The fallout from the pandemic ranges from an unstable economy to an upsurge in socio-emotional problems. Experts suggest the pandemic could also be responsible for a continued upward trajectory of sexually transmitted diseases among the youngest sexually active residents of Connecticut.
Conditions during the pandemic, including less access to sexual health care and more free time, have helped exacerbate the trend among young people, health care providers say. “Most parents work. The students are home alone. They get friends, ”said Ceri Burke, nurse practitioner at Danbury High School‘s on-site health center. “There is an increase in sexual activity in the children that I see.”
These factors, coupled with recent trends in data, suggest a continued upward trajectory of sexually transmitted diseases (STDs) during the adolescent pandemic, with black adolescents disproportionately affected.
In 2019, national The data from the Centers for Disease Control and Prevention (CDC) showed that STDs reached their highest level for the sixth consecutive year, a statistic that is in part responsible for the Trump administration’s dismantling of accessible and affordable health care and associated educational resources and programs. Adolescents and young adults (aged 15-24) make up a disproportionate share of these numbers; adolescents of color are particularly affected.
CDC data from 2018, for example, showed that the rate of reported chlamydia cases in black women aged 15 to 19 was 4.5 times higher than in their white counterparts; for black men in this age group, the rate was 9.1 times higher than for white men in the same age group. And in Connecticut, the rate of chlamydia in women ages 15 to 24 was nearly 12 times higher among blacks than whites in 2014, according to The data of the State Department of Public Health (DPH). Additionally, statistics indicate racially similar differences for other STDs.
Virtual education continued during the pandemic
A program at Yale sought to better understand and address these disparities. the Yale Center for Health & Learning Games works to empower black teenage girls in dating and sexual experiences. Virtual focus groups with black teenage girls have played an important role in this endeavor.
“We really wanted to understand what it means to be a black teenage girl,” said deputy director of the center, research scientist Kimberly Hieftje.
The focus groups revealed barriers to healthy attitudes toward sexuality common to this demographic: hypersexualism, colorism, and other stereotypes. These challenges, coupled with mistrust of health providers, impact black adolescent girls’ sexual health attitudes and behaviors, Hieftje said.
To help tackle these challenges, the center has designed a video game that uses role-playing and requires users to navigate situations such as discussing condom use with their partners and getting tested for STDs. Ultimately, the goal is to empower players to become adept at controlling their sexual health. Researchers at the center hope to make it available for use in schools and other public forums.
Elsewhere in Connecticut, virtual sex education efforts continued during the pandemic. For example, Southern New England Parenting Planning offers a peer education program, STARS (Students Teaching About Responsible Sexuality), which promotes healthy relationships through responsible choices. As part of the program, Planned Parenthood trains teens to answer basic questions from their peers on topics related to sexuality and to recognize when and how to make referrals to professional sources. During the pandemic, peer ambassadors created videos on TikTok about STDs and the importance of getting tested for them – a service that, along with treatment for STDs, is among Planned Parenthood’s most widely used.
Access to sexual health services declined during the pandemic
Knowing the importance of MST testing is not the same as having easy access to testing. Since March 2020, when Connecticut schools closed – some for several months – teens have had reduced access to convenient and confidential sexual health services that protect and screen for sexually transmitted diseases.
In a typical year, School Health Centers (SBHCs) are the most convenient, accessible, and confidential source of adolescent sexual health services. According to DPH, 20,216 students made 62,159 medical visits to school health centers in 2018-2019, an average of 3.1 visits per student.
SBHC healthcare providers regularly ask adolescent patients if they are sexually active. When patients answer yes, they are encouraged to undergo confidential STD testing; a right granted to all minors 12 years of age and over under Connecticut state law. Many SBHCs also provide on-site testing services.
But during the pandemic, as schools were operating remotely or in hybrid capacity, even SBHCs that did not shut down saw far fewer students. Angela Matera, nurse practitioner at SBHC at Stratford High School, says she usually sees 14 children a day, five days a week, 190 days a year for various medical needs. This changed during the pandemic.
“It was a lot more uncomfortable for these kids,” said Matera, who followed students on a spreadsheet during the pandemic and attempted to contact those she deemed to be at high risk.
Since March 2021, when Stratford students returned to campus, Matera has seen “a huge increase” in positive STD cases: nine cases of chlamydia, two cases of oral chlamydia and gonorrhea. “It’s a jump,” Matera said.
Other health care providers are also reporting having less contact with adolescent patients during the pandemic. Dr Alyssa Bennett, Head of Adolescent Medicine at Connecticut Children’s Medical Center, says many teens who could normally be tested for STDs have slipped through the cracks during the pandemic. “It’s very difficult to test a patient for an STD if they’re not in your clinic,” she says.
Bennett says she inquires about sexual activity during the private, one-on-one portion of the visit with her teenage patients, a practice recommended by the American Academy of Pediatrics. She then offers to perform STD tests. “Very rarely I have teenagers who refuse the test once they know we can provide it in confidence,” Bennett said. But many adolescents are unaware of their legal right to confidential sexual health services. This is just one of the many gaps in adolescent sexual health awareness.
Bennett says many teens don’t know you can be asymptomatic with an STD. “If you don’t ask a teenager if he’s having sex, you aren’t going to think about asking him [STD] tests, ”Bennett said.
This story was first published on May 27, 2021 by the Connecticut Health Investigation Team.