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Statistics on STDs in St. Louis Spark Debate on Sex Ed.

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Alarming rates of sexually transmitted diseases in St. Louis are provoking debate about whether sex education programs in the public schools there are effective.

The city had the highest rates of gonorrhea and syphilis and the second-highest rate of chlamydia in the country in 1995, according to the federal Centers for Disease Control and Prevention in Atlanta. Among young people ages 12 to 19, the rate of syphilis was 38 times the national average for all age groups. The rates are also high in surrounding counties.

The startling statistics were examined in a June 1 article in the St. Louis Post-Dispatch newspaper, which questioned whether the school district needs more comprehensive sex education programs.

Teachers who integrate sex education into their classes, school nurses, and visiting health experts stress abstinence as the best way to avoid STDs and rarely, if ever, talk about condoms.

School officials defended the 44,000-student district's sex education policy last week.

"The statistics indicate that we're not as effective in preventing STDs as we'd like to be, but we feel those issues should be dealt with by parents and city health officials," said Robert W. Nordman, the director of curriculum services. "Abstinence is what we heavily emphasize."

Queen Fowler, the school system's executive director of student support services, pupils, and personnel, suggested that St. Louis might show higher rates of STDs compared with other cities because it collects data so thoroughly.

While rates of gonorrhea, chlamydia, and syphilis among St. Louis teenagers surpass state and national averages, they fell between 1992 and 1996, according to the Missouri state health department. But the rate of infection for HIV, the virus that causes AIDS, climbed from 12 to 37 out of 100,000 youths between 12 and 19 years old.

'Real World' Concerns

Karen Omvig, the education director at Planned Parenthood of the St. Louis Region, a nonprofit organization that promotes access to birth control, said the high rate of STDs reveals a gap in sex education.

"We do support abstinence for teenagers, but in the real world, we know every teenager won't remain abstinent," Ms. Omvig said. "We need to give them information about every aspect of sexuality, including the pros and cons of contraception."

Research shows that comprehensive sex education programs that offer specific information about the risks of unprotected sex are most effective. Several studies also refute the common objection to sex education that learning about condom use will increase sexual activity. ("Teaching About AIDS," Feb. 5, 1997.)

The St. Louis district's AIDS education guide is optional for teachers of different subjects. It recommends, for example, that 3rd grade math teachers show students how to add AIDS statistics, and that 7th grade music teachers help students write AIDS-prevention jingles.

The guide does not mention condoms. An 8th grade home economics manual suggests explaining how contraceptives prevent pregnancy, but does not link condom use to the prevention of sexually transmitted diseases.

Betty Wheeler, the principal of Metro Academic and Classical High School, said she thought the St. Louis schools needed to do a better job of teaching STD prevention, but she declined to elaborate. Another high school principal, Susan Tieber of the Gateway Institute of Technology, said students there learn appropriate information about risky sexual behavior and have organized a team that talks to middle school students about health issues.

Mixed Reactions

Margo Thomas, the district's acting supervisor of health services, said all school nurses are trained in AIDS education and give presentations to students annually. But nurses aren't allowed to mention condoms, which, in addition to preventing pregnancy, can protect against the transmission of diseases.

"We teach a lot about prevention, but teenagers don't believe anything will happen to them," Ms. Thomas said. "We teach them abstinence, but when teenagers hit puberty, they're going to be sexually active. All we can do is teach them."

Schools should teach STD prevention but shouldn't bear full responsibility, said Debra Haffner, the president of the Sexuality Information and Education Council of the United States, a New York City-based sex education research and advocacy group. She said parents, health-care providers, and clergy also need to get involved.

"There needs to be a major STD-prevention campaign, and the schools are only a part of that puzzle," Ms. Haffner said. "It sounds like St. Louis is crying for a response."

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