Recently Madison West High School announced a “Condom Availability Program” in an attempt to prevent sexually transmitted infections and to teach students about sexual health. In addition to availability of free condoms, the program includes teaching on reproductive health, proper condom usage and sexual consent.  

Nationally, sexually transmitted infections (STI) continue to increase at alarming rates. In Wisconsin, STI rates reached a historical high in 2017 and students at Madison West appear to be contributing more than their fair share, having more than doubled their STI rates between 2015 and 2017. Unfortunately, youth ages 15-24 carry the greatest burden of infection. While they only account for 25% of the sexually active population, they account for 50% of newly diagnosed infections. Nearly 40% of sexually active teen girls (ages 14-19) have at least one STI.  Frightening odds.

Rolling the Dice

For years, sex education philosophy has largely focused on easy access to condoms and a message that ‘safe sex’ is the result of condom use, sorry ‘proper condom use.’ There is ample evidence that proper condom usage significantly reduces sexually transmitted infections, still STI rates continue to rise at alarming rates. This leads to the conclusion that the condom availability philosophy in schools may not be as effective as it could/should be and the result is 10 M new cases of infections in youth ages 15-24.

In the STI public fact sheet, the CDC states, ‘The most reliable ways to avoid transmission of sexually transmitted diseases (STDs), including human immunodeficiency virus (HIV), are to abstain from sexual activity or to be in a long-term mutually monogamous relationship with an uninfected partner.’  This would be considered risk prevention and setting the bar at the highest level. This is an attainable goal and lifestyle, despite being culturally non-normative.

Improving the Odds

What has been learned from evidence-based research offers a starting place for discovering potential success paths for STI reduction in youth. Ascend, a nationally known youth sex education and research group has established themselves as a leader in the field of sexual risk avoidance. Their youth training resources focus on empowering youth to make smart, forward-thinking choices about their sexual behavior. Much of the data and information used by Ascend is derived from the Youth Risk Behavior Surveillance System which provides significant data pools.

Using Data to provide Direction

  1. 40% of teens state that sex education classes make them feel pressured to have sex.
    1. Counter the ‘everybody’s doing it – here’s your condom’ message with statements indication the benefits of delayed sexual activity.
  2. It’s ok to NOT be having sex! Among 15-17 year olds, 66% of boys and 70% of girls have never had sexual intercourse.’
    1. Provide encouragement and reasons for students to wait including the fact that delayed age of first sexual activity has a direct correlation to the number of lifetime sexual partners or how delaying sex appears to aid in the permanence of future marriage.
  3. It’s ok to wait. About one half of 18 and 19 year olds wish they had waited longer before becoming sexually active.
    1. Provide relationship building skills and give students training on healthy relationships and boundaries.
  4. Sexually active high school students were 13% more likely to use a condom in 2007 than in 2017. 
    1. Teach truthfully about the risks and limitations of condom usage in preventing STI exposure. Stress the importance of proper usage all the time (a near impossibility). Honestly share the fact that HVP and Herpes can easily be transmitted even with condom use since it can be spread by skin-to-skin contact. 

It is evident that the practice of handing out condoms in high schools has not reduced near-epidemic levels of STI rates in youth. Perhaps expanding the ‘condom availability message’ to include information stated in points a through d above, as well as other risk prevention strategies, has a better potential for preventing infection. Maybe it’s time we look beyond a practice that has produced unhealthy results and consider a different message.

To the students at Madison West High School – good luck! May those handing out condoms to you carry the weight and responsibility to fully inform you of the risks and limitations of condom use. In the end – may your decisions lead you to places of health, prosperity and bright futures! You deserve to know.

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