Adolescent girls who use alcohol and other substances are disproportionately more likely to engage in risky sexual behaviors that can result in STIs. National survey data show that 42% of 10th graders and 62% of 12th graders reported lifetime use of alcohol, and 11% of females aged 12 to 17 years reported alcohol use in the last 30 days compared with 8.8% of males. Alcohol continues to be the most widely abused substance by adolescents in the United States.

The co-occurrence of alcohol use and sexual risk taking contribute significantly to STI acquisition, particularly in vulnerable populations, such as adolescent girls. There is a considerable need for a new paradigm in adolescent STI prevention efforts, particularly for girls, given the current data that suggest that prevention efforts do not seem to be effective. Adolescent girls are particularly vulnerable to STI acquisition compared with their male peers, as they face unique biological, social, and cultural vulnerabilities, such as increased cervical ectopy and decreased power over sexual relationships. STIs are associated with significant morbidity and mortality, including pelvic inflammatory disease and infertility in women. They also found that young women aged 15 to 24 years had the highest reported cases of chlamydia and gonorrhea, and that there was a 7.8% increase from 2016 in reported cases of primary and secondary syphilis. The Centers for Disease Control and Prevention recently reported that 25% of sexually active adolescent girls currently have an STI. Young people aged 15 to 24 years comprise half of all new sexually transmitted infections (STIs) in the United States, despite the fact that this age group accounts for just 27% of the sexually active population.

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