPHILIS INCIDENCE

Number of cases per 100,000 population for 15- to 19-year-olds.

1986 44.8

1987 42.5

1988 66.1

1989 99 (U.S. average 27)

1990 160

Percent change in San Francisco since 1986 = 357%

Source: San Francisco Dept. of Public Health, National Center for Disease Control

CHRONICLE GRAPHIC

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