Commentary Sexual Health

On National Youth HIV and AIDS Day, the Boston College ‘Troublemakers’ Speak

Lizzie Jekanowski

Our crime has made national news: We’re giving out condoms. At a Catholic University.

To commemorate the first annual National Youth HIV & AIDS Awareness Day, April 10, this blog is part of a series recognizing young people as key partners in the fight against HIV and AIDS and calls on leaders to fully invest in young people so we can reach an AIDS-free generation.

Published in partnership with Advocates for Youth.

See all our coverage of National Youth HIV & AIDS Awareness Day here.

Lately we’ve been having some trouble at school. Our grades are fine. We’re not vandalizing the campus. We’re not part of a cheating scandal. But our crime has made national news. You might have heard about it.

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We’re giving out condoms.

And we’re giving out information about how to use condoms to protect against sexually transmitted infections (STIs) and unintended pregnancy.

At Boston College (BC), a Catholic university.

For this, we’ve been told by the dean that we’ll be disciplined if we don’t stop.

This is all happening just in time for Wednedsay’s National Youth HIV and AIDS Day (NYHAAD), a day when youth activists around the nation are gathering together to promote HIV testing, fight stigma, and hold our leaders accountable for helping create an AIDS-free generation. This is what we’re doing today: holding BC accountable.

BC promotes abstinence until marriage as the only acceptable means of protection from STIs and pregnancy. Abstinence is a great choice for individuals who choose it. But by age 19, 70 percent of people have already had sex, and 95 percent of people have sex before they are married. What about those students’ lives and futures? Doesn’t BC want everyone to have all the tools they need to be healthy and productive? Why would the college withhold vital information and supplies from its students, and instead promote silence and shame?

For people who are sexually active, condoms are highly effective at preventing HIV. It’s common sense that being able to get condoms nearby and for free makes students likelier to use them. That’s why the Great American Condom Campaign was founded: to make it easier for college students to get protection before they need it. That’s why, on this day dedicated to prioritizing young people in the fight against HIV and AIDS, we refuse to stop providing condoms on our campus.

Boston College is not alone in creating obstacles to ending the AIDS epidemic. Many campuses ban condom distribution. Many school districts don’t provide comprehensive information about contraception and condoms. Most college and high school students have never been tested for HIV. There is still a lot of work to be done to become a sexually healthy nation.

We do this work because we are dedicated to keeping our fellow students and their partners safer and healthier. We have the right to work to make our campus community healthier.

On NYHAAD, we’re standing with thousands of students around the country. We need to ensure access to safer sex materials, resources, and information. All of us need and have a right to comprehensive information and services, and a voice in decisions that affect us.

We’re leading the fight to get to an AIDS-free generation. We’re not backing down.

And, trouble or not, we’re still handing out condoms!

News Law and Policy

Texas’ ‘Fetal Remains’ Rule Could Draw Legal Action

Teddy Wilson

The Center for Reproductive Rights cited statements made by Gov. Greg Abbott (R) soliciting campaign contributions to support his efforts to “establish higher standards that reflect our respect for the sanctity of life.”

Proposed rules requiring cremation or burial of fetal remains may result in “costly litigation for Texas—litigation state taxpayers can scarcely afford,” the Center for Reproductive Rights (CRR) said in comments submitted to the Texas Department of State Health Services (DSHS).

Stephanie Toti, senior counsel at CRR, said in a statement that if Texas lawmakers continue to interfere with reproductive health care, the organization will take legal action. 

The DSHS quietly proposed new rules that would prohibit abortion providers from disposing of fetal remains in sanitary landfills, and would require that fetal remains be buried or cremated. 

The rules were published July 1 without notice or announcement in the Texas Register.

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The new regulations would apply to all fetal remains regardless of the period of gestation. Under the proposed rules, any other tissue, “including placenta, umbilical cord and gestational sac,” could still be disposed of through “grinding and discharging to a sanitary sewer system; incineration followed by deposition of the residue in a sanitary landfill.”

Health commission spokesperson Bryan Black told the Texas Tribune that the rules were developed to ensure high sanitation standards. “The Health and Human Services Commission developed new rules to ensure Texas law maintains the highest standards of human dignity,” Black said. 

The rules would require approval from the Republican-held state legislature.

Gov. Greg Abbott’s (R) spokesperson Ciara Matthews said in a statement that the governor is hopeful the legislature will approve the rules. “Governor Abbott believes human and fetal remains should not be treated like medical waste, and the proposed rule changes affirms the value and dignity of all life,” Matthews aid.

CRR cited statements made by Abbott in a fundraising email in which the governor solicited campaign contributions to support his efforts to “establish higher standards that reflect our respect for the sanctity of life.”  

CRR contends that Abbott’s statements undercut “the state’s claims that these regulations have anything to do with protecting women’s health and safety.”

Blake Rocap, legislative counsel for NARAL Pro-Choice Texas, told Public News Service that the regulations will increase the cost of abortion care and the amount of people involved in the process.

“The rule creates ambiguity and involves other licensed professionals, like funeral service directors and cemeteries that are not involved in medical care, and shouldn’t be involved, and don’t want to be involved in it,” Rocap said.

Carol Everett, an anti-choice activist and supporter of the proposed rules, made dubious claims that methods of disposal of fetal remains could contaminate the water supply.

“There’s several health concerns. What if the woman had HIV? What if she had a sexually transmitted disease? What if those germs went through and got into our water supply,” Everett told the Austin Fox News affiliate

The transmission of HIV or other sexually transmitted infections through water systems or similar means is not supported by any scientific evidence.

The new rules could have unintended consequences for medication abortion care. The proposed rules state that “products of spontaneous or induced human abortion” are subject to the law “regardless of the period of gestation.”

Under Food and Drug Administration regulations, the second part of the medication abortion regime can be taken at home. The new Texas rules could effectively ban medication abortion because an embryo miscarried at home through medication abortion cannot in practice be buried or cremated.

The Texas Alliance for Life supports the new GOP-backed rules. However, Texas Alliance for Life executive director Joe Pojman told Rewire that he was unsure what effect the new rules might have on medication abortions. “We’re going to have to study that further,” Pojman said.

Rocap told Public News Service that proposed rules are part of a “pattern of overreach” by Texas lawmakers targeting abortion providers. “This rule was proposed in the dark of night without any openness, which lets you know that they know they’re doing it the wrong way.”  

DSHS has announced a public hearing on the proposed regulations Thursday at 9 a.m. central time.  

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.

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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.

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