In looking at the issue of sexual health services there are found to be two common areas
1. STD education, identification, and management services
2. General sex education
Most at risk are young people just starting out in life.
As regards STDs
STDs pose threat to sexually active college students (2010) The Daily Toreador
Sam Prien, professor at the Texas Tech University Health Science Center School of Medicine Department of Obstetrics and Gynecology, discussed the Lubbock STD rate in comparison to the national average. "Chlamydia is the most common STD in this area. The rate is somewhere between 10 and 12 percent of the reproductive population. That's three to four times the national average," Prien said. Prien said Chlamydia is not the only STD that has a rate well above the national average locally. "Gonorrhea is the second most common STD. It's between four and five percent," he said.
As regards Sex Education
Sarah Nightingale, Lubbock AJ 11/1/2009 Schools say community help needed in sex education. Six Lubbock teenage girls became pregnant each week in 2008 which reflected the fourth-highest pregnancy rate in Texas. Lubbock County sees more teen pregnancies than the Texas average in a state that ranks third in the nation for teen birth. More than 300 Lubbock County adolescents became pregnant in 2008, up from 214 in 2005. 2008 adolescent pregnancy rate of 38 per 1,000 teens was higher than the state rate of 27 per 1,000 – making the country fourth for teen pregnancies among Texas counties with more than 5,000 girles ages 13 to 17
Summary: The city and county of Lubbock note much higher rates of both STDs and unplanned teen pregnancy significantly above the rates found elsewhere in Texas.
As regards Sex Education
Texas’ Youth: Focus on Sexual and Reproductive Health (2009) found that over 3.5 million youth between the ages of 15 and 24 live in Texas-about 15 percent of the population. Over half of Texas’ youth-1.86 million-are African American or Latino. 53% of high school students in Texas report having had sex and 39 percent report being currently sexually active. 56% of high school students in Texas report having used condoms at last intercourse. Only three states have lower rates of condom use among students.
Texas’ youth, especially young women, are at risk for STDs. Youth ages 15-24 experiences 73 percent of the total number of Chlamydia cases in Texas in 2006. Youth ages 15-24 experienced 61% of the total number of Gonorrhea cases in Texas in 2006. For all youth in this age range, young women were most at risk for STDs, experiencing 83% of Chlamydia infections and 60% of gonorrhea infections. African American and Hispanic/Latino youth in Texas are at higher risk for pregnancy than are their white peers. 65 in 1,000 white youth ages 15-19 experience pregnancy, compared to 120 African American youth over 1,000 and 142 Hispanic/Latino youth per 1,000.
The 2009 Executive Summary: Sexuality Education in Texas Public Schools reported on the teaching of human sexuality in public schools in Texas. Requests were sent out to 1000 Texas schools, 990 responses were received. The Six key findings included:
1. Most Texas students receive no instruction about human sexuality apart from the promotion of sexual abstinence
2. Most school districts do not receive consistent or meaningful local input from their School Health Advisory Councils regarding sexuality education.
3. Sexuality education materials used in Texas schools regularly contain factual errors and perpetuate lies and distortions bout condoms and STDs.
4. Shaming and fear-based instruction are standard means of teaching students about sexuality
5. Instruction on human sexuality in Texas often promotes stereotypes and biases based on gender and sexual orientation.
6. Some Texas classrooms mix religious instruction and Bible study into sexuality education programs.
A lack of comprehensive sexual education poses dire consequence for poor choices. Just Watch the Livestock: Texas schools’ sex ed favors ‘don’t ask, don’t tell… and keep ‘em ignorant’ (2009)
Texas teens are more likely to have had sex at least once (nearly 53%) compared to U.S. teens as a whole (nearly 48%) yet are less likely to use a condom when they do. Nearly 44% of sexually active teens in Texas did not use a condom during their last instance of sexual intercourse. This lead to a sky-high teen-pregnancy rate-at 63.1 live births per 1,000.
While Texas dropped in 2006 to third from first place in teen births, the state’s pregnancy rate actually increased over the previous year. It isn’t that we’re doing any better; it’s just that Mississippi and New Mexico are doing worse.
In 2007 Texas received more than $18 million in federal funds for abstinence-only education.
Some Texas districts change tune on abstinence-only sex ed (2009). The rate of student pregnancies in Austin high schools has increased 57% since the 2005-06 school year and rates of STDs are rising among Travis County teens. Some Texas schools are moving from abstinence only to “abstinence plus” curriculum. Abstinence only gives limited information about contraceptives and condoms and tends to downplay their effectiveness, while abstinence-plus stresses the importance of using such protection if teens are sexually active.
Summary: The state of Texas has much higher rates of STDs and teen pregnancy than is found elsewhere in the United States. Rates of Gonorrhea are particularly high for African-Americans in the state. Recent investigations involving the effectiveness of “abstinence-only” sex education found the programs of little value. “Abstinence-plus” programs being implemented in some school districts in Texas appear to be more effective in reducing teen pregnancy rates.
As regards Sex Education
Other states are addressing these issues of sexual health in a more effective manner than Texas. Seven Steps to Comprehensive Sexual and Reproductive Health Care for Adolescents in New York City, New Your City Department of Health and Mental Hygiene (2009) outlined program goals for bringing sexual education to teenagers with the following goals:
1. Guarantee confidentiality and adolescents’ rights to consent to sexual and reproductive health care
2. Make services accessible and facilities welcoming
3. Deliver sensitive care
4. Screen and refer for sexual and reproductive health issues, substance use, and mental health concerns
5. Provide risk-reduction counseling and education
6. Provide contraceptive methods, including emergency contraception
7. Inform, assist, and support all decisions regarding pregnancy
Red Sex, Blue Sex: Why Do So Many Evangelical Teenagers Become Pregnant (2008) reported on the inconsistency of attitudes and actual behavior in teen’s sexual health. Social liberals in the country’s “blue states” tend to support sex education and are not particularly troubled by the idea that many teen-agers have sex before marriage, but would regard a teen-age daughter’s pregnancy as devastating news. And the social conservatives in “red states” generally advocate abstinence-only education and denounce sex before marriage, but are relatively unruffled if the teen-ager becomes pregnant, as long as she doesn’t choose to have an abortion. A national survey conducted by the University of Texas found that religion was a good indicator of attitudes toward sex, but a poor one of sexual behavior, and that this gap is especially wide among teen-agers who identify themselves as evangelical.
Evangelical Protestant teen-agers are significantly less likely than other groups to use contraception. Only half of sexually active teen-agers who say that they seek guidance from God or the Scriptures when making a tough decision report using contraception every time. By contrast, sixty-nine per cent of sexually active youth who say that they most often follow the counsel of a parent or another trusted adult consistently use protection.
A review of these abstinence-only programs show that many such programs use curricula that distort information about the effectiveness of contraceptives, misrepresent the risks of abortion, blue religion and science, treat stereotypes about girls and boys as scientific fact, and contain basic scientific errors. Research shows that teenagers who receive contraceptive education in the same year that they choose to become sexually active are about 70% more likely to use contraceptive methods (including condoms) and more than twice as likely to use oral contraceptives as those not exposed to contraceptive education. That is why the National Institutes of Health recommends that, although sexual abstinence is a desirable objective, programs must include instruction in safe sex behavior, including condom use.
Summary: Objectives for congenital syphilis, responsible adolescent sexual behavior, and screening for genital Chlamydia are moving toward target goals. Little progress has been shown for primary and secondary syphilis and fertility problems. More than 65 million people in the U.S. are currently living with an incurable STD. Chlamydia infection rates continue to increase significantly. Expedited partner therapy (EPT) appears to be gaining in popularity as it reduces rates of infection however legal challenges remain. Efforts to improve adolescent sexual and reproductive health have had limited success. Major cultural and religious conflicts exist in the provision of sex education.
We are failing to reach out to our youth and the consequence is the potential loss or major damage to an entire generation. We can do better.