Sexually Transmitted Diseases
Last Wednesday morning, Kansas University health educators stood in front of a classroom of Lawrence High School students answering questions about sexually transmitted infections.
But the real education came after their presentation when the students - unabashedly - answered questions posed to them about the prevalence of STIs.
Yes, they said, students talk about STIs. Some of it comes in the way of quick-spreading rumors that are whispered in school hallways. And, some of it is in the form of distressed secrets shared among friends.
Either way, teenagers have STIs, even in Lawrence.
"A lot of people go to parties, drink, don't realize what they are doing, don't use a condom : and the next day they are like 'Oh, my God,' " said Alexah Gudenkauf, an LHS sophomore.
Still, Gudenkauf, like many of the other girls in the class, was surprised by a study that the Centers for Disease Control and Prevention released this month. One in four teenage girls has at least one sexually transmitted disease, the CDC reported.
The study, the first of its kind, tested 838 girls between the ages of 14 and 19 for sexually transmitted infections and included both those who said they were sexually active and those who said they were not.
"I didn't know it was that high; I didn't know it was that common," Gudenkauf said. "But, I understand why."
Notion of invulnerability
A couple of times a week, Ken Sarber, a health educator at KU's Watkins Health Center, goes out in the community giving talks on safe sex.
He is armed with statistics, such as one in four college students will contract at least one sexually transmitted disease before graduating, and half of all sexually active students will have an STI by age 25.
Many teenagers use birth control pills or spermicide, which helps prevent pregnancy but not STIs, Sarber said.
"With a large number of students not using protection, yeah, it's definitely a concern, but it doesn't surprise me at all," he said of the study on teenage girls.
On Wednesday, with peer educator Kara Boston, Sarber arrived at Betty Currie's Personal and Family Wellness class at LHS.
Students asked about symptoms, where to go for help and how to protect themselves (abstinence first and safe sex second, the health educators said).
Many of the girls in Wednesday's class said that teenagers were far more worried about getting pregnant than contracting an STI. And most just don't think it will happen to them.
Nancy Jorn, with the Lawrence-Douglas County Health Department, says research shows that until teenagers reach age 17 or 18, they aren't considering the consequences of becoming sexually active.
"Earlier than that, they aren't thinking about it period. They are thinking, 'It's not going to happen to me,' " said Jorn, the director of the department's maternal child health services.
Alcohol a contributor
Alcohol and the spread of STIs are closely linked, Sarber said. When teenagers drink, their decision-making skills falter as do their fine motor skills. It makes them more likely to have sex than they would if sober. And, when they do, they tend not to use protection or to use it incorrectly.
"A huge part of the problem is mixing alcohol and sexual relations," Sarber said.
He drove home that point Tuesday evening during an alcohol awareness event in the lobby of KU's Corbin Residence Hall. Wearing "drunk goggles" - eyewear designed to give the feeling of having had one too many - students in the female dormitory navigated an obstacle course, tossed balls to one another and tried to put together puzzles. At the end, the group practiced putting condoms on models while wearing the goggles. All this was to give them the sense of just how impaired coordination can be while drunk.
Freshman Katherine Perry was among those wearing the goggles. While little is taboo in college dorms, she said the topic of STIs is.
"There's a stigma associated with it," she said.
At KU's Watkins Health Center, about 2,000 women and men were tested for STIs last year. Four percent tested positive for chlamydia and 0.3 percent tested positive for gonorrhea. Of the 100 or so patients tested for herpes, 32 percent were positive.
That doesn't account for the human papilloma virus, which Watkins Chief of Staff Patricia Denning said is the most common STI detected. The center didn't have the number of HPV cases that were found last year. It's a disease that doesn't get reported to state health departments.
Over at the Lawrence-Douglas County Health Department, out of the 150 to 175 people who get tested each month for STIs, between 5 percent and 7 percent have chlamydia, the most common STI in the United States. Chlamydia is caused by a bacteria and can lead to pelvic inflammatory disease if not treated.
In the CDC report, 18.3 percent of the teenage girls who tested positive had HPV, an STI that can lead to genital warts and cancer.
It's a number that Denning hopes reinforces the need for females to get vaccinated with Gardasil, which protects against several of the more common strains of HPV.
"It tells us that we definitely need to be using Gardasil. That HPV is out there," she said.
Many local health officials and educators interviewed for this story mentioned at some point during the conversation that part of the problem is that sex education classes have moved away from addressing the reality of teenagers having sex.
Dennis Dailey, a retired KU professor who once taught a controversial human sexuality class, agrees. The major message to teenagers is don't do it, he said.
"The dominant sex education standard in our society right now is abstinence-only, fear-based, shame-based education," he said. "It's not comprehensive sex education. In most of those classes, students aren't getting information about contraception and that sort of thing because the assumption is they aren't going to be sexual. Well, that's stupid. They are going to be sexual-unsafe."
Currie's LHS class is an elective. A few years ago, when the course was called Human Sexuality, her classrooms were packed. But, when state standards mandated a name change, Currie said interest dwindled. On Wednesday, she had eight students in the class.
Many students said the information they have picked up would have been useful in junior high before students become sexually active.
"For a lot of people," Gudenkauf said, "ninth grade is when they start having sex."