Yesterday’s Washington Post reported some good news. The District of Columbia’s school system will now offer free STD testing in all high schools. A pilot program last year at eight high schools in D.C. found that 13 percent of about 3,000 students tested positive for an STD, mostly gonorrhea or chlamydia, according to the D.C. Department of Health.
Chad Ferguson, deputy chief of youth engagement for the D.C. schools, said the tests are administered by taking groups of 15 to 20 students at a time to the restroom area. The students are given paper bags containing urine collection cups and enter bathroom stalls. Once they get in the stalls, they can choose whether or not to provide urine samples. All the students return the paper bags, so other students do not necessarily know who did or did not provide a sample.
Test results were provided confidentially…and the city paid for treatment at the school or an STD clinic. Students were counseled about STDs and HIV prevention, were given notification cards to inform partners of the positive diagnosis and were encouraged to share the results with their parents.
I think this is a tremendous step forward in helping to prevent the spread of STDs. Anyone over the age of 12 can be tested without parental notification, but teenagers are very unlikely to seek out information and testing on their own. Bringing it directly to them is key.
There are surprisingly few naysayers–at least, few who would go on the record with the Post. While there was some “well, what about their parents?” fussing, it was mixed with the acknowledgement that whatever parents are doing now obviously ain’t working:
“We have Third World statistics in terms of our HIV issues, and from the HIV perspective, we do need to find a way to identify students so that we can help them,” said William Lockridge, a member of the State Board of Education. But he said parents need to be involved. “Right now, if you play sports in a public school, you have to get permission from your parents. If you take a field trip, you have to get permission from your parents. Why would it be any less for this? . . . Only if the parent gives the consent upfront would I do this.”
D.C. Council member David A. Catania offered a different viewpoint. “This isn’t necessarily intended to comfort adults,” said Catania, who chairs the health committee. “I don’t think you turn a blind eye and pretend these problems don’t exist.”
Catania said he has not heard much community opposition to the testing. “In this regard, I find our population to be extremely secure,” he said. “I’m not condoning this behavior. I don’t think young people are equipped for the consequences of engaging in sex, but the fact is that they do.”
When you have a public health crisis, particularly among children, community leaders are morally obligated to tackle it. Unfortunately, when the disease in question is sexually transmitted, those leaders often do nothing and hide behind moralizing and condemnation instead. This new program in D.C. is one of the very few examples I’ve seen of leaders embracing practical, effective, non-judgmental solutions. You have to meet the problem where it is, not where you think it should be, and that’s what they are (finally) doing. It had to reach a crisis stage before they could get the funding and support for it, but thankfully, for once someone is getting it right on this issue by making health–not “values”–a top concern.
This may be slightly off-topic and/or missing the larger point, but I resent Mr. Lockridge’s remark about the U.S. having “Third World statistics in terms of our HIV issues, and from the HIV perspective, we do need to find a way to identify students so that we can help them.” I happen to work in HIV surveillance/statistics, and this guy is an uninformed idiot when it comes to HIV issues (as could be guessed by his illustrious status as “member of the State Board of Education”). Apparently he has no clue about the tremendous privacy concerns surrounding the HIV epidemic in the United States. He’s NEVER going to be able to “identify students” with HIV, if that’s what he’s getting at. HIV is a very political disease, and the statistics we do have about the epidemic are difficult to obtain in the face of significant privacy concerns.
/rant
But, on a more positive note, I applaud the D.C. schools for being proactive about this. The epidemic is especially severe in D.C., so any steps they can take in this direction are very much needed.
God it is refreshing to read some good news that involves the words “health” and “education” out of my fair city. I am thrilled that the city is finally waking up to the fact that it is going to take massive, population level, pro active intervention to confront our stratospheric levels of sexually transmitted disease in DC. David Catania is the one non- Democrat on city council; he can be extremely irritating but he is gay and obviously “gets” this issue.
@Kivrin: He was talking specifically about the District of Columbia. And in Ward 8, which he represents, he’s not wrong. (Ward 8 covers the neighborhoods of Anacostia and Southeast).
“Anacostia is an epicenter for the HIV/AIDS epidemic in the District of Columbia with HIV rates that rival sub-Saharan Africa,” said Donald Blanchon, chief executive officer of Whitman-Walker Clinic.
@BeckySharper: Oh Lord, I am overly sensitive: I thought he was implying that the statistical information they have available were lacking (i.e., like in a Third World country with less resources for surveillance). Obviously I am touchy about the work I do!
Yes, the rates are HORRIBLE in the District of Columbia.
(That should be information *was* lacking and *fewer* resources. Argh, grammar.)
Ummm. I’m not a parent, so maybe someone with kids can enlighten me about this, but it seems to me that if your teenager has contracted an STI, it is a good bet that you are not comfortable enough with the idea of your teenager having sex to consent to an STI test.
Besides, the reason that parental consent is needed for sports and field trips is because minors can’t sign waivers for themselves and the school doesn’t want to get sued. I’m not sure how providing an STI test to someone could expose you to liability issues unless you violate their privacy somehow.
@baraqiel: I think it’s safe to say that the majority of teens probably wouldn’t even give their parents the chance to consent or not consent to testing them. They just wouldn’t talk about it, period.
And in every state and the District, teenagers can be tested for STDs confidentially and without parental consent. But like I said, most of them won’t seek out the testing, so this program does them a huge service by just bringing it to them.
Does anyone know at what age patient confidentiality applies to children? (I know it’s in effect by high school, at any rate.)
@Spark: For STD testing, anyone over 12 in every state and DC. For things like abortion and other medical procedures, I think it varies by state.
@BeckySharper — well, unless they were “forced” by the school and not told that they could just go to PP.
You’re right, though. I have a very trusting and open relationship with my parents and if I’d needed STI testing in high school, I would only have notified them. No consent would have been sought.
@baraqiel: No one’s forcing them to do anything in this school program. They can opt not to submit a sample and no one will ever know.
According to the pilot study, 68% of the students who attended the lectures chose to give a sample–about 500 hundred kids. Would those same 500 have said, “You know, I should get tested.” and then looked up their local PP, made an appointment and showed up for testing? Highly unlikely. This is a really valuable program that serves people who otherwise would not be getting tested.
@BeckySharper — I know, I completely agree with you. I’m trying to say why Lockridge’s argument about involving parents is a bad one (but obviously not saying it very well).
This sounds like a great program and a clever way of encouraging participation without stigmatizing anyone.
@baraqiel: I wouldn’t assume that getting an std as a teenager means you don’t have an open relationship with your parents. I think sometimes shame can play a part in the kid’s decision whether or not to tell the parents. If you got the talk and you and your parents communicate and the whole thing, and you still end up getting the clap, you may feel that you failed them. As a parent, I’d hope my kids would come to me,but I’d still want the confidential option to be available to them.
Actually, this already is at a high school near me, because you see, this is the same program (or based on the program) that has been in Philadelphia for a few years! (Isn’t it nice to have some good news out of PA?) I remember doing this when I was in high school, in fact–or rather, not doing it, since I had never come close to having sex. I thought it was a pretty cool program even then. I like the anonymity of the urine sample, even though some friends and I did joke about how it was so not necessary for us…
@Clare:
You’d (of course, I mean the generic “you”) might be surprised how far from “actual sex” you can be and still get an STD, (especially now that some of the really easily-transmitted ones have become widespread again). I hope they impress that on the kids as they’re offering this service, so that more of them choose to opt in. Because hey, there is no downside, so why not?