News Sexual Health

Two Major Cities Make Condoms More Easily Available to Young People

Martha Kempner

Two big cities—Chicago and Philadelphia—are expanding and advertising programs that allow teens to get condoms at school and even at home.

As Rewire has reported in the past, condom availability programs have been credited with increasing the likelihood that sexually active teens use this important pregnancy- and disease-prevention method without increasing the likelihood that teens become sexually active. Though some adults are still wary of giving teens access to condoms or other forms of contraception, the American Academy of Pediatrics recently released an opinion saying that easy access to condoms is essential for teens, that communities should work to make condoms available in places where teens frequent, and that schools are a good place for condom availability programs. Two big cities—Chicago and Philadelphia—are following this advice by expanding and advertising programs that allow teens to get condoms at school and even at home.

At the start of this school year in September, the Chicago school district worked closely with the city’s health department to make condoms available at two public high schools. The program was part of a citywide initiative aimed at reducing teen pregnancy and birth rates which, though dropping, are higher than the national average. In fact, Chicago’s teen birth rate of 57 births to 1,000 young women between the ages of 15 and 19 is just over one-and-a-half times the national average (34 per 1,000) and more than twice that of New York City (23.6 per 1,000). The initiative, which is funded by a five-year, $20 million federal grant, also includes controversial ads featuring “pregnant” teenage boys (see Elizabeth Schroeder’s commentary for Rewire) and age-appropriate sexuality education starting in kindergarten, which is set to be implemented in 2016. Previously, sex education did not start until fifth grade.

City officials recently announced that they will expand the condom availability program to at least 24 high schools in the district for the 2014–15 school year. Though they expect some parents will be upset by the program, officials say it is necessary. Alderman Latasha Thomas, chairman of the city council’s education committee, told the Sun Times, “Some parents are gonna have problems with it—absolutely. I understand it. My kids are grown now. But, I remember those teenaged years. But, the reality is they’re having sexual intercourse and the stats say [35 percent] of the people who are having sexual intercourse in high school aren’t using any protection. None. They still have a process where they teach them to abstain. But, at the end of the day, they have to deal with the reality.”

Mayor Rahm Emanuel echoed these sentiments at an unrelated news conference, saying, “It’s an acknowledgement of what’s happening, whether you did that or not. It’s … an attempt to deal, from a health-care perspective, [with] both pregnancy as well as socially-transmitted diseases. I respect it as a pilot. But, I want everybody to understand that doesn’t mean you’re absolved—either as a parent or an adult—to talk to an adolescent about responsible behavior, respecting who you’re with and doing what’s right, not what’s convenient.”

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A condom availability campaign in Philadelphia is reaching students even closer to home—their mailbox. Run by the city’s health department, Take Control Philly, launched in 2011 in an effort to bring down rates of sexually transmitted infections (STIs) among young people in the city. Philadelphians between the ages of 13 and 19 are eligible to receive free condoms by mail. In addition to the mail-order service, the department also makes condoms available at 180 sites across the city and at events throughout the year. The department has distributed 7.5 million condoms since the campaign launched.

To increase its reach, the campaign uses social media sites like Facebook. For example, in February, it ran a series of ads featuring the “worst Valentine’s ever” such as one from a genital wart saying “I’m stuck on you.” Matt Prior, who runs the campaign for the health department, told News Works that these kind of ads are very popular and consistently lead to a spike in mail-order condom requests: “So in three steps from seeing an ad or seeing a post, they can hit three buttons, enter some information, and they’re getting condoms in their hands. We mailed over 150,000 condoms that way.” He also credited the Facebook ads with increasing from 30 percent to 38 percent the percentage of mail orders that come from young women.

The department believes that making condoms available to teens is working. It claims that internal numbers show a 10 to 20 percent decrease in the case of chlamydia and gonorrhea among young people since the campaign began in 2011.

Condoms are highly effective at preventing pregnancy and remain the only method of contraception that also protects against sexually transmitted infections. Given the success of condom availability programs in increasing the use of this method without increasing rates of sexual behavior, we can only hope that more cities and towns across the country follow the example set by Chicago and Philadelphia.

News Human Rights

Airfare Services Available to Pulse Shooting Victims Present Challenges for Undocumented People

Tina Vasquez

Undocumented people can board commercial airlines for flights within the United States, but if they live outside of Washington, D.C. or the 12 states that provide undocumented people with IDs accepted by the Transportation Security Administration (TSA), they must obtain a foreign passport from their country of origin’s consulate.

In the days since the Pulse nightclub shooting that left 49 people dead and more than 50 injured, advocacy organizations and corporations have taken steps to provide services to the attack’s victims and survivors, along with their families. Some of those services, however, are not without hurdles for undocumented people affected by the tragedy.

Equality Florida, an Orlando, Florida-based LGBTQ advocacy organization, is working with the National Center for Victims of Crime to raise money for the National Compassion Fund, which reports that 100 percent of the proceeds will go to survivors and victims. Those in need of funds must fill out an online form.

Part of the challenge has been making those affected by the tragedy aware of how they can obtain victim relief funds and help with funeral services, or receive counseling and legal services, according to Ida Eskamani, Equality Florida’s development officer for North and Central Florida. The organization is disseminating information about these resources online in both English and Spanish.

JetBlue Airways has been offering free flights to and from Orlando for immediate family members who need to attend funerals or be with their injured loved ones. Survivors and family members can contact 1-800-JETBLUE for more information.

In addition to providing free flights to immediate family members of survivors, United Airlines is waiving all costs for the transportation of remains. In order to qualify for flights or the repatriation of a loved one’s body, family members must fill out forms provided by United Airlines that ask for basic contact information, the victim’s name, and their relationship.

A spokesperson from United Airlines told Rewire that the airline has provided similar services to families affected by other tragedies, dating back to the Sandy Hook Elementary School shooting in 2012. The airline doesn’t typically promote it, she said, because it’s not about publicity, but rather “doing the right thing and assisting families in a tangible way.”

Other organizations are making their services available to affected families. On Friday, the American Immigration Lawyers Association’s Central and South Florida chapters partnered with Immigration Equality to launch “Immigrant Action Orlando,” which includes a hotline number community members can call. According to a press release, the project was created as a way of helping the many community members who have come forward since the shooting asking for help on immigration matters.

Sunday’s shooting hit Orlando’s immigrant community particularly hard, and families are struggling with the costs of repatriating bodies. Jorge Rivas and Rafa Fernandez De Castro of Fusion reported Monday that several of the victims were undocumented, including Juan Chavez-Martinez, whose family is currently fundraising online to repatriate his body and hold his funeral in Mexico, where his family is based. JetBlue is offering free flights to undocumented community members and Eskamani confirmed with Rewire that United Airlines is also offering flights and transferring remains regardless of citizenship status.

“These are unique circumstances because the Pulse shooting has impacted vulnerable communities who already live in fear, communities who have not been immune to hate,” Eskamani said. “This primarily impacted the Latino community and many who were undocumented, whether they were victims or family members.”

As Rewire reported Wednesday, undocumented survivors and the undocumented family members of victims could qualify for U visas, set aside for victims of violent crimes who are willing to help law enforcement with the investigation. But in the state of Florida, the coverage for hospital care for an undocumented victim is limited. Traveling to Orlando from within the United States can also prove to be difficult for undocumented people.

Undocumented individuals can board commercial airlines for flights within the United States, but if they live outside of Washington, D.C. or the 12 states that provide undocumented people with IDs accepted by the Transportation Security Administration (TSA), they must obtain a foreign passport from their country of origin’s consulate. Without a passport, they cannot travel by plane to the consulate, which may be located across their state or across the country. Funerals happening outside of the United States are likely off-limits for undocumented family members, even those with foreign passports. In most cases, traveling abroad will result in not being able to re-enter the United States.

For undocumented family members seeking to attend funerals within U.S. territories, immigration law professor Allan Wernick told Rewire there is good news: Many consulates have an emergency process in place and will be empathetic to the circumstances surrounding the Pulse nightclub shooting, and will likely do what they can to hasten the process. But, ultimately, the length of time it takes to obtain a passport depends on the country. Wernick recommends checking with the consulate for specific information about emergency processes and any documentation needed to expedite the process.

Wernick suggests undocumented family members who are able to obtain passports to attend a funeral and who are flying for the first time not be afraid if their undocumented status comes to the attention of the TSA.

“I double dare any TSA or immigration officer to hassle somebody who is suffering this tragedy,” the professor told Rewire. “If they were a member of my family who only had a passport from their country of origin, I would tell them not to worry about flying to attend the funeral.”

Though the professor could not guarantee the successful return of undocumented people taking advantage of these opportunities, he said the chances of an issue arising are slim, “if, for no other reason, TSA or ICE won’t want the bad publicity of hassling the family members of those injured or killed in the shooting.”

Eskamani said the challenges facing immigrant and undocumented communities after the shooting may seem overwhelming, but organizations like hers—and the greater Orlando area—are committed to serving the victims, survivors, and their families.

“As a whole, I believe people are approaching this with love and compassion,” the development officer and Orlando native told Rewire. “We’re very aware that the communities impacted in this shooting are already so vulnerable, but we’re doing whatever we can to lift up those voices, connect these communities, and make some good out of this horrific hate crime.”

Commentary Sexual Health

Don’t Forget the Boys: Pregnancy and STI Prevention Efforts Must Include Young Men Too

Martha Kempner

Though boys and young men are often an afterthought in discussions about reproductive and sexual health, two recent studies make the case that they are in need of such knowledge and that it may predict when and how they will parent.

It’s easy to understand why so many programs and resources to prevent teen pregnancy and sexually transmitted infections (STIs) focus on cisgender young women: They are the ones who tend to get pregnant.

But we cannot forget that young boys and men also feel the consequences of early parenthood or an STI.

I was recently reminded of the need to include boys in sexual education (and our tendency not to) by two recent studies, both published in the Journal of Adolescent Health. The first examined young men’s knowledge about emergency contraception. The second study found that early fatherhood as well as nonresident fatherhood (fathers who do not live with their children) can be predicted by asking about attitudes toward pregnancy, contraception, and risky sexual behavior. Taken together, the new research sends a powerful message about the cost of missed opportunities to educate boys.

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The first study was conducted at an adolescent medicine clinic in Aurora, Colorado. Young men ages 13 to 24 who visited the clinic between August and October 2014 were given a computerized survey about their sexual behavior, their attitudes toward pregnancy, and their knowledge of contraception. Most of the young men who took the survey (75 percent) had already been sexually active, and 84 percent felt it was important to prevent pregnancy. About two-thirds reported having spoken to a health-care provider about birth control other than condoms, and about three-quarters of sexually active respondents said they had spoken to their partner about birth control as well.

Yet, only 42 percent said that they knew anything about emergency contraception (EC), the only method of birth control that can be taken after intercourse. Though not meant to serve as long-term method of contraception, it can be very effective at preventing pregnancy if taken within five days of unprotected sex. Advance knowledge of EC can help ensure that young people understand the importance of using the method as soon as possible and know where to find it.

Still, the researchers were positive about the results. Study co-author Dr. Paritosh Kaul, an associate professor of pediatrics at the University of Colorado School of Medicine, told Kaiser Health News that he was “pleasantly surprised” by the proportion of boys and young men who had heard about EC: “That’s two-fifths of the boys, and … we don’t talk to boys about emergency contraception that often. The boys are listening, and health-care providers need to talk to the boys.”

Even though I tend to be a glass half-empty kind of person, I like Dr. Kaul’s optimistic take on the study results. If health-care providers are broadly neglecting to talk to young men about EC, yet about 40 percent of the young men in this first study knew about it anyway, imagine how many might know if we made a concerted effort.

The study itself was too small to be generalizable (only 93 young men participated), but it had some other interesting findings. Young men who knew about EC were more likely to have discussed contraception with both their health-care providers and their partners. While this may be an indication of where they learned about EC in the first place, it also suggests that conversations about one aspect of sexual health can spur additional ones. This can only serve to make young people (both young men and their partners) better informed and better prepared.

Which brings us to our next study, in which researchers found that better-informed young men were less likely to become teen or nonresident fathers.

For this study, the research team wanted to determine whether young men’s knowledge and attitudes about sexual health during adolescence could predict their future role as a father. To do so, they used data from the National Longitudinal Study of Adolescent Health (known as Add Health), which followed a nationally representative sample of young people for more than 20 years from adolescence into adulthood.

The researchers looked at data from 10,253 young men who had completed surveys about risky sexual behavior, attitudes toward pregnancy, and birth control self-efficacy in the first waves of Add Health, which began in 1994. The surveys asked young men to respond to statements such as: “If you had sexual intercourse, your friends would respect you more;” “It wouldn’t be all that bad if you got someone pregnant at this time in your life;” and “Using birth control interferes with sexual enjoyment.”

Researchers then looked at 2008 and 2009 data to see if these young men had become fathers, at what age this had occurred, and whether they were living with their children. Finally, they analyzed the data to determine if young men’s attitudes and beliefs during adolescence could have predicted their fatherhood status later in life.

After controlling for demographic variables, they found that young men who were less concerned about having risky sex during adolescence were 30 percent more likely to become nonresident fathers. Similarly, young men who felt it wouldn’t be so bad if they got a young woman pregnant had a 20 percent greater chance of becoming a nonresident father. In contrast, those young men who better understood how birth control works and how effective it can be were 28 percent less likely to become a nonresident father.9:45]

Though not all nonresident fathers’ children are the result of unplanned pregnancies, the risky sexual behavior scale has the most obvious connection to fatherhood in general—if you’re not averse to sexual risk, you may be more likely to cause an unintended pregnancy.

The other two findings, however, suggest that this risk doesn’t start with behavior. It starts with the attitudes and knowledge that shape that behavior. For example, the results of the birth control self-efficacy scale suggest that young people who think they are capable of preventing pregnancy with contraception are ultimately less likely to be involved in an unintended pregnancy.

This seems like good news to me. It shows that young men are primed for interventions such as a formal sexuality education program or, as the previous study suggested, talks with a health-care provider.

Such programs and discussion are much needed; comprehensive sexual education, when it’s available at all, often focuses on pregnancy and STI prevention for young women, who are frequently seen as bearing the burden of risky teen sexual behavior. To be fair, teen pregnancy prevention programs have always suffered for inadequate funding, not to mention decades of political battles that sent much of this funding to ineffective abstinence-only-until-marriage programs. Researchers and organizations have been forced to limit their scope, which means that very few evidence-based pregnancy prevention interventions have been developed specifically for young men.

Acknowledging this deficit, the Centers for Disease Control and Prevention and the Office of Adolescent Health have recently begun funding organizations to design or research interventions for young men ages 15 to 24. They supported three five-year projects, including a Texas program that will help young men in juvenile justice facilities reflect on how gender norms influence intimate relationships, gender-based violence, substance abuse, STIs, and teen pregnancy.

The availability of this funding and the programs it is supporting are a great start. I hope this funding will solidify interest in targeting young men for prevention and provide insight into how best to do so—because we really can’t afford to forget about the boys.