Little common ground in STD debate

Possible solutions to rising infection rates vary widely

Sunday, November 4, 2007

By TOM LOEWY

The Register-Mail

Knox County ranks 13th in the rate of gonorrhea infection and 18th in the rate of chlamydia infection in the state. There are 102 counties in Illinois.

Last year, 91 teens between the ages of 15 and 19 were treated for chlamydia in Knox County. In the 20-to-24 age group, 66 people were treated for chlamydia. In the same time period, 36 people in the 15-to-19 age group were treated for gonorrhea and 31 more in the 20-to-24 age group.

All told, 211 people were treated for chlamydia and 99 more were treated for gonorrhea in 2006.

Organized by director of clinical services Laura Fullerton, the Knox County Health Department conducted a Sexual Health Town Hall Meeting on Oct. 18. The health department offered more statistics of reported chlamydia and gonorrhea cases in Knox County and Illinois. In 2006 Knox County had a case rate of 177.3 per 100,000 population for gonorrhea, while the state average was 159.8. In the same year Knox County had a case rate of 377.9 per 100,000 population for chlamydia, while the state averaged 427.0.

But the goal of the town hall meeting wasn't to bombard residents with more numbers. Organizers wanted to bring diverse groups - like religious leaders, school officials, government officials, parents and teens - together for a brainstorming session.

The health department wanted to know how to better reach people about the risks of sexually transmitted diseases.

The meeting was a described as "a good first step" by both Fullerton and health department administrator Greg Chance. A little more than 30 people showed up - and the vast majority of those who attended were affiliated in some way with health services.

Conspicuous in their absence were members of the Galesburg City Council and Knox County Board, school board members and district administrators, as well as parents and teenagers. Only two people claiming religious affiliations - Curt Linderman Sr. and Debbie Goodrich, from the Christian ministry Women's Pregnancy Center - attended the town hall meetings.

"What do you expect?" a woman remarked as she left the meeting. "Knox County is conservative. People just want to bury their heads in the sand and pretend like it's all someone else's problem."

It is clear the effort to reduce STDs - especially the rate of infection in people under the age of 20 - is tangled in larger issues. Knox County, like many places across the country, is grappling with what to teach teens about sexual health.

That conflict has political, religious or social battle lines. It is clear the effort to prevent the spread of STDs in Knox County is as polarizing an issue as abortion or the prevention of teen pregnancy.

A basic disconnect

While the Sexual Health Town Hall Meeting was the first in Knox County to directly address the problem STDs, it's not the first time the issues of teens, health and sex education have been raised in a public forum.

And at least one attempt to address the outcomes of teen sex, Knox County Together We Can, foundered because of a disconnect between those who advocate comprehensive health education for teens and those who believe abstinence - and abstinence alone - should be the cornerstone of efforts to educate young people.

In 1997 Steve Watts was a Special Assistant State's Attorney for Family Support Education. He was moved to try and make a difference.

"In my capacity at that time, I saw young girls who were pregnant and sexually active," Watts said. "I decided that we had to try to reach out and make a dent in Knox County's teen pregnancy rate. Of course, I wasn't the only one concerned about the issue."

With Susan Woolsey and others, Watts founded Knox County Together We Can and set out to write a blueprint for a workable way to address the issue of teen pregnancy.

"We didn't want a one-size-fits-all approach," Watts said. "We knew the entire community needed to work together. We felt like we needed to encourage abstinence and teach kids how to take precautions if they chose to not be abstinent."

Woolsey and Watts said the diverse composition of Together We Can struggled to find common ground. Condoms and other forms of birth control were the biggest points of contention.

"The bottom line is condoms," Woolsey said. "We have to willing to put them in the hands of kids - and we have to get past the concept that by doing that we are giving kids permission to have sex. By giving kids condoms we are giving them permission to protect themselves."

The opinion condoms could reduce teen pregnancy polarized Together We Can.

"People on opposite sides of what they see as a moral spectrum couldn't get together," Watts said. "The same goals - reducing teen pregnancy and keeping kids safe from some of the dangers that can accompany sex - were fought over because people have a lot of moral differences on how to achieve those goals."

Watts said he didn't lay all of the blame for Together We Can's eventual demise on people with conservative or religious views.

"My only thought is that if each person puts down their own bucket and tries to work within family and community we could make some progress," Watts said. "But my hunch is that we are looking at one of those never-ending battles that we as people have."

Ends of the spectrum

While many members of the health community stop short of saying conservative views hamper the effort to educate teens and reduce STDs, Val Harding and Ashley German-Cooper of Family Planning of Western Illinois aren't among them.

"Knox County's conservative mentality is thwarting a lot of efforts to reach kids with information," said Harding, the director of Family Planning of Western Illinois. "It's tough to help kids when some adults are committed to not fully informing kids of their options."

Harding and German-Cooper said every parent should teach their beliefs and morals - but those convictions shouldn't be forced on other kids.

"We live in an incredibly conservative area," said German-Cooper, the education coordinator at Family Planning. "The thing is, we should offer to teach kids how to protect themselves. If a parent doesn't want that taught, that's fine. But we should make education available. It is a public health issue."

Lee Johnson is the pastor at Galesburg's largest church, Bethel Baptist. He represents the polar opposite of the attitude taken by Family Planning and believes schools and society need more God.

"The very successful attempts to kick God out of any public forum - including schools - has been going on for some time now," Johnson said. "We are telling kids that there are no absolutes, there is no God. Morality is left up to everybody to decide for themselves.

"What you sow is what you reap."

Johnson said he thinks STDs are a "very big problem" and an issue that offers "no simplistic answers." He said his role is to reach out and model the teachings of Jesus.

"God made us male and he made us female and he said how we should live," Johnson said. "We have to encourage people to live by the standards that God clearly gave us. We try to be proactive and positive."

Yet opposite ends of the spectrum do have some common ground.

Johnson, Harding, German-Cooper, members of the health department and those who attended the Sexual Health Town Hall Meeting agreed children and teens are bombarded with sexually explicit imagery.

"Everything we sell - from toothpaste to automobiles - sex is used," Johnson said. "Powerful, powerful voices in our country use sex to sell. And they target kids."

Harding and German-Cooper echoed Johnson.

"The media presents sex without consequences," Harding said. "Both through shows and through advertising, kids see plenty of sex. There are never - or very rarely - any consequences of the behaviors.

"You see plenty of sex and sexual images on TV. You don't see condom ads."

Changing circumstances, behaviors

Kids have changed. Families have changed. Both factors are contributing to the rising numbers of teens infected with STDs.

"Kids are not doing the traditional meeting and dating," Harding said. "We are hearing about something called 'Hook-up' parties. The kids go to a party and hook-up at the party.

"It's a big change from what we used to see - a boy and girl dating and having a relationship. That has changed completely. Now we have girls come in for testing and when we ask their partner's name, the girl will only be able to tell us a first name or a nickname. They won't even know where the boy lives."

While sex with a relative stranger is a reality for some teens, catching an STD once is not always a deterrent.

"We have had a 17-year-old girl in here who has two children already," Harding said. "She has already had two rounds of treatment for gonorrhea and a round for chlamydia. She was in recently and I know she will have to be treated for gonorrhea again.

"Whether she is being re-infected or not following through with her treatment, she isn't following through to protect herself."

While behaviors have changed, so have circumstances. German-Cooper said traditional families are rare.

"Galesburg High School is dismissed at 2:40 p.m.," German-Cooper said. "How many kids have a parent at home when they get there after school.

"Most traditional families with two parents are now families where both parents work. On top of that, you have single-parent families, you have kids being raised by grandparents."

Cindy Paulus has taught high school health for 22 years, the last 11 at Abingdon High School.

"We are looking at a busier adult population," Paulus said. "If both parents are in the house, it takes both working to make ends meet. I know. I'm a single parent and I work two jobs. That doesn't leave much time for my daughter."

Paulus said one factor has not changed.

"The scope of a teenager has been very limited," she said. "Teenagers have always had a hard time imagining they will face consequences for behaviors.

"In small towns, I think kids tend to live in a white-picket-fence world where nothing will touch them. Kids just aren't concerned about STDs."

Where to go for help with sexual health issues

Family Planning Service of Western Illinois, Inc.

- Room 220 - 311 East Main St. (The Bondi Building)

- (309) 343-6162

- Open from 8:30 a.m. to 6 p.m., Monday through Friday

- Family Planning of Western Illinois is an independent, not-for-profit agency that provides preventative, comprehensive, low-cost health care to men and women. Services include pap smears, breast and pelvic exams, pregnancy testing, screening and treatment of STDs, birth control methods and emergency contraception. Condoms are available.

Knox County Health Department

- Patty Russell, R.N., Communicable Disease Coordinator

- (309) 344-2224, Ext. 288

- e-mail: prussell@knoxcountyhealth.org

- The goal of the Knox County Health Department's STD program is the interruption and prevention of the spread of sexually transmitted diseases through testing, treatment, case surveillance, education and partner notification. Testing for chlamydia, gonorrhea, syphilis, HIV, trichomonis, herpes and genital warts are available. Condoms are available at the health department. Call Patty Russell for a same day appointment.

Women's Pregnancy Center

- 1252 West Fremont Street

- (309) 343-4739

- Open Monday from 10 a.m. to 4 p.m. and Wednesday from 2 to 5 p.m.

Other hours available by appointment.

- 24-hour voice mail (309) 343-4739

- The Women's Pregnancy Center is an evangelical Christian ministry that offers pregnancy tests and information, abortion alternatives, prenatal information and basic decision-making, sexual abstinence, post-abortion information, friendship and encouragement, maternity clothes, referrals for medical care, adoption, foster care, legal and financial assistance. Condoms and other forms of contraception are not available.