The STD Crisis: We have to save our kids

This requires action, and now.

It was hard to miss the recent terrible news that 3.2 million girls have a sexually transmitted disease. Worse, blacks were infected at twice the rate of white or Mexican-Americans, with more than half of black girls and young women reporting at least one. Again and again, those stats were splashed across newspapers, trumpeted on websites and floated at the bottoms of the TV screens.

Alright already—we got it. We know the numbers, but what's the why? Why are so many U.S. black girls and women infected and why is our rate double that of the others? Most news reports didn't bother to explain the difference in rates; because most of the reporters didn't ask.

The huge unanswered question—and the 10,000-pound elephant in the news—is: Do the high rates mean that compared with their peers, black teen girls are having more indiscriminate sex with less protection?'

The answer is no. Even the CDC was quick to point this out: John Douglas, director of the Division of STD Prevention, stressed that "This does not mean that African Americans are taking greater behavioral risks." And, in fact, previous studies of high school students have found that black youth more often use condoms and are much more likely to be sober when they have sex.

Poverty and lack of access to healthcare play a role in these numbers, but socioeconomic factors can't explain them away. In reality, a knotty tangle of factors heighten black women's risk of contracting STDs.

First and foremost, it's a numbers game. African Americans make up roughly 12 percent of the population but comprise nearly 50 percent of people infected with Chlamydia and almost 70 percent of those infected with gonorrhea. Like those of other races, we generally have sex with each other, which confines the infections within our social networks. In other words, we're keeping STDs in the family: Each unprotected sexual encounter with another black person is riskier than it might be among members in a group with a smaller pool of infection. It's not more sex; it's more infection. Truly, it takes only one time.

Still there's more to the STD epidemic than just numbers. In the Age of AIDS, why is anyone having unprotected sex at all—ever? It's not because they don't know better. This is what seems very baffling, but what we need to quickly understand.

High rates of STDs among bright, beautiful and talented young women is a tragedy and a crisis; the kind of national emergency that demands an action plan. What do we need to do—and do now—to stop a generation from getting infected with a disease that could make them sick, destroy their fertility or, at worse, kill them? Here are my ideas; let's hear yours, too:

1) Demand better sex education in schools. What is offered to school-age kids today isn't just inadequate; it's embarrassing.

A few years ago, when I asked my teenage niece what she learned in her high school "sexual health" class. She informed me that abstinence was the only way to keep from getting pregnant and contracting HIV because "condoms, don't work." In her community, a suburb outside of a large city in the South, schools must teach abstinence-only or lose federal funding. Educators can mention birth control only in the context of failure rates.

PLEASE!

Reams of studies have shown that abstinence-only education is not effective. And, obviously, in the real world it's not working and it hasn't worked for the past eight years. Popular culture, especially music, thrusts sex on kids every few seconds. So why is any young person going to believe a teacher insisting "don't ever have sex," while Soulja Boy is urging "super man dat ho?" (Translation: during sex, come on the back of a woman; when she wakes up with the sheet stuck to her back, she looks like she's wearing a cape!)

With a new administration poised to take office, now's the time to demand school-based sex education that makes sense in our world.

2) Talk the talk, and help other parents, too.

No one should be foolish enough to leave educating their daughters and sons about their bodies, sex and sexuality up to the school system. It's our responsibility as parents, mothers especially, to spell out the facts. However, many experts believe that African-American women have an extremely hard time talking about sex.

Dr. Gail Wyatt, an African-American psychiatrist, UCLA professor and author of the book "Stolen Women," believes these feelings of discomfort are rooted in slavery. Here's how she puts it: "Black women often react against the idea that we are sexually promiscuous—a myth perpetrated by slave masters to justify rape--by denying our sexuality. Women who had been raped or abused by the masters on plantations, were the ones who knew a lot about sex. So it was better to be ignorant about sex and sexuality rather than give off the impression that you'd been 'used.'"

These feelings linger—particularly when black women as "nappy headed hos" becomes a national discussion. Still, given the STD crisis, we must find ways to have open, honest, informed dialogues with our daughters. The challenge is to help them define who they are sexually, rather than let them be taken over by the music, or the images, or by someone of the opposite sex.

3) Don't let this be just a girls' issue.

We have to teach our sons about sex and sexuality and encourage men and boys to be part of the solution. Studies show that most girls have their first sexual encounter with a boy or man several years older. In fact, statistically, the younger the girl, the older the man. So even if boys get the message from both school sex education and their parents, who's going to make sure men are doing the right thing, too? We all must.

4) Let's begin a serious, community-wide discussion about the effects of the "man shortage" on sexually transmitted disease transmission.

Though women outnumber men in the general population, the gender gap is much wider among blacks. On college campuses, where many of the 18 and 19-year olds in the STD study now reside, the numbers are particularly lopsided. On some campuses, the ratio of women to men is several times higher.

Are young women sometimes hesitant to insist upon condom use, afraid of losing out on love and companionship? Are men "sleeping around"—and not using a condom every time in every encounter-- because they're in high demand? Yes and yes. Let's discuss.

5) We must demand better methods of protection against STDs

Nearly 50 percent of sexually active people will contract HPV, the country's most common STD. But condoms do not provide 100 percent protection against the disease; HPV can infect areas not covered by a condom. Same with herpes. There's now a vaccine to protect against HPV, but it's new, for girls only at this point, and not everyone's on board with it.

So where's the method that protects against both pregnancy and STDs, including HIV? Off in the future somewhere. The best we have now is the promise of microbicides. These are creams, foams, gels or other topical substances that a woman can apply to the vagina (or rectum) before sex to stop pregnancy and STD infection. There are currently dozens of products in development and several are being studied for effectiveness in very large groups of women. However, nothing will hit the market until 2010 at the soonest.

It's time to flip the switch. Let's move sexual health R and D attention and dollars away from yet another new form of Viagra and toward STD protection that's easy-to-use, woman-controlled, widely-available and inexpensive.

6) Take extra time to let all the girls and young women in your life know that they're valued and celebrated.

Once we give them the tools they need, it's ultimately up to individual young women to make safe sexual health decisions. If they feel good about who they are and where they're going, they will care enough about themselves to make good, sound choices.

Linda Villarosa is a health columnist for The Root. "Passing for Black" is her first novel. For more go to her Web site.