Let’s Talk About Sex

Fall 2014

Why Accurate And Comprehensive Education About STDs And Teen Pregnancy Is Critical

BY SARAH WENDGERT

It was way back in the early ’90s when Salt-N-Pepa suggested through song that society become more open to discussing sex. Now, 23 years later, kids may listen to new music, but the sentiment offered by the old-school rap duo is as important as ever for Omaha teens.

The Women’s Fund of Omaha’s Adolescent Health Project (AHP) hopes to get more people talking and plans to use research to foster initiatives that will increase sexual literacy among teens, while also combatting teen pregnancy and STD rates. Those involved believe AHP findings are essential to pragmatically tackling the issues at hand.

“Omaha is in its 15th year of an STD epidemic,” says Christopher M. Fisher, Ph.D., assistant professor in the Department of Health Promotion, Social & Behavioral Health at UNMC, and director of the Midlands Sexual Health Research Collaborative. “Our rates of infection continue to surpass both the state of Nebraska and the U.S. as a whole. A number of efforts have been engaged in over the years, and while there have been some very minor improvements, there is still a long way to go. The AHP brings a renewed sense of importance and strategic alliances that can serve as the basis for a long-term, high-impact approach to addressing the STD epidemic, as well as reductions in unplanned teen pregnancies.”

Roberta Wilhelm, executive director at Girls Inc., sits on the AHP Advisory Board.

“I am happy to be at the table as someone who works with girls at a grassroots level and sees the challenges they face every day,” she says. “At Girls Inc., our mission is to inspire girls to be ‘strong, smart, and bold.’ When we talk about ‘strong,’ we are talking about healthy. The work that the AHP is doing is critical to the girls we serve and, of course, to adolescents throughout our community.”

Wilhelm hopes the AHP “raises awareness, educates people and dispels myths, and rallies young people to take action”—whether that action is getting tested, abstaining or having safer sex.

“When it comes to STDs, too many people take a head-in-the-sand approach,” she says. “They think, ‘It’s not my child’ or ‘It’s not my neighborhood.’ We need to work together to reduce rates of infection throughout our community.”

Fisher served as lead investigator on a study that sought to “understand teen perceptions and knowledge on the issues of teen pregnancy and STDs,” while also seeking respondents’ advice on what could be done to address teen pregnancy and epidemic STD rates in Omaha.

“We interviewed 41 teens and young adults from predominantly the north and south Omaha areas where the STD epidemic has hit hardest,” he says. “Those interviews were then analyzed using scientific methods to bring the youth voice to the table for the AHP.”

One of those essential teen voices was 16-year-old Mychael Shields. Now a senior at Central High School, Shields has attended Omaha Public Schools since kindergarten. She’s also a member of Girls Inc.’s Board of Educated Ladies (BEL) peer educator program. Shields told Today’s Omaha Woman that she has accumulated the majority of her sexual health knowledge from Girls Inc. and BEL.

“Before I was in BEL I didn’t feel I knew enough, because in school they are very brief when discussing sexual health,” she says. “They give the basics, like, ‘This is what the female reproductive system looks like. This is what the male system looks like. Here is how you get pregnant, here is a list of birth control methods…’”

Shields notes that in her experience the list of birth control methods wasn’t complete or fully explained. She got the impression that most teachers tasked with teaching Human Growth & Development weren’t passionate about the crucially important duty. But she’s certainly one teen who is rightfully passionate about teen sexual literacy.

“If you’re a teenager and are sexually active, you should know as much as you can learn. Period. So you can protect yourself,” she says. “If you are not sexually active, it’s still important so you’re not so naive and know what’s out there. When you do choose to become sexually active, you will know all that goes along with that choice.”

“Sex education in OPS was first developed in the late 1980s and may have been adequate then, but is not now,” says South High School RN and Health Educator Andrea Genereux.

Wilhelm tells an eye-opening story in which her husband asked the Human Growth & Development teacher at an open house about curriculum and was told it was “mostly abstinence” and “the curriculum isn’t great. It’s pretty old.” This lent Wilhelm little confidence in the information being received by the three boys to whom she and her husband are serving as guardians.

“Personally, I am pleased with the education and skill training we offer girls at Girls Inc. There are, however, enormous gaps in health and sexuality health education both in the schools and in out-of-school programs,” says Wilhelm.

“Teens are comfortable talking about sex today, but I’ve found that [often] they don’t have accurate information about sex,” Genereux says, adding there’s usually a disconnect between what teens see and hear in the media versus real life.

Genereux, who’s been a school nurse for the past nine years and currently has five new teen moms pumping breastmilk in her office during school, says she wants to see attitudes regarding teen sex education change.

“Students deserve to be given medically accurate information in regards to safer sex, consequences of unprotected sex, sexual responsibilities for both males and females, and the benefits of delaying pregnancy until after they complete their education. If they are given all the information, I believe that they’ll make better choices in regards to their sexual behavior,” she says.

“We need to stop prefacing our discussions with, ‘It’s a sensitive topic,’ and start facing the fact that teen pregnancy is costing us a fortune,” says Genereux, noting the 2008 estimate that Nebraska taxpayers pay $67 million per year for teen pregnancy costs.

But even beyond the high cost in dollars, Genereux is concerned about the emotional and personal toll of teen pregnancy. She’s seen students struggle to attend school due to a sick baby, medical appointments, day care issues or exhaustion, which often leads to difficulty keeping up with schoolwork, and, in some cases, causes legal trouble due to excessive absences and/or causes them to drop out. She also sees teen parents face trouble negotiating the healthcare system, fear of giving birth, post-baby body image issues, health complications, being pushed into marriage, a lack of knowledge and resources, giving up on goals such as college, and many other negative effects.

“I have many girls who are really good moms,” Genereux says. “They breastfeed their babies at home and pump milk for them while they are at school. They take books from school home so they can read to their children at night. But should any student have to become a parent at 14 years of age?”

Wilhelm says she applauds young women who choose to delay childbearing until they are emotionally, socially and financially prepared, and that “reducing teen pregnancy is critical to breaking a cycle of poverty.”

In Douglas County, for example, African Americans and Hispanics/Latinos have much higher teen birth and STDs rates than Caucasians, and teen pregnancy is associated with poverty and lower graduation rates.

“These statistics have implications for success throughout life,” says Wilhelm. “It means these young people will, in general, have greater struggles and have to work even harder than they already are in order to be independent, productive citizens. In terms of pregnancy rates, it means a higher chance for negative outcomes in everything from school performance, to health, to gang involvement, to involvement with the juvenile justice system, and to family income levels. It also means their children themselves will more likely become teen parents, thus perpetuating the struggle.”

According to Genereux, last year Omaha South had 53 pregnant students—three times more than any other OPS high school, she says—and that only one reported she’d been using birth control.

“Most said they didn’t know where to get it, didn’t know that they could get it without their parent’s permission or about places they could get it free, or they just didn’t think about it,” she says. “More than half of them were 16 and younger, and the majority—43 of the 53—were Latino. Five were African American.”

Genereux says this doesn’t even include the 50-plus South High students who were already parents.

“These numbers seems to suggest that we need to start our sex education in the schools at a younger age, and that we need to be able to tailor programs we use in the schools to the different racial and ethnic groups that we serve,” says Genereux.

So, how can the AHP work toward improving teen sexual literacy and such disarming statistics in Omaha’s schools?

“My hope is the project will keep all the relevant stakeholders, including teens themselves, engaged in addressing the issue,” says Fisher. “I hope teens will become more knowledgeable and proactive in managing their sexual health and the sexual health of their peers in a manner that promotes a positive development into sexually healthy adults. To achieve these goals, I hope the AHP can build on the successes of sex education in our schools by promoting policies that ultimately equip teens with the knowledge, skills and tools they need to mature into sexually healthy adults.”

Indeed, updating and altering sex education curriculum seems in dire need in the Omaha area. Genereux says she’d like to see OPS’s health education updated to provide students comprehensive, medically accurate, unbiased information.

“I think if you incorporated the sexual health aspect into a curriculum that covered all aspects of their health—nutrition, car/bike safety, relationship safety, alcohol/drugs awareness—it would be more effective because they would have more time to learn the information and ask questions. They need the facts about their sexual health taught in a way that is without moral judgment, and it needs to be taught at all levels of school in age-appropriate language,” she says.

Shields also noted that school sex education omits the relationship aspect of sex—something she sees as crucial for teens to learn about, as something that directly affects sexual health.

“Learning about the difference between a healthy relationship and an unhealthy [one] is important,” she says. “Many young women don’t know the difference. They just listen to the ‘sweet nothings’ without considering the relationship. I think it is important for young women to know the difference. The scenarios we review at Girls Inc. help us see the differences.”

Wilhelm says a collaborative approach recognizing that this is a community problem is crucial to addressing the negative impact of STDs and teen pregnancies within the Omaha community.

Dr. Fisher agrees that collaboration is key.

“The community these youth live in and play in and go to school in needs to start talking honestly and openly about these issues in a way that allows for positive sexual development, that does not shame or scare youth—guilt and fear mean they don’t talk about it, and without communication the cycle likely will continue,” says Fisher. “Maintaining a continuous dialogue with all parties is important. This includes the youth, parents, teachers, community leaders, government and health officials, doctors…the list goes on. When everyone communicates and agrees on the goal to reduce the numbers in Omaha, much can be accomplished.”

Wilhelm, Fisher, and Genereux each mention Milwaukee as a model for how Omaha might approach the issue the AHP aims to improve.

“Milwaukee had a very effective strategy that essentially got communities talking about the issues,” says Fisher. “The power of conversation and communication was fully revealed in their community.”

Genereux says Milwaukee dropped its teen pregnancy rate by 50 percent in seven years, surpassing the goal of 46 percent in 10 years.

“They did this [with] a massive public awareness campaign with the United Way about teen pregnancy prevention, revamping their [sex education] curriculum to include pregnancy/STD prevention and allowing the school nurse to offer condoms to students,” Genereux says. “Along with this, they invested in many different programs to encourage teens to delay pregnancy by increasing their self-esteem, getting involved in activities, and doing long-term goal-setting.”

Wilhelm got to learn about it firsthand when she and other AHP Advisory Board members traveled to Milwaukee to learn about how the city tackled teen pregnancy.

“Starting out as one of the states with the highest teen pregnancy rate in the country, they are having great success with their collaborative, community-wide effort to address this issue,” Wilhelm says. “We would like to see our schools step up with more comprehensive curriculum and better trained staff to deliver the curriculum. Health and sexual education is too important to assign to a teacher who is not skilled and confident delivering the lessons, or to teach as an afterthought.”

Genereux says we need to provide education about sex before students become sexually active. She suggests that contributions from schools, parents, healthcare staff, and the community at-large is needed in this effort.

“Kids are curious about sex, and if we don’t provide them with the information that they want and need, they will look for it elsewhere, and more than likely will receive inaccurate information or none at all,” she says.

“Teens talk a lot about sex and half of what they say isn’t true,” says Shields. “When you actually learn what the real deal is, you can share medically correct information with your friends. Most teens aren’t comfortable talking to their parents about sex. Sometimes it’s easier learning about sex from people you don’t have to go home to everyday—people that care about you and are concerned about your well-being, but they aren’t all up in your business 24/7 like a parent is.”

“At the end of the day, teens are going to be teens,” Shields continues. “When kids have good information, they know the ways they have to protect themselves, including abstinence.”

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