Delaware Programs Combat Teen STI Rates with Education, Resources

Delaware teens are at higher risk of acquiring sexually transmitted infections (STI) because of limited access to preventive and regular health care services include STI testing.¹ This poses a unique challenge in a state with three distinct geographic landscapes – urban, suburban and rural, all within less than 2,000 square miles. While there is some access to these services, it varies from county to county, and often town to town. Delaware Health Tracker reports one in four sexually active teens contracts a sexually transmitted disease (STD) every year. Additionally, sexual activity may lead to unplanned pregnancies, an outcome which often comes with physical, emotional, and financial hardships.

Problem

According to the 2013 Delaware’s Youth risk Behavior Survey – which monitors six types of health-risk behaviors that contribute to the leading causes of death and disability among youth and adults, including sexual behaviors – 49% of Delaware teens have had sexual intercourse; of that 49%, 6% had sexual intercourse for the first time before age 13 years; and 15% had sexual intercourse with four or more persons during their life.

In addition:

• 34% had sexual intercourse with at least one person during the 3 months before the survey

• 37% did not use a condom during last sexual intercourse

• 12% did not use any method to prevent pregnancy during last sexual intercourse

• 15% were never taught in school about AIDS or HIV infection²

These statistics, while jarring, are a snapshot of teen sexual health across the country. With the almost-constant advancements in smart phone technology, one has to wonder what role these changes play in influencing risky sexual behaviors among the teen population. These advancements provide instant access to social media sites like Facebook, Instagram and Snapchat, where photo-sharing has become the norm. They also have created alarmingly easy access to sexually explicit media content. Even more thought-provoking is the impact of dating apps like Tinder or Grindr, which provide GPS-based grids of users in one’s local area. How these apps are utilized varies by user; however, it is safe to assume these platforms have made it exponentially easier to find sexual partners. For example, Tinder has a platform just for teenagers. Grindr on the other hand, requires a birthday to be entered; however, there are a number of instances where an underage teen has misrepresented their age to gain access.

Solution

Fortunately, there is a cadre of state-wide programs which aid in bridging the health access gap, providing education and resources for Delaware teens. The Alliance for Adolescent Pregnancy Prevention (AAPP) works to reduce the number of teenagers who are sexually active, become pregnant and become teen parents. AAPP coordinates, collaborates and executes consistent, message- driven educational programs statewide through three unique programs: Wise Guys, for males, aged 13-18; Be Proud! Be responsible! for teens, aged 13-18; and, Making Proud Choices! for teens aged 11-13. The latter two are both identified as evidence-based programs by the Centers for Disease Control. AAPP programing is implemented in school and community settings and groups are facilitated by trained educators who are authorized to deliver these critically important health messages.

Another vital resource for Delaware teens are the School-Based Health Centers (SBHCs), which are located in 29 public and vocational high schools across the state. The SBHCs are operated by a multi-disciplinary team of health professionals who use a holistic approach to address a broad range of health and health-related needs of students. This includes testing and treatment of STIs in some sites. These SBHCs may be funded by state, federal and/or third-party billing funds; through a community partnership; through grant sources; but they also require the support of the school through in-kind or actual dollars.

Two community-based resources which serve Delaware teens are Planned Parenthood (PPDE) and the Adolescent Resource Center (ARC). With a combined 100 years of service, both provide essential sexual health services for adolescents. Planned Parenthood of Delaware has been providing high-quality reproductive health-care and sexual health information to the citizens of Delaware. Planned Parenthood serves the entire state, with three offices in Wilmington, Newark and Dover. The majority of patients are women between the ages of 16 and 30. In fiscal Year 2014, as with most years, Planned Parenthood’s target population was individuals at or below 250% of the federal poverty level, and the organization’s medical centers served approximately 11,000 patients. No one is turned away for lack of insurance. In addition, PPDE’s Sexuality Education Training Institute (SETI) is a national award-winning team of masters-level experts in youth and adult education as well as professional training. SETI provides youth education to approximately 4,000 individuals per year with a focus on evidence-based programs, adult and parent education, professional training and technical assistance, and individual consultation services ARC (Adolescent Resource Center) is a comprehensive counseling, educational and medical service program for youth, to help reduce risk-taking behaviors, especially related to sexual health. The ARC program helps teenagers and young adults create and sustain healthy, responsible attitudes, behaviors, and choices about their sexuality. Through partnerships with local schools and districts, ARC educators visit schools with students in 5th through 12th grade to teach age-appropriate information related to puberty and sexual health. ARC educators work closely with schools and teachers to tailor lesson plans. ARC adheres to curriculum standards set by the Delaware Department of Education for family life education. Additionally, this program provides workshops for parents in schools and community centers with the goal of helping adults communicate effectively with their children on topics related to human sexuality.

With the challenge to address sexual health issues as critical as ever in Delaware, these resources continue to be a go-to for clinicians and anyone working with teens. They serve as safe, reliable access points for Delaware to receive quality education and medical services, both of which are critical during this important period of adolescents’ development.