Texting to Prevent STIs: Can It Work?

Robin Marty

A Minnesota hotline is being set up to text STD info to interested parties.  But will it be more successful than texting birth control reminders has been?

Minnesota is taking the next step in using technology as a means to reduce the spread of sexually transmitted infections.  The Minnesota Family Planning and STD Hotline will now be communicating via text message as well as by phone, according to the St. Cloud Times:

The Minnesota Family Planning and STD Hotline announced Wednesday that it has improved its website and will begin providing updated services including Web chat and text messaging, in addition to the toll-free hot line 1-800-78FACTS.The hot line aims to provide confidential health education. By offering personalized text messaging and Web chat options, users will be able to easily access information in the format that is most convenient for them.

Finding new and innovative ways to communicate with clients is especially useful in the technology age, especially as more smart phone, portable computing devices and mobile communication devices become commonplace.

But will STD texting info help reduce the spread of disease, or will we find, like text reminders for birth control, that just because something is innovative, it doesn’t directly translate into successful?  Via iHealthBeat:

Like This Story?

Your $10 tax-deductible contribution helps support our research, reporting, and analysis.

Donate Now

Women who receive text message reminders to take oral contraceptives are no more likely to do so than women who do not, according to a study published in the September issue of Obstetrics & Gynecology, MedPage Today reports.

For the study, researchers at Boston University recruited 82 birth control pill users from a local Planned Parenthood clinic. The women were given oral contraceptives from an electronic monitoring device that reported missed pills in real time through wireless transmission.

The women were divided into one group that received daily text message reminders to take the pill, while a control group created their own reminder system, such as through a cell phone or clock alarm.

The researchers found that missed pills were common regardless of whether the women were reminded via text messages (Phend, MedPage Today, 8/24).

Of course, providing periodic information via text is quite different from receiving daily reminders.  And in general, anything that could disseminate information in a cost-effective and convenient means is something that should be applauded, especially in a state where cervical cancer is on the rise due to the spread of HPV.

News Law and Policy

Texas Could Be Next to Give Police Hate Crime Protections

Teddy Wilson

Police officers have shot and killed 165 people in Texas since the start of 2015. Of those, 35 were Black men, 12 of whom were unarmed. There were 2 officers killed by firearms in Texas in 2015.

Texas Gov. Greg Abbott (R) announced Monday that he would ask the state legislature to pass a law classifying acts of violence committed against law enforcement officers as hate crimes, mimicking a similar measure passed by Louisiana lawmaker.

Abbott said in a statement that the proposal is intended to send a message.

“At a time when law enforcement officers increasingly come under assault simply because of the job they hold, Texas must send a resolute message that the State will stand by the men and women who serve and protect our communities,” Abbott said.

Abbott will ask the GOP-held Texas legislature to pass the Police Protection Act during the upcoming 2017 legislative session, which convenes in January. The proposal would extend hate crime protections to law enforcement officers.

Like This Story?

Your $10 tax-deductible contribution helps support our research, reporting, and analysis.

Donate Now

Abbott’s proposal would increase criminal penalties for any crime against a law enforcement officer, regardless of whether or not the crime qualifies as a hate crime. The proposal would create a campaign to “educate young Texans on the value law enforcement officers bring to their communities.”

Abbott’s proposal comes in the wake of a shooting in Dallas that left five police officers dead, and six others injured. Micah Xavier Johnson targeted police officers during a peaceful Black Lives Matter protest, before he was killed by law enforcement.  

Police officers killed at least 1,146 people in the United States in 2015, according to the Guardian’s database The Counted. Police officers have shot and killed 165 people in Texas since the start of 2015. Of those, 35 were Black men, 12 of whom were unarmed, according to the Guardian’s database. There were two officers killed by gunfire in Texas in 2015, according to the National Law Enforcement Officers Memorial Fund (NLEOMF).

Police in Texas have shot and killed 53 people so far in 2016, per the Guardian‘s database.

The Dallas shooting increased the urgency of calls to increase the penalties for violence against law enforcement.

U.S. Sen. John Cornyn (R-TX) introduced similar legislation in Congress, designed to make killing a police officer a federal crime. Cornyn said in a statement that police officers protect communities and deserve “unparalleled support.”

Louisiana Gov. John Bel Edwards (D) in May signed into law the so-called Blue Lives Matter bill, which amended the state’s hate crime law to include acts of violence against any “law enforcement officer, firefighter, or emergency medical services personnel.”

Proponents of laws creating more penalties for crimes against law enforcement claim these measures are needed because of a growing threat of targeted violence against law enforcement. Data shows that violence against law enforcement has declined to historically low levels, while killings of civilians by police officers have risen dramatically.

Violent attacks on law enforcement officers are lower under President Obama than they have been under the previous four presidential administrations, according to the Washington Post’s analysis of data from the Officers Down Memorial Page.

During the Reagan presidency, there was an average of 101 law enforcement officers intentionally killed per year; during the George H.W. Bush administration, there was an average of 90 police killed per year; during the Clinton years, there was an average of 81 police killings annually; and during George W. Bush’s presidency, there was an average of 72 police killings via stabbings, gunfire, bombings, and vehicular assault per year.

There have been an average of 62 law enforcement officers killed annually during Obama’s seven and a half years in the White House.

The number of Texans who died during the course of an arrest almost doubled from 2005 to 2015, according to an analysis of state data by the Dallas Morning News. The increase in deaths coincided with a 20 percent reduction in the number of arrests statewide.

Matt Simpson, a policy strategist at the ACLU of Texas, told the Dallas Morning News that the number of deaths during arrests in Texas add to the evidence of systemic racism within the justice system.

“We have pretty strong evidence in a variety of ways that the criminal justice system is disproportionate,” Simpson said. “These numbers are unfortunately stark reminders.”

Commentary Sexual Health

Fewer Teens Are Having Sex, But Don’t Pop the Champagne Yet

Martha Kempner

The number of teens having sex may be less important than the number having protected sex. And according to recent data from the Centers for Disease Control and Prevention, condom use is dropping among young people.

Every two years, the Centers for Disease Control and Prevention’s Division of Adolescent and School Health (CDC-DASH) surveys high school students to gauge how often they engage in perceived risky behaviors. The national Youth Risk Behavior Surveillance (YRBS) is wide ranging: It asks about violence, guns, alcohol, drugs, seat belts, bicycle safety, and nutrition. It also asks questions about “sexual intercourse” (which it doesn’t define as a specific act) and sexual behaviors.

Started in 1991, this long-running study can provide both a picture of what high school students are doing right now and a historical perspective of how things have changed. But for more than a decade, the story it has told about sexual risk has been the virtually the same. Risk behaviors continually declined between 1991 and 2001, with fewer high school students having sex and more of them using condoms and contraception. But after the first 10 years, there has been little change in youth sexual risk behaviors. And, with each new release of almost unchanging data, I’ve reminded us that no news isn’t necessarily good news.

This year, there is news and it looks good—at least on the surface. The survey showed some significant changes between 2013 and 2015; fewer kids have ever had sex, are currently sexually active, or became sexually active at a young age. More teens are relying on IUDs and implants, which are virtually error-proof in preventing pregnancy.

In 2015, 41 percent of high school students reported ever having had sexual intercourse compared to 47 percent in 2013. The researchers say this is a statistically significant decrease, which adds to the decreases seen since 1991, when 54 percent of teens reported ever having had sexual intercourse.

Like This Story?

Your $10 tax-deductible contribution helps support our research, reporting, and analysis.

Donate Now

Another change is in the percentage of students who had sex for the first time before age 13. In 2015, 4 percent of high school students reported this compared to almost 6 percent in 2013. This is down from a full 10 percent in 1991. As for number of overall partners, that is down as well, with only 12 percent of students reporting four or more partners during their lifetime compared to 15 percent in 2013 and 19 percent in 1991. Finally, the percentage of students who are currently sexually active also decreased significantly between 2013 (34 percent) and 2015 (30 percent).

These are all positive developments. Delaying sex can often help prevent (at least temporarily) the risk of pregnancy or STIs. Having fewer partners, especially fewer concurrent partners, is frequently important for reducing STI risk. And those teens who are not currently having sex are not currently at risk for those things.

While I want to congratulate all teens who took fewer risks this year, I’m not ready to celebrate those statistics alone—because the number of teens having sex is less important to me than the percentage of teens having sex that is protected from both pregnancy and sexually transmitted infections. And that number is lower than it once was.

Among sexually active teens, there were no significant positive changes in measures of safer sex other than an increase in the number of sexually active high school students using the IUD or implant (up to 4 percent from 2 percent in 2013).

Moreover, some results indicate that today’s teens are using less protection than those who were teens a decade ago. The most telling finding might be the percentage of teens who used no method of contraception the last time they had sex. This decreased between 1991 and 2007 (from 17 percent to 12 percent), inched up to 14 percent in 2013, and stayed the same in 2015 (14 percent). There was also little to no change in the percentage of high school students who say that either they or their partner used birth control pills between 2013 (19 percent) and 2015 (18 percent) or those who say they used the contraceptive shot, patch, or ring (5 percent in 2013 and 2015).

For me, however, the most distressing finding is the backward progress we continue to see in condom use. The prevalence of high school students who used a condom at last sex went up from 45 percent in 1991 to 63 percent in 2003. But then it started to drop. In 2015, only 57 percent of sexually active high school students used condoms the last time they had sex, less than in 2013, when 59 percent said they used condoms.

It’s not surprising that teens use condoms less frequently than they did a decade ago. In the 1990s, the HIV epidemic was still front and center, and condoms were heavily promoted as a way to avoid infection. As this threat waned—thanks to treatment advances that now also serve as prevention—discussions of the importance of condoms diminished as well. The rise of abstinence-only-until-marriage programs may have also affected condom use, because these programs often include misinformation suggesting condoms are unreliable at best.

Unfortunately, some of the negative messages about condoms inadvertently came from public health experts themselves, whether they were promoting emergency contraception with ads that said “oops, the condom broke”; encouraging the development of new condoms with articles suggesting that current condoms are no fun; or focusing on teen pregnancy and the use of highly effective contraceptive methods such as long-acting reversible contraceptives (LARC). The end result is that condoms have been undersold to today’s teenagers.

We have to turn these condom trends around, because despite the decreases in sexual activity, young people continue to contract STIs at an alarming rate. In 2014, for example, there were nearly 950,000 reported cases of chlamydia among young people ages 15 to 24. In fact, young people in this age group represented 66 percent of all reported chlamydia cases. Similarly, in 2014, young women ages 15 to 19 had the second-highest rate of gonorrhea infection of any age group (400 cases per 100,000 women in the age group), exceeded only by those 20 to 24 (489 cases per 100,000 women).

While we can be pleased that fewer young people are having sex right now, we can’t fool ourselves into believing that this is enough or that our prevention messages are truly working. We should certainly praise teens for taking fewer risks and use this survey as a reminder that teens can and do make good decisions. But while we’re shaking a young person’s hand, we should be slipping a condom into it. Because someday soon (before high school ends, for more than half of them), that teenager will have sex—and when they do, they need to protect themselves from both pregnancy and STIs.