Rates of sexually transmitted diseases among teens reaching epidemic levels

By SHAWN DOHERTY | The Capital Times

Four sets of locked doors slam shut behind Meghan Benson as she marches into the Dane County Juvenile Detention Center lugging a plastic storage container. Teens in maroon jumpsuits wave. Benson is a Thursday night regular. She is here to fight an epidemic that will infect more young people at the center and in the rest of Wisconsin than H1N1, and Benson is one of the few people willing to take it on openly.

After signing in at the security desk, Benson opens the container and pulls out her weapons: condoms, a replica of the female reproductive system, birth control pills and patches, a diaphragm, a dental dam and a wooden model of an erect penis. She has given 20 similar presentations this week to local teenagers in public schools and community centers.

The 25 kids in the detention center’s classroom are giggling and quarreling and gossiping like any other group of teens. Many are accused of crimes ranging from theft to assault. But Benson knows many will end up victims, too, not just of crime but of one of the most serious public health threats facing Wisconsin and the rest of the country. She starts by setting the ground rules — respect and confidentiality — for what they are about to talk about.

Sex.

Sexually transmitted diseases are reaching epidemic levels in Wisconsin and across the country. The Henry J. Kaiser Family Foundation estimates that there are 253,500 new cases of sexually transmitted infections in Wisconsin each year. A key reason: a surge in infections among teens, according to a Capital Times analysis of state health reports and interviews with local experts.

One in four teenage girls in the U.S. has an STD, according to the Centers for Disease Control. In Wisconsin, the rate of four of the most commonly reported STDs among teens jumped 53 percent between 1997 and 2007. Females and minorities, especially African-Americans, have been hit hard. And these are numbers that have been reported; actual cases may be much higher. But it remains a hidden epidemic, not just because many STDs have no symptoms, but because of the stigma and politics that complicate efforts to fight them.

Benson, an educator with Planned Parenthood of Wisconsin, is among a growing number of local advocates, educators and medical professionals convinced that the best way to fight the spread of STDs is to talk about them and to teach kids to use protections like condoms. A vocal group of others, many of them religious and conservative activists, believe the exact opposite. There is already too much talk about sex and contraceptives, they say, and that’s why the four out of 10 Wisconsin teens who claim to be sexually active face soaring rates of infection. What these kids really need, they say, is to be taught how to abstain from sex completely. “It’s a titanic cultural clash,” says Julaine Appling, chief executive officer of Wisconsin Family Action and a leader of the local abstinence movement.

The presence, or absence, of sexual education — or sex ed, as most call it — is not the only theory for why STDs among young people are on the rise in Wisconsin and elsewhere. There’s a long list of other potential explanations, too. Biology: Children go through puberty earlier thanks to better nutrition, and the immature cervix of teenage girls is especially vulnerable to infection. Psychology: Kids with raging hormones think they are invincible and take stupid risks. Sociology: Children who grow up in the inner city take risks because they can’t imagine a decent future. Technology: Better screening detects more STDs. Poverty: A lack of access to medical care means those infected won’t know they have an STD and will continue to spread it. Culture: Casual high school hookups have replaced the romance of dating. The media: Kids are being sexualized in ads, movies and on the Internet.

But sex ed is what gets people most riled up. The issue erupted in the Legislature this fall after lawmakers introduced a bill that would encourage more comprehensive sex education in Wisconsin schools. Just weeks ago, Milwaukee officials also created a firestorm with their decision to distribute condoms in public high schools. “What if, God forbid, a kid comes in and gets a condom and takes a girl into the school bathroom?” asks Sally Ladky, executive director of the Milwaukee-based Wisconsin Abstinence Coalition. Many say it was a decision born of desperation and embarrassment: Milwaukee County has some of the highest rates of poverty, teen pregnancy, infant mortality and STDs in the entire nation — rates that account for nearly half of some of the state’s sexually transmitted infections.

“The hysteria over this has been mind-boggling,” says Rep. Tamara Grigsby, D-Milwaukee, a co-sponsor of the sex education bill. “We have to deal with reality. Just look at the numbers and how horrible they are. Why wouldn’t we want to protect our kids?”

The numbers are horrible. Yet in all the sound and fury over contraceptives and sex education, they have been mostly — some say even deliberately — ignored. Far more attention and resources and news stories have been devoted to another epidemic sweeping the state and country: H1N1. In Dane County, for example, around two-thirds of the eight public health nurses on the STD-HIV team have been reassigned to fight swine flu. “No state wants to admit it is having an epidemic of STDs,” says Chris Taylor, public policy director with Planned Parenthood Advocates of Wisconsin. This reluctance to deal with sex “as a natural part of growing up” the way many other countries do, Taylor believes, is why the U.S. has some of the worst teen pregnancy and STD rates in the Western world. “If we saw any other infections growing like this, we’d be going totally ballistic,” Taylor says.

Agrees Linda Denise Oakley, a professor of nursing at UW-Madison and a psychiatric nurse practitioner who counsels young adults at risk for sexually transmitted diseases: “We are not taking care of our children.”

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