Abstinence-only Sex Education

To all those card-carrying abstinence-only sex education supporters out there, hopefully you're doing some major damage control at the dinner table. (That is, if you’re even having dinner as a family these days[1].)

Abstinence-only sex education in schools is an interesting idea. But…how realistic is it in today’s society where there is literally access to information and influence everywhere? For example, assume the main character in any teen’s favorite prime time television series is probably not abstinent. Add a few hundred online/tv interviews with sexy celebrities (or their pregnant siblings) and the lyrics of most any song on the radio/top 100 list and you have a pre-existing after school sex education program that you (the parents) probably pay for (meaning the cable, ipod, movie tickets, laptop and that HD flatscreen television you bought).

Yep, abstinence-only sex education or not, your kid is exposed to sexuality and the choices other people their age make about sex every minute of every day. Advocating abstinence-only sex education - when documentaries, online quizzes, made for tv movies, Oprah Winfrey and Tyra Banks are covering everything from vibrators and viruses to whether or not oral sex is in fact sex - is probably not the best choice.

But, not having the uncomfortable conversations with your own children on top of your kids not learning about sex at school is really nuts. Some parents are afraid to ask or just naïve about what their teenagers knowledge of sexual health and healthy sexual activity but, waiting until your teen comes home pregnant or infected seems a little hands-off.

---

[1] http://www.pittsburghlive.com/x/pittsburghtrib/lifestyles/fooddrink/s_763761.html

Are young minority women screened for Chlamydia at a higher rate than young white women? #disparitiesmatter

Lots of people, who have recently read a study done by the Regenstrief Institute at the Indiana University School of Medicine, agree that young minority women are tested for Chlamydia more often than young white women. The purpose of this post is to begin to highlight the questions that follow this statement of STD testing disparity.

How much more likely are African-American and Hispanic women to be tested for Chlamydia then white women?

"Despite a recommendation from the U.S. Preventive Services Task Force to annually screen all sexually active young women for this disease, only about half of sexually active women, ages 14 to 25, who receive health care, are screened appropriately. The IU and Regenstrief researchers found that black young women were 2.7 times more likely and Hispanic young women 9.7 times more likely to be screened for chlamydia, compared with white young women."
(According to http://www.sciencedaily.com/releases/2011/01/110124111148.htm)

Why?

When asked if young minority women are screened for Chlamydia at a higher rate than young white women? Most providers said "Yes." When asked, "Why?", some providers thought that judgments are made about a woman's likelihood of infection based on her race or ethnicity and some did not. Those that did not think judgments are made based on race or ethnicity cited statistical probability as a possible motivation for (seemingly) biased Chlamydia screening, which seemed like circular reasoning to their opposition...

Does type of insurance factor into screening probability?

In addition to race or ethnicity, the researchers found screening likelihood varied by insurance status and also by age. Women with public insurance had greater odds of chlamydia testing, compared with women with private insurance.
(According to http://www.sciencedaily.com/releases/2011/01/110124111148.htm)

Does medical history factor into screening probability?

A medical history of STDs was more important than race or ethnicity or insurance status in terms of differences in chlamydia screening. Young women who had a previous STD were more likely to be screened for chlamydia, no matter their race or ethnicity, and differences by race or ethnicity in testing decreased substantially in this subgroup.
(According to http://www.sciencedaily.com/releases/2011/01/110124111148.htm)

What about pregnancy?

The same was not true for young women who had been pregnant in the past. After a pregnancy, young minority women were much more likely (24 times for Hispanic women and 4 times for black women) to be screened than young white women.
(According to http://www.sciencedaily.com/releases/2011/01/110124111148.htm)

What if any impact does this disparate chlamydia screening practice have on the Chlamydia infection rates of minority women?

What do you think?

Are teens using the web for sex-ed/sexual health info? Should they be? #disparitiesmatter

It almost seemed that Dr. Fulbright was against teens using the web as a resource for sex-ed/sexual health info. But, if you read the article all the way through it seems to highlight the fact that - although a recent study (done by Guttmacher Institute and United Nations Population Division) shows teens are more likely to get sex-ed info from friends, family, doctors or teachers - previous studies on web users build a case for the internet being the ideal arena for sex info exploration. Moreover, the Doc actually cites some useful websites and valid reasons to seek sex-ed/sexual health info (from reputable resources) online.

Recapping Dr. Yvonne K. Fulbright's insights:

“...previous studies have found that web users, in general, see the anonymity and openness offered by the Internet as attractive for finding answers to their questions. Other positive features are that a person can do so with minimal embarrassment and judgment when it comes to one's physical appearance, gender, age, or health status, especially if dealing with private, sensitive issues like sex. Users are further able to explore the information on their own, working at their own pace and without the fears that a more public setting for sexuality information may invite.”

Re-posting sex-ed/sexual health resources here ...just in case you didn’t get to check them out the first time.

What do you think?

Should teens be using the web for sex ed?

HE:ED Share: Self-testing for STDs may soon be possible?

Ok, basically health officials in the UK are saying that STIs will soon be able to be diagnosed by plugging a computer chip containing a sample of urine or saliva) into your phone. Post transmission/receipt and processing, health officials also say the results would be available in minutes.

Why are they doing this? It's an attempt to control herpes, chlamydia, and gonorrhea infection rates.

Questions:
What implications does this have for American mhealth?
Will this lead to pre-hook up testing?
How accurate will the results be?

HE:ED Share : Does the recession effect teens' sexual choices?

The associated press reported that the U.S. teen birth rate in 2009 fell to its lowest point in almost 70 years of record-keeping. "Experts" are reported to believe the decline in teen birth statistics is partly due to the recession. (To read their article click here)

They sight the painstaking sights of neighbors loosing their houses make kids and their families feel stress...not sure about you but...don't think so. If in 2009 34% of currently sexually active high school students did not use a condom during last the time they had sexual intercourse it doesn't seem like recession related stress is helping kids make the right decisions. Plus, the article fails to tackle pertinent data including the amount of sex occurring amongst the highlighted group, whether their use of contraception changed, or whether they were having more abortions.

This create curiosity about the rate of teen birth in countries around the world, that are not experiencing a recession...anyway, if teen birth rates are in fact down (for whatever reason) that is a good thing. Hopefully, it has more to do with events like sex:tech 2010 and advocacy groups like www.advocatesforyouth.org, It's Your Sex Life, Go Ask Alice and others...

HE:ED Highlight: Sexual Health and Awareness

Many groups are doing something about the sobering STI rates amongst youth around the world. It’s hard to discuss education disparities without discussing health disparities and more specifically the lack of informed sexual health action amongst youth/young adults. With World AIDS Day not too far in the rearview it seems pertinent to mention the infection statistics for youth, LGBTQ and women of color. The following sources were used for the statistics and organization links below: http://www.mysistahs.org/ ; http://www.avert.org/usa-transmission-gender.htm ; http://www.cdc.gov/hiv/resources/factsheets/youth.htm ; http://www.cdc.gov/HealthyYouth/sexualbehaviors/index.htm ; http://www.avert.org/worldstats.htm ; http://www.advocatesforyouth.org/about-us/mission

2009 America[1][2]:

46% of high school students had ever had sexual intercourse

14% of high school students had had four or more sex partners during their life

34% of currently sexually active high school students did not use a condom during last sexual intercourse.

Approximately 19 million new STD infections each year (almost half of them are among youth aged 15 to 24.)

Worldwide:

Estimated 2 million people under 15 living with HIV in 2007,[3]

AIDS is the second most common cause of death among 20-24 year olds (globally).[4]

RESOURCES:

Groups questioning why sexual health awareness amongst young adults is lacking and actually speaking to youth and driving awareness around STI prevention (in general or just HIV/AIDS) have been highlighted below.

UNISEX

http://www.advocatesforyouth.org/

Established in 1980 as the Center for Population Options, Advocates for Youth (AFY) champions efforts to help young people make informed and responsible decisions about their reproductive and sexual health. Advocates (AFY) believes it can best serve the field by boldly advocating for a more positive and realistic approach to adolescent sexual health.

http://www.sextech.org/

Sex::Tech, hosted by ISIS, is the premiere event for health and technology professionals, parents and youth, and community leaders to share insights and strategies for youth sexual health education and disease prevention.

Centers for Disease Control STD Hotline
Provides facts and information on STDs.

The hotline is 1-800-227-8922 (English)

1-800-344 7432 (Spanish)

1-800-243-7889 (TTY).

Go Ask Alice
Produced by Columbia University's Health Education Program, this site has questions and answers on relationships, sexuality, and sexual health issues.

Health Initiatives for Youth (HIFY)
Works to improve the health and well-being of all young people. HIFY gives information about health in a non-judgmental, straightforward kind of way, so that young people can make their own decisions about what affects them.

It's Your Sex Life
Sponsored by the Kaiser Family Foundation, this site offers information on STDs, birth control, abstinence, and how to talk with your partner or your parents about sexual health issues.

I Wanna Know
A project of the American Social Health Association, this site provides information on STDs, body basics, and advice on how to deal with peer pressure.

National HIV Testing Resources
This Web site contains many resources on HIV testing including a national database of HIV testing sites and answers to many questions about HIV/AIDS and testing.

Not Me Not Now
A site for teens who are choosing to wait, with articles, quizzes and a safe space where you can chat with other teens like yourself.

Planned Parenthood
Believes in the fundamental right of each individual, throughout the world, to manage his or her fertility, regardless of the individual's income, marital status, race, ethnicity, sexual orientation, age, national origin, or residence. Planned Parenthood clinics offer medical services, STI, HIV and pregnancy testing, and counseling. To find a clinic in your area, please go here. Teen Wire
This site from Planned Parenthood gives great information on body basics, how not to have sex if you don't want it, safer sex, and dealing with breaking up. It also provides referrals to local clinics.
Scarleteen
A resource for sex information for teens as well as a supplement to in-home and school-based sex education to allow teens to make their own choices, and develop their own systems of ethics and values from themselves and their families.

Scenarios USA
This site allows you to watch films—written by and for teens—that address important topics such as relationships, communication, sexual identity, teen pregnancy, and HIV/AIDS.

Sex Etc.
Written by teens, this Web site offers information on sexual health issues for young people.

Teen Pregnancy
Created by the National Campaign to Prevent Teen Pregnancy, this site has information for young people and adults who want to prevent teen pregnancy.

WOMEN

4 Girls Health
Developed by the Office on Women’s Health in the Department of Health and Human Services gives girls between the ages of 10 and 16 reliable, current health information.

Black Women’s Health
An online forum for African American women that provides information and strategies targeted at improving health and wellness.

Center for Young Women's Health
The mission of their website, YoungWomensHealth.org, is to help teen girls, their parents, teachers, and health care providers improve their understanding of normal health and development, as well as of specific diseases and conditions. They want to empower teen girls and young women around the world to take an active role in their own health care.

Feminist’s Women’s Health Center
Providing women of all ages with information so they can freely make their own decisions about their bodies and sexuality.

National Women’s Health Information Center: Minority Women’s Health
A Web site to help you learn about the most common health risks and concerns of minority women

Native Shop
A project of the Native American Women's Health Education Resource Center, to address pertinent issues of health, education, land and water rights, and economic development of Native American people

Not-2-Late
This Web site provides information about emergency contraception, to prevent pregnancy after unprotected sex.

Pro-Choice Public Education Project
The Pro-Choice Public Education Project (PEP) puts choice on young women's radar screens, educates them about threats to their reproductive rights, and helps young women identify with pro-choice ideas. PEP is energizing a new generation of pro-choice leaders.

FYI (America)

The Ford Foundation awarded grants totaling $4.1 million to six organizations to design and undertake innovative research on youth sexuality in the United States. http://www.fordfoundation.org/

Ford Foundation Grant recipients:

The Public Health Institute (Center for Research on Adolescent Health and Development)

The University of Arizona/Gay-Straight Alliance Network/YWCA Tucson

The University of Illinois

The University of Michigan

San Francisco State University's Health Equity Institute

The Face Value Project

---

[1] CDC. Youth Risk Behavior Surveillance—United States, 2009. [pdf 3.5M] MMWR 2010;59(SS-5):1–142.

[2] Weinstock H, Berman S, Cates W. Sexually transmitted diseases among American youth: Incidence and prevalence estimates, 2000. Perspectives on Sexual and Reproductive Health 2004;36(1):6-10.

[3] UNAIDS (2009), '2009 AIDS epidemic update'.

[4] Patton G et al (2009, 12th September), 'Global patterns of mortality in young people: a systematic analysis of population health data' The Lancet 374(9693).