Risking STIs

The incidences of STIs in our country are out of control.  15 - 24 year olds are at the highest risk and by the age of 25, 1 in 2 sexually active persons will have (or have had) an STI.  1 in 2!  That means that half of all sexually active people my age have had an STI!  That is a huge percentage... doesn't anyone else think that's really scary??  I think it's horrifying!  Especially when it's so easy to protect yourself against them.  What can you do - other than the obvious, which would be abstaining from sex - ?? The most obvious are:

• be in a monogamous relationship
• make sure you & your partner both have blood test done before having sex
• use latex condoms - EVERY single time you have sex!
• limit your sexual partners

I know that to a lot of people that seems ridiculously obvious - but so many people simply do not understand the risk or what they can do to prevent it.  Sometimes I hear people say silly things like "Oh I know I'm clean, I've only had sex once.."  Really?!  You can absolutely get an STI the first time you have sex, if it's with an infected person.  I often hear "I almost always use condoms." Again, really?!  How can a person who "almost always" uses a condom not realize the dangerous situation they are putting themselves into?  With half of all sexually active adults having had an STI it is way too risky for someone to "almost always" have protected sex.  Unless you are in a committed monogamous relationship, if you care about your sexual (& physical) health you should always be having protected sex.

Some women that I know think that wearing a condom is the male's responsibility.  Some women would prefer that he wear a condom but don't feel confident enough (or are too embarrassed) to speak up and request that he wear one.  And by request I of course mean demand.  I can only assume it's much more embarrassing to find out you have an STI that you easily could have avoided - especially if it's one that will be with you for the rest of your life and will require you to tell every future sexual partner you have about it.  I think it's so sad that in this day and age women would either a) think that making sure condoms are used is the male's job and/or b) not be confident enough to speak up for what they want (& their health).

First of all, few things annoy me as much as people who are sexually active and unable to talk about sex with their partner or partners.  If you are having sex you should be able to talk about it.  Yeah it can be embarrassing and uncomfortable sometimes, but that's part of it and you should be able to deal with that.  Secondly, women who want to have protected sex, who are not in a relationship with someone who they trust to provide condoms, should carry their own condoms.  There is nothing wrong with a woman keeping condoms in her purse and requiring any partners she has to use them.  Whenever a woman goes out, if there's any chance she might end up hooking up with someone or having a one night stand, she should be prepared to protect herself.

Both women and men should know their risk and know how to protect themselves.  I know that protection is sometimes skipped because people are in the moment - but trust me it's worth the interruption.

gaga, ooh la la

I was recently talking to a class about the sexual nature of most of the music videos they're watching.  We were discussing how most of the current pop and rap songs have the same basic element to their videos.  They often feature one man dancing around large groups of women or a few men with an even larger group of women.  In the majority of these videos the men are almost always in control and it is clear that women are only there for the men's pleasure.  (For one example - out of so many - watch Katy Perry's California Girls video.)  I asked them if there were any videos that they could think of where men outnumbered women.  Or if they could even name a video where the woman was controlling the man or sexually in power.  Immediately someone shouted out "Gaga", which led to everyone calling out the names of different Lady Gaga videos where she was the only woman clearly dominating one man or a lot of men.  I'm sure that there are a lot of videos out there where the woman is in control, however, off the top of my head I can only think of Gaga videos and a few Britney videos.  

The best example I can think of is the Alejandro music video.  She is absolutely in control (what with many of the men being chained and all :) and all of the men are clearly submissive to her.  I know that in some places it is a very sexual video, however, I see videos all of the time that are just as sexual - only sang (or rapped) by men.  So I think it's really interesting that a lot of t.v. stations and websites banned the Alejandro video... but still play equally sexual videos by male performers.  I suppose it could be because of the chains (and some people might see parts of it as sacrilegious)... but I wonder if some of that fallout is because it's shocking to people to see a woman being so sexually aggressive?  Personally I would love to see videos where no one is in "control" or has power over another person.  In a healthy relationship neither partner should have control over the other... and I really think that the youth in our nation are constantly getting the message that "when it comes to sex men should be in charge."  However, since it's clear that music videos and television shows are going to keep portraying that image I love that there is someone out there, like Lady Gaga, showing the opposite.  In my opinion she's showing young women - and even women my age - that females can not only be sexual but that they can also voice what they want and take control of their own sexual needs and desires.  And of course, that message I love.

Disclaimer:

I love pop music & I love Gaga.  

I think she is so sexy & powerful - and I love any music I can dance to!  

I think that the Alejandro video is one of the greatest videos ever... 

however, a lot of people will vehemently disagree.  

If you love Gaga as much as I do and haven't watched it yet, check it out:

Alejandro Video - Lady Gaga

Are you ever really ready to be a parent??

It's confusing to me that I've reached an age and point in my life where no one would be disappointed in me if I found out I was pregnant.  Even more confusing is the fact that people seem to expect me to become pregnant.  The other day someone I work with asked me if I was going to have children soon.  My only thought was "who asks that to someone they barely know??"  She then went on to imply that if I want children I should start trying soon.  Statistically I know that's true.  I know that female fertility begins to drop at age 27 (which I'll be in a few months) and there's a more drastic drop in fertility after age 35.  I'm aware of these drops in fertility... but I also know that they don't happen to all women.  More than that I can't comprehend how anyone could think that it is acceptable to imply that someone else is ready to start a family.  Whenever I go home (to the town I was raised in) there are always a few people who ask me when I'm going to start having babies.  Ugh, how can these people have such a complete lack of social skills?!  Not only do I find it rude to ask someone something so personal, but I think it's ridiculous to assume that everyone wants to have children.

While I know that I'd like children someday I can't imagine the idea of having children now.  I can't imagine anything but sadness for the life I haven't gotten to live.  I have so many things I want to do before I have kids.  I just don't get the whole "baby" thing.  I cannot imagine loving something that much.  Several years ago when a friend of mine was a few months pregnant she said, "it's it crazy that my baby is the size of a peanut and I already love him more than anything else in my life."  I can't imagine what that must be like... does that feeling just automatically occur when you find out you're going to be a parent?  Will there ever be a time when I don't dread having children but actually look forward to it??  If anyone has any thoughts I'd love to hear them.  I spend most of my days teaching people how to avoid unwanted pregnancies... but secretly the idea of a planned pregnancy almost seems just as scary to me!

What is the goal of sex education?

A few weeks ago, before starting our unit on reproduction/ birth control, one of my students asked me "is it okay to reuse a condom?"  When I said no, another student chimed in "have you ever reused a condom??"  Clearly I was horrified.  No not because he asked me a personal question (another teacher I talked to thought that was the problem), but that they would even question whether or not reusing a condom was safe.  After telling this story to some friends, several of them admitted that they had either never realized that condoms shouldn't be reused or that they had actually used the same condom twice in a row.  Horrifying.  These sort of statements make me feel confident that everyone should be receiving sex ed.  It's so confusing to me that most of our television shows contain dozens of sexual references and innuendos, movies have countless sex scenes, the songs that teenagers are listening to are filled with sexual lines - and yet people fight to keep sex education out of schools.  Our children and teens are being bombarded on a daily basis with messages encouraging them to believe that "everyone" is having sex - that sex is fun and risk free.

The main argument I encounter is that "sexual education should be taught at home."  Absolutely- I agree 100%.  Parents need to start a dialogue with their children, about sex, before they start having sex. But lets be honest... it isn't happening.  There are a lot of reasons:

      a) parents naively believe that if they don't talk to their children
           about sex they won't do it (that always makes me laugh :)

      b) they think that if they talk to their children about sex it will
           encourage them to start doing it (wrong again, kids are curious -
           they want to understand how their bodies work, they should  

           understand.)

      c) they are uniformed and simply don't know the right information to
           tell their children (easy to understand - in order to thoroughly
           teach their children they need to understand anatomy and how 

           each part of the reproductive anatomy functions, statistics on
           birth control and STIs, all of the types of birth control out there
           and how each one works... why??  because we know abstinence 

           only doesn't work.)

      d) they are uncomfortable or nervous talking about sex with their
           children (I can only assume it's more uncomfortable to have your
           teen tell you they pregnant or have an STI...)

I simply cannot understand how anyone can think that sex educators are encouraging teens to have sex.  I find that notion appalling... and ridiculous.  I am a huge advocate for postponing sex.  As someone who's only ever had sex with one person I think that postponing sex is one of the healthiest things a person can do.  However, research shows that not teaching teenagers about their options will not keep them from having sex, it will only keep them from having safe sex.  Personally I think that should be a major goal of all parents - for their children to be able to make safe, educated decisions.  Lets face it- most kids aren't learning about sex at home.  Instead they are learning about it from the media - which rarely shows the risk and consequences of sex - and their peers.  

Thankfully my students are lucky enough to have one of the best health education programs in the state.  They get to learn about the benefits and risks of sex - which hopefully will guide them in making healthy choices.  They know the importance of postponing sex.  They know that the incidence of contracting an STI is highest in their age range and they know how to take precautions to keep from becoming a part of that statistic.  (And of course, now they know never to reuse a condom!)  Health education is about teaching students to make healthy, educated decisions that will positively impact the rest of their lives... it is not about teaching them how to have sex.  

Honeymooning!

For anyone who might read this... sorry for the delay, but I will be posting again soon!  The past few weeks have been crazy - with finals, moving home for the summer (half way across the country), packing & unpacking.  We're honeymooning now and have a crazy summer planned... I'll write as soon as things calm down :)

The sex trade in India - Stopping child prostitution and the spread of HIV/AIDS

Lately I've been doing a lot of research on the red-light districts in Asia, especially in India.  For anyone who doesn't know a red-light district is an area of a town or city containing numerous brothels, strip clubs, and other sex businesses.  Honestly I have no problem with sex workers - as long as they are of age and choose to work in the sex industry.  My biggest problem with prostitution is the abuses the women are often forced to suffer.  However, the red-light districts in Asia have a huge problem with selling children and women into the sex trade and forcing them to work.  (I know that there are children sex workers in the U.S., too.  But since it is not as common and it is not socially acceptable here I am focusing on the problems in Asia.)  

If you are looking for a humanitarian cause to support or donate to, I suggest doing some research on groups working to remove children from the sex trade.  I'm so inspired by the work being done by all of the different individuals, humanitarian groups, and documentary film makers who are working to either stop children from entering the sex trade or educating the world about what is happening to these children.

I have attached two documentaries on the red-light districts in India (click on the links above the pictures at the bottom of this post).  The first one is called India - The Sex Workers, by PBS's Frontline and is only 20 minutes long.  It talks briefly about the children, but focuses more on the problems sex workers face, specifically AIDS.  It is an educational and powerful film.  I think that everyone should watch it - you can find the time!  The second one is full length documentary called Born into Brothels.  As you can tell from the name, it focuses on the children.  It is a little bit slower and wasn't as powerful for me, but definitely worth watching if you have the time.

The videos focus on sex workers in Kolkata, India (which was previously known as Calcutta) and Mumbai, India (which is largest city in India and home of the largest red-light district in Asia).  The stories are both inspiring and heartbreaking.  It was so shocking for me to see (in The Sex Workers) how intelligent, well spoken, and determined the workers were.  I was overwhelmed by how hard they were working to make their lives safer and how hard they were working to try and keep the children of India out of the district.  At the same time I was sickened by the fact that parents willingly sell their children into the sex trade.... knowing the life of abuse they will be facing.  I cannot imagine what sort of parent would voluntarily put their child into that life, fully aware of the continuous rape, abuse, degradation, and possibility of death that their children will be facing on a daily basis.  It makes me feel sick.  But then I wonder if maybe those parents truly believe that they are giving their children a better life??  How can that be?  It makes me so thankful for where I was raised and for the fact that we expect our children to be safe and receive an education.  I'm often angry at our leaders and our policies, but today I'm feeling very grateful for my country, the life I live, and the knowledge that my children will never experience what these children experience every day.  

India - The Sex Workers

Born into Brothels

So, how effective are condoms??

In one of my sexuality classes I came across a list of rules for condom usage that I thought was really good.  I think that too often people do not realize how often condoms are not used properly and therefore how high the risks of transmitting STIs and becoming pregnant actually are.  When used consistently (that means every time :) and correctly condoms have an incredibly high success rate at preventing pregnancies.  In fact they have have a 0.02% failure rate.  Unfortunately, people often use them improperly (meaning they fail to follow one of the rules below), so in typical use the failure rate is actually 12%.  That means that 12 women out of 100 whose partners rely on condoms alone can expect to become pregnant during a year of use.  In my opinion that is a very high number!  And Trojan sure does not advertise that their condoms typically work 88% of the time!  So we know that condoms can work - then why aren't they?  I can only assume that people are unaware of how easy it is to misuse a condom.  I know putting on a condom might seem incredibly basic to most of us, but just in case you are doing something wrong - if you ever use condoms as contraceptives - I would suggest reading these rules:

• Use a condom each and every time you have intercourse!
• Check the expiration date - do NOT use if it has expired!!!
• Do not use any condom that feels sticky or brittle, or is discolored looking.  (Also, do not use if the package has been damaged prior to opening.)
• Do not expose condoms to extreme heat or cold.  (This means don't leave condoms in your car glove box or in your wallet!)
• Handle the condom carefully - make sure not to damage it with your fingernail, teeth, or sharp objects.  
• Place the condom on the erect penis before it comes in contact with the vagina.
• Uncircumcised men should pull back their foreskin before putting on a condom.  
• If you use a spermicide, place some inside the tip of the condom before putting on the condom.  (Though I suggest using a spermicidal condom every time!)
• For a condom without a reservoir tip (which I do not suggest using), leave a small empty space - about a half-inch - at the tip for semen, but do not allow air to get trapped at the tip.
• Unroll the condom all the way to the bottom of the penis.
• Ensure that there is adequate lubricant, or else the friction may cause the condom to break
• If your partner is a female and the condom breaks during intercourse, withdraw and use a spermicide.  (I would also suggest taking Plan B - it is most efficient if taken within 72 hours, the earlier the better.  Of course I do not suggest taking it if it is against your personal or religious beliefs.)
• After ejaculation, carefully withdraw the penis while it remains erect.
• Hold the rim of the condom against the base of the penis as the condom is withdrawn to prevent the condom from slipping off.
• Always check the condom for tears before removing it.  If any are found take the necessary precautions.
• NEVER USE A CONDOM MORE THAN ONCE!  If you plan on having sex again - put on a new condom.  (I recently heard someone say that they'd use a condom twice in a row because they are expensive... that logic is ridiculous and I'm pretty sure condoms are way cheaper than a baby...)

I know these rules seem simple and obvious, but you wouldn't believe the stories I hear.  I'm continually amazed by the stories people tell me and the lack of common sense people use.  Make protecting your sexual health a priority!  I wish that more people would take the risk seriously - you only have to have unprotected sex once to get pregnant or contract an STI.  Is the risk worth it, when the consequence could be HIV??

Contraceptives... so many options!

In my last post I talked about the number of people who are having unprotected sex.  While some people do choose to have unprotected sex, lots of people are simply unaware of their options.  So, this post is for anyone who is wondering what type of contraceptives are available and which ones would work best for you.
The main methods of contraception are as follows:
Condoms

Condoms serve as a barrier, preventing the passage of sperm and (in some cases) prevent the spread of STIs!  They are the only contraceptive device worn by men.  They are typically made out of either latex rubber or the intestinal membranes of lambs.  Latex condoms protect against STIs.  The latter is more expensive and the pores are large enough that HIV and other viruses can slip through (so they do not protect against STIs).  Unfortunately condoms often fail because they are not used correctly (I will soon post on proper condom usage).  The failure rate for typical use of condoms is 12%.
Advantages to condoms:

• Protects against pregnancy AND STIs!
• Does not rely solely on the woman to provide birth control.
• Cheaper than many other forms of contraceptives, no prescription necessary.  
• No side effects.

Disadvantages:

• They are often not used properly.
• Some people feel they make sex less spontaneous.
• Lessen sexual sensations for men.  

Hormonal Methods 
Oral Contraceptives (the pill): There are many kinds of birth control pills which vary in the type and dosage they contain.  There are two major categories: combination pills and mini-pills.

1. Combination pills contain synthetic forms of the hormones estrogen and progesterone.  Since women cannot conceive once they are pregnant, the combination pill tricks the brain into acting as though the woman is already pregnant, so that no ova mature or are released.  Since ovulation does not happen, she cannot become pregnant.  
2. Mini-pills contain synthetic progesterone only.  The mini-pill thickens the cervical mucus (it sounds gross, I know) so that the sperm cannot pass through, while also making the uterine lining less receptive to potentially fertilized eggs.  

Advantages to the pill: 

• Almost 100% effective when used properly!  The failure rate is incredibly low (0.5% or less)
• Easy to take, just set your phone alarm to remind you every day!
• Empowers women by letting them control their contraceptives (unlike condoms)

Disadvantages: 

• The pill should be taken at the same time daily.  (Missing days can = a baby) 
• Backup contraceptives must be used when starting the pill/ changing pills (again = baby)
• Since a lot of women do not always remember to take the pill daily or around the same time, the fail rate of typical use is higher, at 3%.
• No protection against STIs.
• Expensive. 
• Exposure to hormones (some people - like myself, but hey I'm a crazy worrier - worry about future health risk from the long-term exposure to estrogen.  This is very controversial though, do some research and decide how you feel about the issue!

The Contraceptive Patch: like the combination pill it also contains estrogen and progesterone.  The patch can be worn on your stomach, butt, upper arms, or back.  They are worn for a week (so you need four a month) and it slowly releases the hormones into your bloodstream.

Advantages to the patch:

• Like the pill it is more than 99% effective.
• Women do not need to remember to take it daily!  Put it on once a week and you are done!

Disadvantages (same as the pill):

• Cost.
• No protection against STIs.
• Exposure to hormones.  

Injectable Contraceptives: The seond-most popular method of contraceptives, after the pill.  There are two types - Lunelle and Depo-Provera.

1. Lunelle contains both estrogen and progesterone, and prevents ovulation.  It is injected monthly and has a failure rate of less than 1% when used properly.
2. Depo-Provera contains progesterone only and (according to the American Academy of Family Physicians) is as effective as female sterilization!!  It is injected every three months.  

Advantages to injectables:

• Highly effective.
• Not taken daily.

Disadvantages:

• Side effects (similar to the pill/patch, but possibly more intense): vaginal bleeding, headaches, breasts tenderness, irregular periods, vomiting, etc. 
• Exposure to hormones.
• Do NOT take if you smoke, have breast or uterine cancer, elevated blood pressure, or a history of heart disease, blood clots, or stroke.  

Intrauterine Devices (IUDs)

An IUD is an object that is inserted into the uterus and left in place to prevent conception.  They are used by over 100 million women in the world (they are used by nearly 1 in 3 women in China), however, they are used by only about 3% of women in the U.S.  In the 1960s IUDs became very popular in our country, they remained popular until the 80s when one popular brand became associated with high incidences of infertility and pelvic infections. Today IUDs are highly effective and a great option for women who do not want to worry about their birth control.  There are two types of IUDs: the Progestasert T and the Copper T 380A (otherwise known as ParaGard). They work by irritating the uterine lining, which leads to a mild inflammation.  The inflammation then causes the body to produce antibodies that are toxic to sperm and prevent the fertilized egg from becoming implanted.

1. The Progestasert T releases progesterone daily and must be replaced annually.  The failure rate is 2%.  Since insertations can possibly carry the risk of infection, health providers recommend the use of the ParaGard.
2. The Paragard is a copper based (T-shaped) devise, which has a failure rate of 0.8%, and it can be used for up to 8 years.  

Advantages to IUDs:

• Highly effective.
• Can last for years without replacing.  
• Paragard does not release any hormones into the body.  

Disadvantages:

• Insertion can be painful and there may be intense cramping and spotting for the first month or so.  
• Pelvic Inflammatory disease can occur after the insertion.
• Since they irritate the uterine wall there is a possibility that they could be expelled through the vagina.  Spontaneous expulsions occur in 2-10% of users within a year of use.
• Insertion can be expensive.
• No protection against STIs.

NOTE: IUD users are at a greater risk for ectopic pregnancies, during and after usage, and for miscarriages.  
Diaphragm

A rubber cup or dome that is fitted to the contour of the vagina.  It is coated with spermicide and inserted into the vagina before sex.  They are available by prescription, since they should be individually fitted to the woman.  Diaphragms can be inserted up to two hours before sex (any longer and the spermicide might start to lose its effectiveness).  They should be left in the vagina for at least six hours after sex - this ensures that the spermicide is able to kill any remaining sperm.  The failure rate of a diaphragm is 6%, however, in typical use the failure rate is 18!  This is often because it is not fitted properly or because they are removed too early.
Advantages to diaphragms:

• No side effects.
• No use of hormones.
• Can be used when needed, instead of daily (like the pill).

Disadvantages:

• High failure rate in typical use.
• Irritation may cause urinary tract infections or vaginal infections.
• No protection against STIs.

Spermicides
Spermicides are agents that kill sperm; they can come as jellies, creams, suppositories, foam, or a contraceptive film.  The failure rate of using spermicides alone is 21% - they are most effective when combined with other contraceptives.

NOTE: It is easy to find Spermicidal Condoms... if you choose condoms as your primary source of contraceptives USE SPERMICIDAL CONDOMS!  Double the protection :)
Advantages to spermicides:

• Great when used when other forms of contraceptives.

Disadvantages:

• Using them alone = too risky!  Always use them with another contraceptive!

The Contraceptive Sponge

The sponge is a soft, disposable device that provides a barrier that has built it spermicide.  It is placed in the vagina before sex and it absorbs sperm.
Advantages to the sponge:

• Can be inserted an hour or two before sex.
• Not as messy to remove as the diaphragm.  

Disadvantages: 

• Not as effective as other forms of birth control.
• There is a possibility (though rare) of developing toxic shock syndrome.  

The Cervical Cap

The cap is similar in shape to the diaphragm and must be fitted by a health provider.  However, it is smaller than a diaphragm and it fits over the cervical opening.  Before insertion the cap should be filled with spermicide and it should be left in place for 8 hours after sex.  The cap should be cleaned after each use and can last for up to three years.
Advantages to the cap:

• Can be inserted prior to sexual activity.
• Can be left in place, while offering continuous protection, for up to 48 hours!

Disadvantages:

• Failure rate ranges from 18%- 36%... scary!

Douching and the Withdrawal Method should not be considered viable methods of contraception.  Douching is ineffective, can cause vaginal infections, and may actually propel sperm toward the uterus.  The Cowper's gland releases pre-ejaculatory secretions of fluid, before ejaculation so the withdrawal method is unreliable and has an incredibly high failure rate!

Why choose risky sex when safe sex is so easy??

It absolutely horrifies me how little most teenagers and young adults know about contraceptives and safe sex practices.  Every once in awhile I encounter someone who naively believes that basically everyone knows how to have safe sex, they just choose not to.  The people that believe this are very lucky - they clearly had someone in their life (possibly a parent, doctor, or health teacher) who was willing and able to educate them.  While I realize that many people do choose not to have safe sex, there are so many others that do it because they truly do not know how to have safe sex.  According to several studies almost 40% of the teenagers in our country have never been taught about the different types of contraceptives or how to properly use them.  Many teenagers are unaware of how to properly put on a condom.  There are both teenagers and adults that falsely believe that they should wear more than one condom at a time to avoid pregnancy and STIs.  Wearing more than one condom at a time is incredibly risky because the friction between them often results in the condoms ripping.  There are also a lot of people who are also unaware that they need to take their birth control at the same time daily.  Women often do not use a second form of contraceptive when they start taking the pill or switch to a different type of pill, which might result in pregnancy.  It is not uncommon for people to have never heard of alternate forms of contraceptives such as IUDs.  I recently learned that a number of students in my graduate health education class had never heard of birth control shots before taking our class.  Although I am familiar with them, I have never known of anyone (that I know of) using a female condom.  How is it possible that there are so many products out there and yet so many people are either unaware of their options, or actually choosing to have unprotected sex?

FYI: Don't ever use a condom with a staple stuck through it :)

I think the most disturbing fact is that a significant portion of sexually active teens and young adults admit that they will most likely be having unprotected sex in the near future.  What has happened in our society that makes us think that this is acceptable behavior?  How is it possible that the risk of pregnancy, STIs and STDs such as HIV does not scare the crap out of our generation?  Are the current teens and young adults in our country really so arrogant that they truly do not believe it can happen to them?  I find that hard to believe.  I know so many people that have had unplanned pregnancies, and I know the STI rates for my age group... clearly it is happening to us.  So why is there so little concern over these possibly life threatening consequences?  No matter how hard I try I simply cannot wrap my mind around the choices that people make...  When it is so easy to purchase contraceptives why do people still choose to engage in risky sexual activities?  I continue to hope that with a stronger emphasis on the importance of sex education in combination with great health educators, maybe the next generation will make better, safer choices than ours.

Is teen pregnancy still an issue?

A sexually active teen who does not use contraceptives has a 90% chance 

of becoming pregnant within a year.

Often when I discuss teen pregnancy with people I am surprised with their negative reactions.  I often hear comments about how teen mothers are uneducated and mainly found in small, impoverished towns. Although I am from a small town and do remember a number of people I went to high school with having children before graduation, I do not believe that this is an accurate assumption.  I am appalled by how often pregnant teens and mothers are viewed as "trailer trash".  Don't get me wrong, I am by no means condoning teenage pregnancy.  I just do not believe that looking down on teen mothers or judging them is appropriate.  Considering the fact that the majority of high school students are having sex and the majority of those students are not always having safe sex - I think it's amazing that more high school students do not become pregnant.  I think that the real problem here is a lack of education and that so many boys and girls have false beliefs about sex and conception.  Some teens believe that you have to be having regular intercourse to get pregnant and many teens believe that the withdrawal method will protect them from pregnancy.  Teens often account their unplanned pregnancies to simply getting "carried away."  They had not planned on having sex, so they did not have any contraceptives... which lead to them having unprotected sex.  This is why education is so important.  Good health educators, who have the trust and respect of their students, can make them understand why it is necessary to have safe sex every time and how they can be safe.  The only way for us to dramatically reduce the number of teen pregnancies in our country is for parents and educators to work together, informing students about safe sex practices, making safe sex the norm for all people, and creating an environment where it is not only acceptable, but also expected to talk about sex.  

Facts:

In the U.S., in 2006, the teen pregnancy rate increased for the first time in more than a decade.  We currently have a higher teen birth rate than any other industrialized nation.  10% of all U.S. births are to teen mothers; 1 in 5 teen births is to a teen who already has a baby.  There are numerous negative consequences for teen mothers, such as: decreased level of education, poverty, and increased dependence on public assistance.  The children of teen mothers also face serious health issues such as being born prematurely and having lower birth weights.  

How does this affect you??  Teen childbearing cost taxpayers more than $9 billion per year!

Why are teens getting pregnant?  Lack of an adequate, comprehensive health education, false information about safe sex practices, language barriers, and problems at home are just a few of the reasons why some teenagers become pregnant.  

* The National Campaign to Prevent Teen and Unplanned Pregnancy has an amazing website, full of statistics, studies, and what you can do to help prevent teen pregnancy.

Should condoms be distributed in high schools?

I recently had to debate this subject, and I had to debate against condom distribution. Although I felt condoms should be available in high schools, before this assignment I really didn't know much about either side of the argument. Here is what I knew: condoms help reduce the risk of Sexually Transmitted Infections (STIs) and reduce the risk of pregnancy. Condoms are used inconsistently among sexually active teenagers. In the United States 1 in 5 sexually active teens (ages 15-19) become pregnant every year. That adds up to almost 800,000 pregnancies a year, resulting in half a million births and a quarter of a million abortions. Also in the U.S., 1 in 4 teens will contract an STI. So as you can see I knew a few statistics (in my opinion very alarming statistics) and that was it. This is what I learned:

Among sexually active high school students who reported being sexually active in 2003:

• 14% used oral contraceptives only
• 49% used condoms only
• 6% used both oral contraceptives and condoms
• 11% relied on the withdrawal method
• 3% contraceptive injections
• 2% used both condoms and contraceptive injections
• 12% used no method
• (the remaining 3% did not give clear answers)

Condom use among adolescents decreases as they mature.  In the 9th grade self-reported condom use is at 62.9%, however, it drops down to 49.5% by senior year.  In schools where condoms are available - 98% of schools offer counseling to students and in 49% of schools counseling is mandatory for condom receipt.  Counseling typically includes: information on abstinence, instruction on proper storage and use of condoms, and demonstration of how to put a condom on and take it off.  

PROS

1. Teenagers are already having sex - make it safe sex
2. Distribution of condoms creates an environment in which safe sex is seen as normal
3. Stop the spread of STIs and STDs (such as HIV)
4. Each year an estimated 3 million adolescents are infected with STIs, accounting for 25% of the estimated 12 million new STIs occurring annually in the United States
5. AIDS is the 6th leading cause of death among 15-24 year olds
6. Condom availability does not increase sexual activity in teens
7. Make using condoms the norm for teenagers
8. Enforces responsibility 
9. Teens may not buy condoms because of the cost or embarrassment 
10. If you are teaching safe sex, students should have access to safe sex!

CONS

1. Not the school's responsibility
2. Classrooms disturbances
3. Condoms are not the answer - we should not promote teens having sex
4. Condoms are not 100% effective - there is no such thing as "safe" sex
5. Takes away from abstinence only education
6. Takes away from the rights of parents
7. Parents should be educated so they can be responsible for their children's sexual health
8. Offensive to some religious/moral/personal beliefs
9. Very expensive to the school and taxpayers
10. Free contraceptives can be found at many free health clinics

After preparing and presenting my side of the argument, the only con that I agreed with was the expense of distributing free condoms.  However, the research is overwhelmingly clear that teenagers are having sex.  It is also clear that many of them are not using condoms as contraceptives and those that do use them often do not use them properly or consistently.  This leads me to believe that in addition to sex education classes and demonstrations, and available counselors, condoms should be available in schools.  A study here in Massachusetts interviewed more than 4,000 high school students and found that condom distribution did not increase the percentage of sexually active students.  It did, however, lead to more consistent condom use among already sexually active teenagers.    

“In the fight against AIDS, condoms save lives. If you oppose the distribution of condoms, something is more important to you than saving lives." – Melinda Gates

Why is sex education so important?

There is a lot of controversy concerning sex education in our public schools. Honestly, I understand the argument - parents should be responsible for teaching their children about sex. I agree with that statement. In an ideal world children would learn everything they need to know about sex from their parents (and possibly their doctors, too). However, that is not the world we live in. It's easy to say that parents should be educating their children, the tough part is actually getting them to do it. The fact of the matter is that most parents are not talking to their children about sex. Whether it is because they are embarrassed, uncomfortable, or simply lacking information, it is not happening. According to a national survey, by the National Campaign to Prevent Teen Pregnancy, only 1/4 of adolescents had discussed sex with their parents. That means that 3/4 of teenagers were not learning about sex at home - knowing this, how can we say that children should only be learning about sex from their parents?

I think it's really tragic that parents are either not willing or able to discuss these important matters with their children. In another survey (also by the National Campaign) which interviewed thousands of teens, 88% of them claimed that they believed it would have been easier for them to postpone sex if their parents would have talked openly (and informatively) with them about the subject. By directly bringing up the topic and having open discussion about sex parents can have a major impact on their children's behaviors and views. Unfortunately in the majority of households this is not happening.

That is why sex education is necessary in every school. While it would be ideal for parents to educate their own children, it is not happening. In fact most teens learn about sex from their peers and the media, which means that the information they are receiving is often inaccurate and biased. In this day and age every child should be receiving comprehensive health education, including sex education. With teen pregnancies on the rise again, and the growing number of teenagers and young adults with Sexually Transmitted Infections it is vital for every student to be educated about sex, reproduction, and contraceptives. People who believe that sex education is simply teaching their children that it is okay to have sex (or how to have sex) are gravely mistaken. Sex education is about teaching students to understand their bodies and how they work. It is about teaching students what to do in difficult situations, how to handle peer pressure, and how to stand up for their personal beliefs. It is about giving students the confidence to respect themselves and the choices they make. Educating students gives them all of the necessary tools they need to make informed appropriate decisions. For all of these reasons and more sex education is essential in our schools.