"STI rates are at an all-time high," the study states in its list of recommendations. "Current resources for STI prevention and treatment are inadequate to address this priority public health issue.

"Increased federal and state funding is needed to build public health education campaigns and make testing and treatment more accessible."

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The study finds STI rates are disproportionately high in communities of color based on their percentage of the youth population - the highest chlamydia and gonorrhea rates being found among black and American Indian youth. The gonorrhea rate is nearly 25 times higher among black youth than their white counterparts, while the chlamydia rate is nearly nine times higher.

Despite accounting for just seven percent of the population in that age group, black youths account for 51 percent of all gonorrhea cases and 31 percent of all cases of chlamydia, the study shows.

The study found the county with the highest rate of chlamydia in the state in that age group was Mahnomen County, followed by Hennepin, Ramsey, Olmsted, Freeborn and Itasca counties. The county with the highest gonorrhea rate was Hennepin, followed by Cottonwood, Ramsey, Freeborn, Olmsted and Wabasha counties.

According to the study, rates of pregnancy and births among those ages 15 to 19 continue to fall. The average birth rate in Minnesota among that age group is 12.1 per 1,000 people.

Birth rates in that age group are much higher in rural Minnesota. In Mahnomen County, the rate is 69.8 per 1,000 people. In Nobles County, it is 50.8 per 1,000 people, and Clearwater County's rate is 45.8 per 1,000 people.

The study also found youth who have experienced homelessness and/or have run away from home have significantly higher rates of sexual activity, involvement in a pregnancy, substance use before their last sexual encounter, no condom use during sex, and suicide attempts.

The cause of the increase in STI's statewide is unclear, according to Jill Ferris, MPH. She wrote the report and leads the University of Minnesota Medical School's adolescent sexual health training program.

“One of the really common misconceptions that people still have about STI’s is that you know when you have one,” said Ferris.

“A common symptom is no symptom,” she said. “A lot of people have these for many years in their bodies they're unknowingly, unwittingly infecting people, other sexual partners. Quite sadly, in some cases it can cause infertility and issues when trying to start a family.”

She said there needs to be more education about testing and treatment.

“I think the messaging around wanting to avoid getting an STI is probably not held up with the same importance [as pregnancy] and I think it needs to be,” said Ferris. “I think we have a lot of work to do in terms of educating everybody, but especially young adults, about testing and treatment.”

At the Annex Teen Clinic in Robbinsdale, there are resources to help parents talk to their children about sex.

“To parents I want to say, you are the primary sexuality educator for your child whether you're doing it or not,” said Brian Russ, the executive director.

Russ said it's important for parents to be "providing a climate where asking questions is okay and where nothing is off limits in terms of asking for information.”

He said they see about 2,000 young adults every year for birth control, yearly exams and STI testing.

“Part of what we're seeing is young people are being screened and tested in greater rates than they have been in the past,” said Russ.

As the report points out however, there isn’t equal access statewide. According to the report, nearly 50 percent of Minnesota’s rural counties do not have a sexual health clinic.

And there is no statewide standard for sexual education, according to Russ.

“It can really be hit or miss wherever the young person is living, the extent to which they’re getting sexuality education,” he said.

“Young people, when given the information that they need, make great decisions about their health.”