It is Friday evening and Madison Dyer has dropped by a Tempe Starbuck’s on her way home. Tall, blond and willowy, Dyer carries herself with a confidence that belies her age; she is 20 until mid-September.
As she adds sugar to her latte, Dyer is talkative and more than willing to discuss in great detail her plans for the night.
“I have to go home and get ready and wait for my roommates to get home,” says the hazel-eyed, part-time ASU student. “We are going out in Scottsdale for awhile, then back to Tempe for a party a friend is having.”
She goes on to list the clubs she and her friends will visit; unlike her, both of her roommates are 21, and the trio rarely has a hard time getting past doormen.
Dyer leans on the counter and offers her philosophy on dating, as well as a checklist for the standards that potential dates must meet – a height requirement, high level of intelligence and an air that says he is “not an obvious player.”
When asked where the evening might lead, she is coy.
“Well, that’s hard to say,” she says. “It just depends on what sorts of interesting people and situations come my way.”
But when the discussion turns to the topic of sexually transmitted diseases – What does she know about them? Does she always use protection? Are she and her friends concerned enough to ask potential partners about their sexual history? – the young woman who was just a self-possessed chatterbox becomes visibly uncomfortable and clams up.
The conversation, she says, is over.
So, as a result, is any discussion about the fact that the United States has the highest rate of STDs among industrialized countries, that 12 million Americans – even young, well-educated ones with good hygiene – acquire an STD every year.
In Phoenix and Tempe, the risk 18- to 29-year-olds face is growing. Cases of syphilis, a physically and mentally destructive disease that causes blindness, psychosis and death, are rising – even as the disease is eradicated in most other parts of the country.
Dyer’s hear-no-evil reaction is common among the college-aged crowd, say sexual-health advocates.
For years, they were bombarded with scare-tactic advertisements about AIDS, drugs and other STDs – the majority of which vastly overstated the problem.
“I call it the ‘Reefer Madness approach,'” says Drew Pinsky, the California doctor better known as Dr. Drew of the radio and television sex-Q and A show Loveline, referring to the 1936 propaganda film that suggested pot smokers would turn into rapists and murderers.
“To this day, I can’t have an intelligent conversation about the dangers of marijuana because during the ’70s it was so drilled into kids that something horrible would happen to them if they smoked pot.
“When they saw that the things they were told – that they would move on to shooting up, that they would become vegetables, that they would go insane – didn’t happen, they stopped listening to anything that has to do with the consequences of smoking pot.
“That’s how it is now with STDs,” he continued. “For awhile they all believed they were going to get AIDS. Then they found out that the danger had been overstated, and they slipped back into their previous behaviors.”
These scare tactics, Pinsky says, only work in the short term.
But even honest discussion about the risks of unprotected sexual activity isn’t typically enough to cause a change in behavior.
“There’s a huge distance between what (younger adults) know and how they adjust their behavior to fit with what they know,” he says.
As for syphilis, Pinsky says it “doesn’t even register on (their) radar screens.”
“It sounds medieval, like something Christopher Columbus would get,” he says. “It is weird to them, foreign. You might as well talk to them about the risk of leprosy.”
The Centers for Disease Control reports that syphilis last hit epidemic levels in 1990.
For those who seek treatment early, the disease is easily curable with penicillin.
But for those who don’t get treatment, the disease gets worse. Most get tricked because the initial genital sores go away and, for some time, there are no visible symptoms.
During this time, however, the disease is actually getting worse. Syphilis progresses in stages – ending in damage to the heart and nervous system, blindness and dementia.
While syphilis primarily targets established risk groups, such as prostitutes, the story of the so-called “lost children” of Rockdale County, Georgia, serves as a cautionary tale for anyone who doesn’t take the risk seriously.
No red flags pop up when you see the statistics on this suburban Atlanta area. The kids are mostly white and middle-class. But that didn’t stop a syphilis outbreak from erupting amongst this unlikely group in 1996.
Claire Sterk, a professor at Emory University School of Public Health, was part of the team that investigated the outbreak. She told PBS’s Frontline in 1999 that her first meeting with the group of teenage girls who were exposed surprised her.
“(They) looked like what I would call sweethearts, without meaning that in a negative sense,” she said. “They had soft faces, soft expressions, their voices were soft. They acted insecure, had shy smiles.”
She said they blushed when they talked about the sex that had lead to the outbreak. Initially, Sterk said, they built up an image of “poor, innocent girls who were sucked into a situation” they had no control over.
The truth, however, was much different.
The girls, who ranged in age from 13 to 16, were participating in what amounted to orgies, in which no sexual act or number of partners was considered taboo. These encounters took place at the girls’ homes and, eventually, in local hotel rooms.
“There wasn’t a situation where the older kids were forcing the younger kids to engage in something,” Sterk said on the program. “In many ways it was seen as a special status to be invited to these events.
“In many ways we could compare this to just teenagers making plans for what they’re going to do tonight and you could be the teenager who was sitting at the phone waiting eagerly for a phone call, hoping that you’re going to be invited that night.”
The current syphilis rate in the Valley is hard to compare to what happened in Georgia. The age group in Arizona is higher, and most of those diagnosed with the STD fit into more traditionally affected groups.
Still, the rise has made Maricopa Country second in the nation in syphilis rates, and the current outbreak lead to the deaths of five babies last year whose mothers passed the disease onto them at birth.
But it’s not just syphilis that is on the rise. Chlamydia – one of the most common STDs affecting those of college age, along with gonorrhea and genital warts – is going up, as well.
Besides abstinence, condoms remain the best tool for prevention. And the fewer sexual partners one has, the better.
“Abstinence is becoming a more normal behavior” among teens and college students, Pinsky says. “The reality, though, is that there are plenty of them who are going to (have sex). We have to arm them.”
Anyone who is having sex, he says, should view safe sex like wearing a seatbelt.
“It has to be something you do all the time.
“If you just wear your seatbelt 98 percent of the time, it cuts way down on its effectiveness. It’s the same with condoms. If you are going to have sex, you have to be alert and aware and accepting that this is behavior that carries risk.”
Pinsky says that he sees a real revival in dating versus hooking up for a one-night stand.
“Many young people are moving from hook-up culture to relationship culture,” he says. “Young people are looking for more substance. I’ve definitely seen the trend happening.”
ASU student Austin Johnson and his friends are part of that trend. The 19-year-old sophomore has a girlfriend, as do, he says, about half of the guys he hangs out with.
“My friends and I are all about meeting somebody and getting to know her,” he says. “We’re mostly all looking for someone to have a relationship with, somebody you could be with and not have to worry about things like (STDs).”
Johnson’s levelheaded demeanor, however, is offset by his belief that there is a certain “kind of girl” who is prone to passing on a disease.
While he says that he and his friends “always think about safe sex and generally practice it,” he goes on to say that “the people we choose are not those who we think would have an STD). We avoid people with bad reputations or those who seem like they get around.”
Johnson’s biggest fear is not an STD.
“What we worry most about is pregnancy,” he says. “That is what we are thinking of when we think of safe sex. You hear about someone who was our age and they have a kid and it changed their lives forever.
“If I had to pick between getting somebody pregnant and getting an STD, I guess I’d rather have an STD. I think it would have less effect on my life.”