by Karen Sue McKenzie

In the Bible Belt, abstinence is ideal, but oftentimes people choose to have sex anyways. In turn, rates of sexual infections in the South continue to rise.

 

 

In July 2017 I worked at an ice cream shop. I was scooping a sample of caramel ice cream for a kid when my phone started vibrating in my back pocket. It was Monday afternoon, a time when anyone who regularly called me––my parents, my sister, my best friend––would be working. I was eager to see who needed to talk at this peculiar time. I handed the boy the miniature, metal spoon so he could taste the smooth caramel, and then I quickly stepped behind the freezer, out of view. I pulled out my phone quickly as the screen lit up with an unsaved (but familiar) number. I wish it would have been my mom calling.

I stared at the ringing numbers until they stopped. The customers left the creamery, I stayed hidden behind the freezer, and the missed call remained on my phone screen. I had called the same number a little over a week ago to schedule an appointment at the Tulsa Health Department for Monday, July 3, to get checked for STDs. It was now July 10, exactly one week after my visit. That’s how long they said it would take for the lab to process test results: one week. If any came back positive, they’d call ASAP. They don’t bother calling back the patients who are clean.

If you don’t hear from us, you’re healthy. You don’t want to hear from us.

“Karen? You tested positive for chlamydia. When can you come in for treatment? It’s one dose of an oral antibiotic called azithromycin.”

This was my first encounter with an appointment that was strictly STD based. I’ve had four other STD check ups since, and the procedure is always as frank as it seems: a checkup, simply because you’re sexually active. You pee in a cup, give blood and let a doctor swab your cervix after she’s finished inspecting it.

I was 20 years old when I contracted chlamydia. Just 11 months prior I could be seen wearing a silver cross ring on my left ring finger. It represented a commitment to refrain from sex until marriage. Growing up, that was the expectation in my household, though it was rarely vocalized. I was confused and embarrassed. I told four, maybe five people my diagnosis, mostly because I desperately wanted answers and comfort and advice. Sex was still new to me. We didn’t really talk about sex, but I knew that abstaining from it met the Christian standard.

Naturally, I did the opposite of what was ‘right,’ and when I started having sex, my world became a different one.

In August 2016, I claimed to believe that my wedding night would be extra special if I remained a virgin. By September that same year, I was having regular, unprotected sex with my boyfriend of one month.

Before, I had never looked down any Family Planning aisles in Walmart or Walgreens. By November, I had navigated several in search of take-home pregnancy tests and emergency contraceptives.

 

 

I never considered taking birth control pills in the past, but in October I scheduled an appointment with a women’s health clinic to get a prescription. The amount of risky sex I was having with my boyfriend became too stressful: buying condoms was expensive (even though we didn’t ever really buy them), buying pregnancy tests was embarrassing, and buying Plan B was humiliating.

I wasn’t even supposed to have a sex life, let alone one that was this perilous. The first time I had sex, my boyfriend opened a condom, put it on, and took it off after two strokes. It hurt less that way, but it put my health at a much higher risk, and I wouldn’t realize this until it was too late. I even looked away from the condom when he pulled it out because I didn’t know how to use one. It was the first of three total condoms I encountered until I got chlamydia.

Plus, sex without a condom felt so much better, and prescribed contraceptives could be 99 percent effective against pregnancy, if taken correctly. And I could easily take them correctly. The pill was the answer, not the leftover condoms hiding in my panty drawer. My boyfriend and I were only concerned about not getting pregnant. STDs were never mentioned, and frankly, they never crossed my mind until I got one.

Needless to say, my promise ring came off and stayed off. I remained sexually active after the relationship ended in April 2017, and by July I had become a statistic. I was one out of nearly 2 million reported cases of chlamydia trachomatis in 2017. Within 10 months of sexual activity, I had lost my virginity and found an STD. All because I never knew how important practicing safe sex was. I’d only ever been taught that abstinence was my only option.

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The idea of sex education in schools began in 1970 as a result of rising concerns about teen pregnancy, and later HIV/AIDS. While most states today have a policy requiring HIV and sex education, the programs vary across the U.S. Most states provide general guidelines on how and when to teach sex ed, but individual school districts personally decide how and what content to present to students

Twenty-four states, as well as the District of Columbia, require public schools teach sex education, and 33 states mandate HIV education, according to the National Conference of State Legislatures. However, only 20 states that provide sex education require that it be medically accurate. Thirty-seven states require that when sex education programs must include abstinence, and 26 of those programs require that it be heavily emphasized, according to the Henry J. Kaiser Family Foundation. In the state of Arkansas, “Schools that offer sex education in school-based health clinics shall include instruction in sexual abstinence, and no funds shall be utilized for abortion referral,” according to Arkansas Code Title 6. 

Oklahoma, the state where I grew up, does not require that information on contraception be provided. Instead, Oklahoma requires that educators stress abstinence, but that abstinence-only education didn’t work for me.

But the federal government has spent nearly 2 billion dollars on abstinence-only until marriage programs, AOUM, between 1982 and 2017 when few Americans waited until marriage to initiate sexual intercourse.

“Evidence shows that AOUM programs do not help young people delay initiation of sexual intercourse,” said John Santelli, professor of Population and Family Health at Columbia University Mailman School of Public Health.

There is an 8-10 year gap between median age at first intercourse and first marriage. I was 19, one year older than the average age at which women (and men) first start having sex. Research from the Journal of Adolescent Health shows that women typically don’t get married until 27 and men don’t get married until 30.

It would be extremely likely for a sexually active young person to contract an STD in this period because sexually active adolescents and young adults are at higher risk of acquiring an STD, according to the Centers for Disease Control and Prevention. Young people between ages 15 and 24 acquire half of all STDs, and one in four sexually active adolescent females has an STD.

“While abstinence is theoretically effective, in actual practice, intentions to abstain from sexual activity often fail,” Santelli said. “These programs simply do not prepare young people to avoid unwanted pregnancies or sexually transmitted diseases. 

Back in 2017, rates of gonorrhea, syphilis and chlamydia hit an all time high, according to the CDC’s STD surveillance report.

So if abstinence isn’t actually happening, and if STDs are on the rise and habitually common among 15 to 24 year olds, why didn’t anyone teach me how to use a condom in grade school?

Studies show that “abstinence-only-until-marriage programs are required to withhold information on contraception and condom use, except for information on failure rates,” according to Mary Ott and John Santelli’s research article Abstinence and Abstinence-only Education. Abstinence-only programs have been found misrepresenting information on topics like condom efficacy and often promote unhealthy gender stereotypes. Ott and Santelli also found that comprehensive sex ed programs have been found to help teens delay when they begin having sex and have healtheir sexual behaviors when they do start. 

“Abstinence-only polices violate the human rights of adolescents because they withhold potentially life-saving information on HIV and other STIs,” according to the article.

I was educated through the Tulsa Public Schools system and remember covering a total of three sex-health related units. They started in 5th grade and ended by 9th. All my friends from Oklahoma can recognize the little jingle “just around the corner,” if it’s sang in the right tune. It comes from an educational video about puberty that I remember watching in 5th grade on a roll-in television VCR set. We learned about what to expect from puberty, the emotional and physical changes experienced, menstruation, healthy hygiene, and the importance of maintaining good health, according to Marsh Media’s general description about the educational video, not my personal memory. I didn’t learn or remember anything besides the catchy jingle, because after the lesson, we often jokingly sang it at recess on the playgrounds. The joke still sometimes surfaces in conversations I have present day.

The lesson given in 7th grade science is difficult to remember. I only remember being required to sit on the opposite side of the room compared to the boys, and when my teacher flashed animated diagrams of male and female reproductive organs, I felt embarrassed.  Every boy on the other side of the room laughed at every joke, while the girls rolled their eyes. I was more focused on the hushed chuckles rather than the content on the SmartBoard.

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By January 2017, my mom found out I was taking birth control pills. I claimed my period cramps were unbearable and that my acne needed clearing up, but I’m sure she put two and two together when she noticed my promise ring was gone. We were in the car on the way to lunch when she asked me for the first time if I was sexually active.

“So, are you and your boyfriend having sex?” Her voice sounded stern and disappointed.

“What? No mom. I’m not ready for that.” I turned my head away from my mother and looked out the window.

“Well, you know condoms don’t work if they stay unopened in your underwear drawer,” she said.

My stomach dropped, it was like she read my mind. But it was already too late. I LIKED having raw sex with my boyfriend, and I WAS protected from pregnancy with the pill. I just kept looking out the window.  

My mom was right. Sexual behaviors that contribute to widespread STD transmission have almost nothing to do with how much sex people are having, rather, but how much risk there is in the sex that’s being had, Gail Bolan, director of the CDC’s Division of STD Prevention, said in an article published in the Atlantic in 2018.

Five months later, I was on vacation with my family in California when my mom’s words about protection began to haunt me. I acted like everything was okay, but it wasn’t. I started to notice things that I didn’t even realize were STD symptoms. Every night in a different hotel bathroom, I noticed my underwear would be damp from a day of producing an excessive amount of vaginal discharge. After I went pee, there was always more discharge floating in the toilet bowl. It was so much sometimes I felt like I could smell myself during daily activities with my family. I constantly felt like I had to pee. Often times, my uterus experienced a piercing pain seemingly out of nowhere. I’d jump up and rush to the bathroom so I wouldn’t pee myself, but nothing ever came out. The pain felt similar to a urinary tract infection, but it came and went however it pleased for months.

I kept this constant disruption to myself and searched the internet for answers.

I discovered that most STDs are sneaky and usually don’t have symptoms that can be seen or felt. But if symptoms do occur, they’d appear several weeks after getting the infection. Abnormal discharge, maybe yellowish in color and strong in smell was listed as a symptom of chlamydia and gonorrhea. 

My heart sank.

That’s what raw sex and the pill can do to you. You’re fairly certain that you’re protected from pregnancy, but you lose sight of the other risks. At least that was the case for me. Maybe the actuality of catching an STD was never really clear to begin with, but when I found out I had one, it was clear as day.

But to me, the phrase “I’m getting checked for STDs” holds a strong negative connotation in my mind. It makes me feel like a rescued street cat who has a veterinarian appointment to get treated for rabies. 

Maybe that’s because my first time getting checked was so horrific. Maybe because I didn’t see it coming.  Maybe because no one said anything that stuck. 

Maybe because the culture of teaching abstinence doesn’t work.