by Kait Scalisi | Jan 16, 2015 | News, Sex Stories
By Kait Scalisi, MPH
Its an established fact that comprehensive sex education helps reduce the incidence of unplanned pregnancy and sexually transmitted infections (STIs). Nevertheless, such programs face resistance from many parents, communities, and educators. Now, two opposing bills have come forward in the Texas Legislature: one promoting the statewide adoption of comprehensive sex ed programs, and the other banning any program produced by an agency that provides abortion services or any affiliate of such agency.
In other words, it’s on.
Texas law currently does not mandate either sex education or HIV education. When provided, parents must be given notice and have the opportunity to opt out. Additionally, when provided, sex ed must
- be age-appropriate.
- stress abstinence.
- include information on the importance of sex only within marriage and the negative outcomes of sex.
- provide a negative view of same-sex relationships.
- cover life skills for avoiding coercion and healthy decision-making.
(Information from the Guttmacher Institute’s Sex and HIV Education Policy in Brief).
Texas’ Health and Safety Code also requires that the education department develop medically accurate model programs to educate the public about AIDS and HIV infections. However, it does not define whether or how these programs should be administered in schools. Lastly, in 2004, information on contraception and STI prevention was removed from the state’s high school biology textbooks.
This sets the scene for the current legislative battle. On one side, we have HB 78 which promotes mandated age-appropriate and medically accurate sex education. The bill not only defines age-appropriate and medically-accurate in strict terms, it also maintains the focus on abstinence while highlighting the impact of birth control, gives schools the freedom to distribute condoms, and requires that healthy relationships and communication skills are taught. The bill has a wide-reaching scope with one overarching message—sexuality is normal and should be presented as such, with all its risks and potential rewards taken into account.
On the opposing side is HB 205. This bill prohibits organizations providing abortions and their affiliates from providing any sex education in or sex-ed teaching materials to schools. To put it bluntly, it appears to be little more than a thinly veiled attempt to ban Planned Parenthood and clinics and non-profits like it from teaching in schools.
Based on Texas’ history with legislation around this topic and other sexual and reproductive health issues, HB 78 looks outnumbered and outgunned. That being said, it does not necessarily mean that HB 205 will carry the day, either. In recent years, we’ve seen small shifts in the Legislature’s bias, a result, at least in part, of Sen. Wendy Davis (D) and her allies. Davis’ 2013 filibuster of a Senate anti-abortion bill rallied fierce support from advocates and proponents of reproductive rights and, by extension, comprehensive sex education. As a result of this shift, then, the question becomes whether Davis’ camp has enough power to sway the Legislature in favor of HB 78—or, if not, face down supporters of HB 205.
Other Sexual Health News
Obama will Offer Paid Parental Leave to Federal Workers (The Miami Herald)
HIV/AIDS Patients in Deep South have Lower Survival Rates, Study Shows (Stanley News and Press)
Federal Judge: South Dakota Ban on Gay Marriage is Unconstitutional (Grand Forks Herald)
Breastfeeding, Sexual Orientation Could Soon Be Protected Under Utah Law (Fox 13 Salt Lake City)
Bill Introduced to Ban ‘Sexual Orientation Therapy’ (First Coast News)
Walgreens Unveils Well Beyond HIV™ Campaign to Celebrate People Over 50 Aging with HIV (Yahoo Finance)
Conference Proposals Due
The following conference proposals are due in January and February. Click on each name for more information.
Woodhull Sexual Freedom Summit, January 28.
National Sexual Assault Conference.
Upcoming Conferences
The following conferences take place in January and February. Click on each name fore more information and to registers.
Sexual Health Expo, January 17-18.
National Conference on Campus Sexual Assault and Violence, January 24.
Southern HIV Alcohol Research Consortium Conference: HIV and Substance Abuse: Global Health Lessons, Local Health Impact, January 29.
National Conference on LGBT Equality, Feb 4-8.
Southern California Sexual Health Summit, February 12.
ISSWSH 2015 Annual Meeting, February 19-22.
Conference on Retroviruses and Opportunistic Infections (CROI), Feb 23-26.
by Kait Scalisi | Jan 9, 2015 | News, Sex Stories
By Kait Scalisi, MPH
Each year, the CDC’s annual report on sexually transmitted diseases (STDs) gives hard evidence that America isn’t a sexually healthy nation. There are an estimated 20 million new sexually transmitted infections in the U.S. annually—more than the number of cases of diabetes, heart disease, breast cancer, and asthma combined—which can lead to many serious health problems, including infertility, male and female cancers, and fetal illness.
The data included in Sexually Transmitted Disease Surveillance, 2013 are compiled from STD case reports from private and public sources. The report does not provide comprehensive STD information for a variety of reasons, including the fact that some infections are not routinely reported, and nationally reported diseases like chlamydia, gonorrhea, and syphilis often go undiagnosed. Nevertheless, the trends highlighted in the report provide an overall picture of the current state of STDs in the U.S. and help public health professionals see trends, set priorities, and adapt strategies for prevention and control.
The 2013 report shows some wins for sexual health. There was a decrease in chlamydia for the first time since nationwide reporting for the disease began. That the decrease was higher among women is also important given that chlamydia’s long-term impacts are more serious for women. While gonorrhea rates remained practically the same, there was a decrease among adolescents (15-24). Increased availability of urine testing have allowed men to get diagnosed with and treated for chlamydia more regularly. Initial visits for trichomoniasis and other vaginal infections among women declined.*
On the other hand, gonorrhea rates went up for non-adolescents and there was an increase in all forms of syphilis (primary, secondary, and congenital). Initial visits for genital warts and herpes increased.* There continued to be sometimes huge discrepancies in STD rates by race, sexual behavior, location, and age. Men who have sex with men (MSM), adolescents, and blacks continue to carry a disproportionate disease burden. Though chlamydia and gonorrhea diagnoses decreased overall for adolescents, they continue to be diagnosed more frequently than any other age group. Meanwhile, the increase in primary and secondary syphilis diagnoses was only among men, with MSM accounting for nearly three-quarters (75%) of the diagnoses. About half of these men also have HIV/AIDS.
Lastly, the report highlights factors that contribute to the disproportionate distribution of STDs. These include but certainly are not limited to:
- The ability to access and pay for any sexual health care.
- The ability to receive culturally-sensitive and appropriate care and treatment.
- The lack of provider training on and/or adherence sexual health guidelines.
- Individual risk behaviors including number of sex partners, condom use, etc.
- Distrust of the medical establishment.
This last piece is particularly important as it highlights the need for better provider training as well as more effective outreach to adolescents and MSM. While public health is slowly becoming more sex-positive, the continued inequality in STD diagnoses represents a call to action to do something differently. While the larger picture is a positive one—some of the lowest rates of unplanned pregnancies ever, for instance—these numbers show the continued need for education, outreach, and empathy around STDs.
*Trichomoniasis and other vaginal infection data are not nationally representative.
Other Sexual Health News This Week
UD Reviewing Sexual Assault Policies (Delaware Online)
Greensboro First in NC to OK Sexual Orientation, Gender Identity Housing Protections (News & Record) while Duke University Application Now Asks about Gender Identity, Sexual Orientation (USA Today)
Veterans Discharged after Sexual Trauma Push for VA Health Benefits (Washington Post)
Big Week Begins for Texas Laws Over Abortion, Gay Marriage (CBSDFW)
Legal Fight Continues after Same-Sex Marriage Licenses Issued in Florida (WFTV.com)
Intel Announces Micro Wrist Computer and Gender Equality Campaign (Tech Week Europe)
New California Law Aims To Help Lesbian, Gay, Bisexual, Transgender-Owned Businesses (CBS San Francisco)
Conference Proposals Due
The following conference proposals are due in January and February. Click on each name for more information.
Woodhull Sexual Freedom Summit, January 14.
Upcoming Conferences
The following conferences take place in January and February. Click on each name fore more information and to registers.
Sexual Health Expo, January 17-18.
Southern HIV Alcohol Research Consortium Conference: HIV and Substance Abuse: Global Health Lessons, Local Health Impact, January 29.
Southern California Sexual Health Summit, February 12.
ISSWSH 2015 Annual Meeting, February 19-22.
National Conference on Campus Sexual Assault and Violence, January 24.
by Kait Scalisi | Dec 18, 2014 | News, Sex Stories
By Kait Scalisi, MPH
Circumcision has long been controversial, and new guidance from the CDC that clearly supports the practice may make it even more so.
Rarely will you find someone who feels indifferent about circumcision. More likely, the conversation will devolve into an argument and the topic of circumcision will be banned from future discussion. Many people have strong feelings about foreskin. Those who favor circumcision offer the following arguments:
- The health argument—”It’s cleaner and protects against STIs, including HIV.” (Maybe valid.)
- The aesthetic argument—”Have you ever seen an uncircumcised penis?! EW!” (Shaming much?)
- The daddy argument—”We want to make sure he looks like his father.” (Because every child has a dad…)
- The what’s-it-for argument—”I don’t know what to do with it!” (Valid + enlightening to the need for more comprehensive sex education.)
Recently, the CDC codified the first argument as fact in their latest guidance on the topic. Specifically, CDC recommends that healthcare providers counsel all uncircumcised, sexually active, straight males, adolescent males, and parents of newborn males on the risks and benefits of circumcision. One big thing to note here: As written, the guidance assumes that physicians are discussing sexual behavior with their patients. Research shows this is not the norm, especially for adolescents.
Now on to the risks and benefits. The CDC guidance concludes that the latter outweigh the former, citing the following compelling statistics in favor of circumcision:
Being circumcised reduces a man’s risk of getting
- HIV from a female partner by 50-60%
- herpes by 45%
- cancer-causing strains of HPV by 30%.
Women also are less likely to become infected with HPV, bacterial vaginosis, and trichomoniasis if their partner(s) are circumcised. There currently is no research showing that circumcision reduces STI risk among men who have sex with men (MSM) or reduces HIV risk to women.
On the other hand, the risk is minimal, with adverse events occurring in 0.5% of newborns, 9% of children, and 55% of adults.
The CDC also echos the sentiment that the procedure should be voluntary and take into account personal, cultural, religious, and ethical beliefs. While this is all well and good, you have to wonder whether this is just rhetoric given both that most circumcisions are done before a baby can consent and that many people take healthcare provider’s recommendations as law, particularly if such recommendations align with their other beliefs.
My biggest issue with this whole topic is the hypocrisy when citing this research. Public health is constantly poo-pooing studies for not being representative or generalizable, yet these guidelines are based on research performed in the developing world. This article provides a wonderful discussion of whether such research can and should be applied to US policy. Of note:
“If you consider the argument that circumcision might prevent HIV among ADULT men in third world country settings, it becomes a bit abstract to make the same conclusion for newborn boys in a developed world. This has always been the intangible factor, when the AAP changed its tone towards encouraging circumcision for newborns in the U.S. As such, having an adolescent make that choice, when presented with the possibility of a health benefit, does make more sense. The HIV prevention argument is far more relevant to an adolescent than to a newborn, so to encourage the inclusion of the adolescent population into this forum is appropriate.”
Another major issue is the message this guidance sends to uncircumcised adolescents. It feels contrary to the decades of messaging around condom use to prevent STIs. If all a teen boy needs to prevent STIs is a circumcised penis, then why deal with condoms at all? (Especially if condoms seen as reducing sensation and pleasure.) In other words, the CDC’s heavy focus on STI prevention as the motivator for this guidance gives teens one more excuse to skip condoms.
Lastly, given that the rates of HIV remain higher among MSM and circumcision offers no protection for such sex, it will be interesting to see whether this guidance ultimately impacts HIV rates overall.
The CDC guidance is currently open to public comments. To add your opinion, click here.
Other Sexual Health News this Week
FDA Grants CLIA Waiver Expanding the Availability of Rapid Screening Test for Syphilis (FDA)
CDC releases Recommendations for HIV Prevention with Adults and Adolescents with HIV in the United States, 2014 (AIDS Info)
Could Big Data Be the New Gender Equality Tool? (Newsweek)
A Comprehensive LGBT Nondiscrimination Bill Is Coming (Time)
Was 2014 the Year Science Discovered The Female Orgasm? (The Daily Beast)
Pam Bondi Files Appeal to Halt Gay Marriage in Florida (Orlando Sentinel)
Colleges Often Reluctant to Expel for Sexual Violence- with U. VA a Prime Example (Washington Post)
by Kait Scalisi | Dec 5, 2014 | News, Sex Stories
By Kait Scalisi, MPH
Earlier this year, the U.S. Department of Education stated that Title IX nondiscrimination protections extend to gender identity and expression. This week, the DOE specified that K-12 schools must let transgender students participate in single-sex classes that align with their gender identity.
The new guidance is but one paragraph in a long memo, but it’s a milestone in the movement toward transgender equality. Not only does it reiterate the nondiscrimination standard announced earlier, it leaves no question about how to treat trans* students going forward.
Some schools might resist or ignore the directive, but not without scrutiny. Several school districts have been investigated already for discriminating against transgender students. In one case, a transgender boy was required to use a bathroom in the nurse’s office. In another, the school ignored a transgender girl’s complaints about bullying.
The DOE clarification feels exceedingly timely given the recent increase in single-sex classrooms. As the New York Times reports, there are currently about 1,600 public schools in the country with at least one single-sex class. This is an estimated increase of over 1,000% in the last decade. The tactic is especially popular among schools with lower standardized test scores. Single-sex instruction is likely to spread even more as a preliminary analysis of test scores showed 70% increases in math and reading scores for elementary students in single-sex classes.
It is important to note that the new guidance on same-sex classes does not formally apply to school sports, which fall under a different section of Title IX. School athletic organizations could take a cue, and act on their own initiative, as the Minnesota State High School League league has. Any policy that touches school sports tends to stir up public emotion. The sports league’s proposed policy made a lot of noise and heat in Minnesota, which could be a preview of a sensational national controversy to come.
Other Sexual Health News This Week
Health CDC: Circumcision Benefits Outweigh Risks (ABC News)
Gillibrand Seeks Another Vote on Military’s Handling of Sexual Assault Cases (New York Times)
Experts Examine HIV/AIDS Epidemic in Pittsburgh Area (Pittsburgh Post-Gazette)
Texas County Clerks Prepare for Same-Sex Marriages (Texas Observer)
Momentum Builds for Review of Same Sex Marriage (SCOTUSblog)
Important Dates
The following conferences have early registration deadlines in December. Click on each title for more information and to register.
National Conference on Sexual Assault and Violence, Feb 24-25, Berkley, CA.
The following conferences have submission deadlines in December and January. Click on each title for more information.
Woodhull Sexual Freedom Summit, Jan 14.
Emory University’s RespectCon, Jan 30.
The following conferences take place in December and January. Click on each title for more information and to register.
Southern HIV Alcohol Research Consortium Conference: HIV and Substance Abuse: Global Health Lessons, Local Health Impact, Jan 28-29, Gainsville, FL.
by Kait Scalisi | Nov 21, 2014 | News, Sex Stories
By Kait Scalisi, MPH
Did you know that this past week was It’s On Us Week of Action?
If you attend or work at a college or university, the answer is probably yes. If you’re involved in sexual health in practically any other way, it isn’t terribly surprising if you didn’t.
For those who are unfamiliar, It’s On Us Week is the next step in the White House’s strategy to end sexual violence on college campuses. The goal: to partner with colleges, universities, and a variety of organizations (e.g. NCAA, SnapChat, etc) to spread the word about the importance of everyone doing their part to prevent such violence. Over 200 schools joined the It’s On Us movement in September, leading to 130 events and 40 campus-created PSAs.
This is a great movement. It’s mobilizing students throughout the country, including athletes and members of Greek life, two key groups in this fight, to speak out about this issue. The PSAs featured people of all genders and race/ethnicities. Generation Progress, the group who is overseeing the entire It’s On Us campaign made some incredibly smart and strategic moves. These include:
- Partnering with Snapchat. Public health as a field is not always the most social media savvy. More and more we’re seeing organizations and schools get on board but in this case, the field’s reliance on data is holding it back. Meanwhile social platforms continue to evolve, Snapchat being one of the newest and most appealing to college students who are leaving Facebook and Twitter due to the invasion of the OPS (old persons). Props to Generation Progress for taking a very business approach to planning and meeting their target audience where they’re spending time.
- Partnering with the NCAA and SB Nation. Sports sports sports! Over the past few years we’ve seen numerous cases where the hero worship of sports stars has come crashing down in a blaze of sexual violence. SB Nation coordinated its social media efforts to reflect is relationship to the campaign and included a number of insightful pieces. My favorite piece acknowledges that fans can and should appreciate the beauty of the sports world without letting it blind them.
All that being said, there were some major disappointments of the week a well.
- The NCAA. Although the college sports association technically was a partner for the Week of Action, they did little to publicly show their support. None of their social profiles were changed to include the It’s On Us filter, there was no feature on the main page of their website, and they tweeted about the Week of Action exactly once. They certainly were not the most engaged partner, a move which implies this issue is still not that important to the college sports world for any reasons other than good PR.
- The lack of Greek Life buy-in. While many individual campuses’ Greek life participated in the Week of Action, there doesn’t seem to be be buy-in from the oversight councils. Individual chapters doing work is wonderful. Whole sorority and fraternity systems is even better.
- The continued disconnect among sex education, sexual health, and violence prevention. Where was Cosmo, Scarleteen, and Bedsider? Where were the PSAs on popular TV shows and Hulu? Perhaps such outlets were contacted and declined. However, in general these three fields tend to work in opposition to one another rather than supporting each other’s efforts during major campaigns like this. Obviously each area has its own unique agenda, target audience, etc. Nevertheless, each piece also supports the other. For example, more comprehensive sex education allows for more conversation around sex and also sexual health, decreasing the shame and stigma that It’s On Us is also working to limit. I’m not saying each group has to always talk about all the issues but during a campaign such as this week, it would allow for broader reach to audiences that may not have otherwise gotten involved. Almost any sex educator who works on a college campus can tell you a story about bearing witness to students’ stories of sexual assault. So though the connection between Sex Week and It’s On Us may not seem obvious at first, the underlying motivations and ideals are very similar. It would be nice to see that being acted out more overtly. And, for the record – sexual violence prevention organizations could also help out during major sexual health and sex education campaigns such as Get Yourself Tested.
None of this is to undermine the work of the White House or It’s On Us. Instead it’s a call for even more strategic thinking for future campaigns. What else do college stud nets do? Where are they spending their time? What are they reading? What makes them laugh? How can It’s On Us and all other sex-related campaigns hone their language and outreach strategies even more? The goal of course it to get broader attention for the campaign, including in places where it might be less likely found (e.g. more traditional or conservative schools).
I believe in progress, not perfection, and the this campaign certainly represents that. The very fact that the media, colleges, Greek Life, and more are openly discussing sexual violence is a positive step. By taking a stand and bringing sexual violence out into the open, It’s On Us is helping to reduce the shame and stigma survivors so often feel and create a cultural shift in how we think about responsibility and fault.
To learn more about the It’s On Us Campaign, click here.
Other Sexual Health News This Week
Rikers Island to Launch Unit for Transgender Inmates (New York Daily News)
State Can’t Make Sex Offenders Give Authorities Their Internet IDs (LA Times)
Judge Lifts Montana Same-Sex Marriage Ban (ABC FoxMontana)
More Women Getting Mastectomies They May Not Need (CBS News)
Olympic President Wants to Add Sexual Orientation to Non-Discrimination Policy (Think Progress)
Sex Ed Controversies in Gilbert, Tempe an Anomaly (AZ Central)
Important Dates
World AIDS Day, Dec 1. Click here to find events near you.
The following conferences have early registration deadlines in December. Click on each title for more information and to register.
National Conference on Sexual Assault and Violence, Feb 24-25, Berkley, CA.
The following conferences take place in November and December. Click on each title for more information and to register.
National Sex Ed Conference, Dec 3-5, Meadowlands, NJ Be on the lookout for presentations by SHR’s Kait Scalisi and the CSPH’s Megan Andelloux
