Analysis Contraception

Finally Some PSAs About Sex; A Closer Look at the New Bedsider Campaign

Martha Kempner

I take a closer look at the Bedsider Campaign which launched last week with PSAs, a website, and other tools to help young people (ages 18-24 specifically) use contraception and avoid unplanned pregnancy. The ads are fun but is the website too light on STI information and too hard on condoms?

The first public service announcement (PSA) that I remember is one about prejudice.  It featured a young white boy fishing in a rowboat with his grandfather. He complains with a little bit of stutter on the big word:  “Grandpa, yesterday Jimmy said I was prejudiced.” Grandpa explains that “prejudice is when you react to someone because of their religion or their color.”  The boy protests that he doesn’t do that but proceeds to describe Jimmy as “one of my Jewish friends.”  Grandpa calmly says, “Then you are prejudiced because you think of Jimmy as one of your Jewish friends and not just one of your friends.”

This commercial, which aired in the late 70s, has clearly stuck with me over the years; though I will admit that in my memory Jimmy was “one of his black friends” and grandpa didn’t have to explain that the kid was prejudiced, we were just meant to see the irony in his protest. (Thanks YouTube for correcting the flaws in my memory.) Still, I’ve got to think that that PSA did its job – 7-year-old me saw it, went to talk to my parents about it, and never forgot what prejudice was – or the image of the kid and grandpa in the boat. 

In the years since, we’ve seen many PSA campaigns come and go.  Who can forget the fried egg – “this is your brain, this is your brain on drugs,” for example.  My sex educator colleagues and I, however, have always bemoaned the fact that there have been few widely released commercials celebrating safer sex, condom use, or contraception.  They have them in Europe – my favorite, as of today’s YouTube search, being one depicting a 6-year old having the king of all supermarket tantrums when he’s denied candy by his father.  The tagline is simply, “use condoms.”

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But in this country, our discomfort with sexuality in general and teen sexuality in particular, has meant that commercials for Axe body spray can be replete with sexual innuendo but PSAs stick to telling kids to eat better, get active, and stay out of their parents’ medicine chests. 

That changed a little bit last week with the launch of the Bedsider campaign.  A joint project of the National Campaign to Prevent Teen and Unplanned Pregnancy and the Ad Council, Besider is described by the two groups as the “first-ever advertising campaign to address unplanned pregnancy among young women.”  The ads encourage young couples not to give up on birth control and the campaign, which includes a website and a social media component as well, is designed to help young women “find a method that is right for them and stick with it through a series of online, video, and mobile components.”

The ads have a distinctly European feel perhaps as a result of the jaunty music (which I’m pretty sure is in French) or the fact that they were created pro bono by ad agency Euro RSCG. The two television ads that I’ve seen feature young couples having a hard time getting it right when it comes to sex – they are fumbling with clothes, falling out of showers, and trying like hell to position themselves on small couches or in tiny cars.  The tag line “You didn’t give up on sex. Don’t give up on birth control either.” 

I like them. They’re fun, silly, positive about sex, and not at all scary.  In fact, let me take a second here to thank everyone involved in creating them for skipping the fear-based messages entirely.  We don’t want to scare people out of having sex – we want to educate them into doing it safely. And we do want them to have some fun.

My only complaint about the ads themselves is that they are intended for an audience of 18-to-24-year olds and therefore depict people and situations on the older side of the phrase “young people,”– like the two couples who run into each other passionately making out in the office supply room.  I understand that there would be far more political ramifications of making a campaign like this specifically for younger teens because, among other things, doing so would require acknowledging that it might be okay for high school couples to have sex. I just think this kind of ad campaign would be great for younger teens and wish it could have targeted them as well.  I don’t know where and when these ads will air but I can only hope that younger teens will see them and comfort myself with the knowledge that, for example, Disney channel’s Shake It Up is about 13-year-olds, probably made for 10-year-olds, and avidly watched by my five-year-old. 

The ads direct viewers to the website which contains information about all options of birth control.  I clicked around it a lot this morning and though I am more than a decade older and far less hip than its target audience, I think it looked pretty good.  It’s got a nice and clean look to it and its information is simple and to the point.  I was particularly pleased that on the front page, or as the site calls it “the method explorer” page, all of the information about each method was positive.  We sex educators often try too hard to cover all our bases (pun intended) and temper the good with the bad or mitigate the bad with the good. I think that if the first goal is to get more people to use more methods of birth control more often, it is good to start with just the good. 

Digging further into the site there is more information on each method, guides on how to use them, articles about the most recent research, answers to frequently asked questions, and very earnest videos of young people describing in lots of detail the method they have chosen and why.   

As I clicked through – clearly seeing some but not all of what is up there – I did have one important concern.  I worry that in its zest to prevent unplanned pregnancies and promote using a method of contraception it de-emphasizes (or at least doesn’t stress enough for my taste), the importance of STI protection.  I realize that there is only one method of contraception that also protects against STIs – the condom – and I’m not suggesting the website limit its information to just that.  That said, unless the young people visiting the site are in a long-term relationship where everyone has been tested for STIs and no one is cheating – the sex educator in me wants to say, “you really should be using condoms.”

Though the website throws in a few quips about how important condoms are with scroll-overs such as “IUDs are party-perfect though of course should be combined with condoms for STI protection,” it by no means emphasizes STI protection and in my opinion, is kind of hard on condoms (that pun was by accident, I swear).  In its comparison of methods, for example, Bedsider gives condoms a low rating for “effort,” saying “you have to use a condom (correctly) EVERY time you have sex.” Ok, but it’s really not that hard to use a condom and it’s certainly no harder to remember to use a condom every time your vagina gets really close to a penis (or vice versa) than it is to remember to take a pill every day at 6 pm or get a shot every three months.    

Still, in the same vein, the website rates condoms low on the scale of “party-ready” (“Some methods mix better with booze. As in you don’t have to think in the heat of the moment”) and  “do me now” (These methods are ideal for “spontaneous hot sex. Anywhere. Anytime.”) Though I’ve never thought about it in quite those words (remember, I’m neither young nor hip), I have to say that I would put condoms on the top of both of those lists.  They’re cheap, easy to find, require no forethought other than throwing it in your purse before the party, and take only a few seconds to put on. That combined with the fact that they protect against STIs (and drunk, hot, spontaneous sex may very well be with someone you just met) should have earned them a few extra stars in my mind.

The campaign launched last week and it will be interesting to see how young people respond.  While I’ve heard mostly positive reviews of it, a couple of colleagues worried that it smacked too much of adults telling young people (or younger adults in this case) what to do and an ad agency telling them what’s cool. 

That may be true, but it may work anyhow – after all, it was an ad agency that taught me that prejudice was uncool, and 32 years later, I still remember it. 

News Sexual Health

State with Nation’s Highest Chlamydia Rate Enacts New Restrictions on Sex Ed

Nicole Knight Shine

By requiring sexual education instructors to be certified teachers, the Alaska legislature is targeting Planned Parenthood, which is the largest nonprofit provider of such educational services in the state.

Alaska is imposing a new hurdle on comprehensive sexual health education with a law restricting schools to only hiring certificated school teachers to teach or supervise sex ed classes.

The broad and controversial education bill, HB 156, became law Thursday night without the signature of Gov. Bill Walker, a former Republican who switched his party affiliation to Independent in 2014. HB 156 requires school boards to vet and approve sex ed materials and instructors, making sex ed the “most scrutinized subject in the state,” according to reproductive health advocates.

Republicans hold large majorities in both chambers of Alaska’s legislature.

Championing the restrictions was state Sen. Mike Dunleavy (R-Wasilla), who called sexuality a “new concept” during a Senate Education Committee meeting in April. Dunleavy added the restrictions to HB 156 after the failure of an earlier measure that barred abortion providers—meaning Planned Parenthood—from teaching sex ed.

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Dunleavy has long targeted Planned Parenthood, the state’s largest nonprofit provider of sexual health education, calling its instruction “indoctrination.”

Meanwhile, advocates argue that evidence-based health education is sorely needed in a state that reported 787.5 cases of chlamydia per 100,000 people in 2014—the nation’s highest rate, according to the Centers for Disease Control and Prevention’s Surveillance Survey for that year.

Alaska’s teen pregnancy rate is higher than the national average.

The governor in a statement described his decision as a “very close call.”

“Given that this bill will have a broad and wide-ranging effect on education statewide, I have decided to allow HB 156 to become law without my signature,” Walker said.

Teachers, parents, and advocates had urged Walker to veto HB 156. Alaska’s 2016 Teacher of the Year, Amy Jo Meiners, took to Twitter following Walker’s announcement, writing, as reported by Juneau Empire, “This will cause such a burden on teachers [and] our partners in health education, including parents [and] health [professionals].”

An Anchorage parent and grandparent described her opposition to the bill in an op-ed, writing, “There is no doubt that HB 156 is designed to make it harder to access real sexual health education …. Although our state faces its largest budget crisis in history, certain members of the Legislature spent a lot of time worrying that teenagers are receiving information about their own bodies.”

Jessica Cler, Alaska public affairs manager with Planned Parenthood Votes Northwest and Hawaii, called Walker’s decision a “crushing blow for comprehensive and medically accurate sexual health education” in a statement.

She added that Walker’s “lack of action today has put the education of thousands of teens in Alaska at risk. This is designed to do one thing: Block students from accessing the sex education they need on safe sex and healthy relationships.”

The law follows the 2016 Legislative Round-up released this week by advocacy group Sexuality Information and Education Council of the United States. The report found that 63 percent of bills this year sought to improve sex ed, but more than a quarter undermined student rights or the quality of instruction by various means, including “promoting misinformation and an anti-abortion agenda.”

Roundups Sexual Health

This Week in Sex: The Sexually Transmitted Infections Edition

Martha Kempner

A new Zika case suggests the virus can be transmitted from an infected woman to a male partner. And, in other news, HPV-related cancers are on the rise, and an experimental chlamydia vaccine shows signs of promise.

This Week in Sex is a weekly summary of news and research related to sexual behavior, sexuality education, contraception, STIs, and more.

Zika May Have Been Sexually Transmitted From a Woman to Her Male Partner

A new case suggests that males may be infected with the Zika virus through unprotected sex with female partners. Researchers have known for a while that men can infect their partners through penetrative sexual intercourse, but this is the first suspected case of sexual transmission from a woman.

The case involves a New York City woman who is in her early 20s and traveled to a country with high rates of the mosquito-borne virus (her name and the specific country where she traveled have not been released). The woman, who experienced stomach cramps and a headache while waiting for her flight back to New York, reported one act of sexual intercourse without a condom the day she returned from her trip. The following day, her symptoms became worse and included fever, fatigue, a rash, and tingling in her hands and feet. Two days later, she visited her primary-care provider and tests confirmed she had the Zika virus.

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A few days after that (seven days after intercourse), her male partner, also in his 20s, began feeling similar symptoms. He had a rash, a fever, and also conjunctivitis (pink eye). He, too, was diagnosed with Zika. After meeting with him, public health officials in the New York City confirmed that he had not traveled out of the country nor had he been recently bit by a mosquito. This leaves sexual transmission from his partner as the most likely cause of his infection, though further tests are being done.

The Centers for Disease Control and Prevention (CDC)’s recommendations for preventing Zika have been based on the assumption that virus was spread from a male to a receptive partner. Therefore the recommendations had been that pregnant women whose male partners had traveled or lived in a place where Zika virus is spreading use condoms or abstain from sex during the pregnancy. For those couples for whom pregnancy is not an issue, the CDC recommended that men who had traveled to countries with Zika outbreaks and had symptoms of the virus, use condoms or abstain from sex for six months after their trip. It also suggested that men who traveled but don’t have symptoms use condoms for at least eight weeks.

Based on this case—the first to suggest female-to-male transmission—the CDC may extend these recommendations to couples in which a female traveled to a country with an outbreak.

More Signs of Gonorrhea’s Growing Antibiotic Resistance

Last week, the CDC released new data on gonorrhea and warned once again that the bacteria that causes this common sexually transmitted infection (STI) is becoming resistant to the antibiotics used to treat it.

There are about 350,000 cases of gonorrhea reported each year, but it is estimated that 800,000 cases really occur with many going undiagnosed and untreated. Once easily treatable with antibiotics, the bacteria Neisseria gonorrhoeae has steadily gained resistance to whole classes of antibiotics over the decades. By the 1980s, penicillin no longer worked to treat it, and in 2007 the CDC stopped recommending the use of fluoroquinolones. Now, cephalosporins are the only class of drugs that work. The recommended treatment involves a combination of ceftriaxone (an injectable cephalosporin) and azithromycin (an oral antibiotic).

Unfortunately, the data released last week—which comes from analysis of more than 5,000 samples of gonorrhea (called isolates) collected from STI clinics across the country—shows that the bacteria is developing resistance to these drugs as well. In fact, the percentage of gonorrhea isolates with decreased susceptibility to azithromycin increased more than 300 percent between 2013 and 2014 (from 0.6 percent to 2.5 percent).

Though no cases of treatment failure has been reported in the United States, this is a troubling sign of what may be coming. Dr. Gail Bolan, director of CDC’s Division of STD Prevention, said in a press release: “It is unclear how long the combination therapy of azithromycin and ceftriaxone will be effective if the increases in resistance persists. We need to push forward on multiple fronts to ensure we can continue offering successful treatment to those who need it.”

HPV-Related Cancers Up Despite Vaccine 

The CDC also released new data this month showing an increase in HPV-associated cancers between 2008 and 2012 compared with the previous five-year period. HPV or human papillomavirus is an extremely common sexually transmitted infection. In fact, HPV is so common that the CDC believes most sexually active adults will get it at some point in their lives. Many cases of HPV clear spontaneously with no medical intervention, but certain types of the virus cause cancer of the cervix, vulva, penis, anus, mouth, and neck.

The CDC’s new data suggests that an average of 38,793 HPV-associated cancers were diagnosed each year between 2008 and 2012. This is a 17 percent increase from about 33,000 each year between 2004 and 2008. This is a particularly unfortunate trend given that the newest available vaccine—Gardasil 9—can prevent the types of HPV most often linked to cancer. In fact, researchers estimated that the majority of cancers found in the recent data (about 28,000 each year) were caused by types of the virus that could be prevented by the vaccine.

Unfortunately, as Rewire has reported, the vaccine is often mired in controversy and far fewer young people have received it than get most other recommended vaccines. In 2014, only 40 percent of girls and 22 percent of boys ages 13 to 17 had received all three recommended doses of the vaccine. In comparison, nearly 80 percent of young people in this age group had received the vaccine that protects against meningitis.

In response to the newest data, Dr. Electra Paskett, co-director of the Cancer Control Research Program at the Ohio State University Comprehensive Cancer Center, told HealthDay:

In order to increase HPV vaccination rates, we must change the perception of the HPV vaccine from something that prevents a sexually transmitted disease to a vaccine that prevents cancer. Every parent should ask the question: If there was a vaccine I could give my child that would prevent them from developing six different cancers, would I give it to them? The answer would be a resounding yes—and we would have a dramatic decrease in HPV-related cancers across the globe.

Making Inroads Toward a Chlamydia Vaccine

An article published in the journal Vaccine shows that researchers have made progress with a new vaccine to prevent chlamydia. According to lead researcher David Bulir of the M. G. DeGroote Institute for Infectious Disease Research at Canada’s McMaster University, efforts to create a vaccine have been underway for decades, but this is the first formulation to show success.

In 2014, there were 1.4 million reported cases of chlamydia in the United States. While this bacterial infection can be easily treated with antibiotics, it often goes undiagnosed because many people show no symptoms. Untreated chlamydia can lead to pelvic inflammatory disease, which can leave scar tissue in the fallopian tubes or uterus and ultimately result in infertility.

The experimental vaccine was created by Canadian researchers who used pieces of the bacteria that causes chlamydia to form an antigen they called BD584. The hope was that the antigen could prompt the body’s immune system to fight the chlamydia bacteria if exposed to it.

Researchers gave BD584 to mice using a nasal spray, and then exposed them to chlamydia. The results were very promising. The mice who received the spray cleared the infection faster than the mice who did not. Moreover, the mice given the nasal spray were less likely to show symptoms of infection, such as bacterial shedding from the vagina or fluid blockages of the fallopian tubes.

There are many steps to go before this vaccine could become available. The researchers need to test it on other strains of the bacteria and in other animals before testing it in humans. And, of course, experience with the HPV vaccine shows that there’s work to be done to make sure people get vaccines that prevent STIs even after they’re invented. Nonetheless, a vaccine to prevent chlamydia would be a great victory in our ongoing fight against STIs and their health consequences, and we here at This Week in Sex are happy to end on a bit of a positive note.