Efforts to curb the spread of sexually transmitted diseases should begin long before most people start having sex, say authors of a new study on STDs and childhood from the University of Washington Schools of Public Health and Social Work.

Lisa Manhart

The study, in the Journal of Adolescent Health, found that children who enjoyed school, grew up in well-managed households (with rules, discipline and rewards), and had friends who stayed out of trouble reported fewer sexually transmitted diseases as young adults.

The study was based on data from nearly 2,000 Seattle-area participants in two youth-development surveys that began in the mid-1980s and early 1990s. Nationally, about 20 million new cases of sexually transmitted infections occur each year, nearly half among young adults 18 to 24.

"A lot of prevention happens after the fact," said co-author Dr. Lisa Manhart, associate professor of epidemiology. When prevention programs are effective, she said, they are "very short term, like dieting. What we don't do often in the STD prevention world is think about why people engage in sex early, why they don't use condoms, and what drives these risky behaviors."

The lead author, Dr. Marina Epstein, a researcher at the UW's Social Development Research Group, said prevention efforts should take into account family dynamics and youth development. Dr. Karl Hill, research associate professor, was principal investigator of the study, which was funded by the National Institutes on Drug Abuse (NIDA).