A report released in April that analyzed national stats on sexually transmitted infections compiled by The Centers for Disease Control and Prevention brought the typical wisecracks on social media from North Carolinians who couldn’t help but sneer at their counterparts to the south, as South Carolina was found to have one of the highest and fastest-spreading STI rates in the country.
A look at the stats for Mecklenburg County, however, shows it to be on the track. There’s been an alarming increase in reported gonorrhea and chlamydia cases in Mecklenburg County during the last three years, a trend that has put the county well over the national average in both categories.
According to the North Carolina Department of Health & Human Services, Mecklenburg County saw 9,287 new cases of chlamydia in 2018, meaning that on average more than 25 new cases were reported every day. That’s the most of any year on record with the NCDHHS, and only the second time the number has surpassed 9,000. The first was 2017.
There were also 3,244 new cases of gonorrhea reported in 2018, which was a slight improvement from the 3,355 reported the previous year. Still, as with chlamydia, the last two years have seen the highest amount of new gonorrhea cases in the county since at least 2002, which is as far back as the county’s health department website goes.
This year, things don’t seem to be slowing down. Though the 2,171 new cases of chlamydia reported in Mecklenburg County in 2019 through March put the county on pace to see a slight decrease from last year, that won’t hold up if the pattern continues as it’s gone thus far. Each month has seen at least 150 more cases than the last, with the 910 reported cases in March representing a 30% increase in the March average over the last three years.
There perhaps could be no better time for the local Planned Parenthood office to launch a Get Yourself Tested campaign in observation of STI Awareness Month. Planned Parenthood’s Charlotte Health Center on Albemarle Road has been offering free STI testing through April, or until funds run out.
According to Liz Schob, community health educator for Charlotte-Mecklenburg County with Planned Parenthood South Atlantic (PPSAT), as access to birth control has gone up, STI rates have increased. That’s because some people believe that birth control protects from STIs, while others simply haven’t been taught proper sex education.
“As far as the adolescents that I work with, the teen pregnancy rate is going down because of greater access to comprehensive education and greater access to birth control options, however, the STI rate is going up,” Schob said. “A lot of those reasons have to do with the fact that if people even have access to condoms, are they using them consistently and correctly every time? No, they’re not.”
That’s where Schob comes in.
As a community health educator, Schob is in charge of Planned Parenthood’s Teen Connections program, which provides comprehensive, evidence-based sex education to teens and their parents through youth programming — including in-school, after-school and out-of-school programs — and parent workshops. She also runs the Teen Connections Leadership Council (TCLC), a group of students that Schob retains from the aforementioned programs and trains as peer health educators.
When Schob took over the TCLC, many students had recently graduated and aged out. Starting with just a couple students, she has built the council up to consist of 21 teens. In her first eight months since transferring to the Charlotte Health Center from Fayetteville, Schob has brought on more than 10 community partners and her programming has reached more than 1,100 students.
When addressing the ongoing rise in STI cases, Schob knows that efforts must start with the youth. People between the ages of 15 and 24 make up 50% of newly reported STI cases, despite making up just 25% of the sexually active population. With all the stigma surrounding STIs, education begins with getting comfortable having a simple conversation, Schob said.
“We have to have an honest conversation, because what we know statistically, is that when teens actually receive comprehensive sex education that is not abstinence-only, they’re more likely to do one of two things: one, delay onset of sexual activity until at least high school graduation, or two, if they are sexually active, to use birth control and/or use condoms consistently and correctly.”
Condom use is especially important because, as high as the rates of reported STI cases have gotten, there are countless people who are infected and don’t even know it. For example, between 70 to 95% of women and 90% of men with chlamydia show no symptoms.
Schob recommends that, ideally, a person gets tested between each different sex partner, though she recognizes that is sometimes unrealistic. Sexually active people should get tested at least every six months, she said, even if they’re in a monogamous relationship.
Once Schob is able to reach people, whether it be teens or their parents, most are open to learning about the dangers of STIs and what they can do to prevent them. It’s reaching them that’s the hard part. Though she’s proud of the amount of people she’s already been able to reach, she’s constantly working on how she can do more.
“I’m only one person. I’ve reached over 1,000 people but Charlotte is massive. It really is a drop in the bucket,” she said. “That’s why it’s so important from a public health perspective to have so many different community partners doing this work, which can be a challenge, especially in the political climate that we’re in, because policy does affect the work that we do, and when policy is not open to comprehensive sex education, this is the result.”
It is a significant situation that Schob finds herself in as an employee of Planned Parenthood, an organization that inspires the ire of right-wing groups across the country because of its involvement with abortion, despite that making up only about 3% of the services it provides. During the fiscal year 2018, which ended last June, staff at Planned Parenthood’s Charlotte Health Center carried out 5,805 STI tests, 319 cervical cancer screenings and 339 breast exams. They also provided 2,468 cycles of oral contraception, 393 cycles of Nuvaring and 423 long-acting reversible contraceptive devices.
Entire political movements have been launched with the goal to end Planned Parenthood as an organization. That sort of controversy can make things difficult for Schob to do her job, but once she’s able to connect with people, most of them see that she’s only there to help them stay safe, she said.
“It can be tricky to navigate. However, having those one-on-one conversations with people … to talk about real life and things that are quote-unquote fake news, because the truth about what we do and who we are does not always fit someone’s political narrative,” she said. “So talking about the actual work that we do, a lot of people are blown away and they’re like, ‘Yeah, that’s awesome,’ because we’re having a one-on-one conversation with an actual person and not looking at something from a source that would be biased against us.”
According to PPSAT spokesperson Sarah Riddle, the opposition to Planned Parenthood comes mainly from a small-but-loud political contingent.
“People love Planned Parenthood, overall. We poll better than so many other institutions,” Riddle said. “One in five women will come to Planned Parenthood at one time in their life for healthcare. So the majority of the time when we’re out in the community doing this work, we’re met with a very warm reception and people are thankful that we’re there providing education and services. This stigma that exists is really political and it’s really pushed by an extreme minority.”
There are times, however, when that minority is able to affect policy.
Sex education has seen opposition both locally and nationally in recent years. In April 2018, the NC Family Values Coalition encouraged parents to keep their kids out of school for a day in support of a national “Sex Ed Sit Out” campaign, which was created in protest of inclusive and science-based sexual education being taught in schools.
Current law mandates that schools teach medically accurate, age-appropriate sex education that includes information on abstinence, STI prevention, contraceptive methods and sexual assault/abuse risk reduction in grades 7-9. The law was passed in 2009 and amended in 2013 to require more information on preterm birth, then again in 2015 to add information on human trafficking. Parents have the option to opt out of sex ed for their children.
A bill filed in February by conservative legislators would make it harder for children to access sex ed by forcing parents to opt in rather than out, meaning a student would need to bring a permission slip home to get signed before they could participate in sex ed classes.
Teen Connections was not asked back into Charlotte-Mecklenburg Schools (CMS) for this school year, despite Schob’s predecessor working closely with the school system. According to CMS spokesperson Tracy Russ, the school system is aligning resources to create a system-wide sex ed curriculum that will not include Teen Connections.
“The CMS sex education curriculum is aligned to NC essential standards and is delivered by certified health teachers,” Russ wrote in an email. “CMS requires outside curriculum providers to go through a formal curriculum review process to ensure quality of instruction and consistency of curriculum lessons, materials and resources. The curriculum provided by Planned Parenthood was not included in this formal review process.”
As an educator with Planned Parenthood’s service-providing 501(c)3 nonprofit, Schob doesn’t get involved with discussions around policy. All she can do is continue the work that’s in front of her, reaching as many teens and parents as she can and hoping those people, in turn, spread the true, safe information.
“As Planned Parenthood, we stand for certain things: access to knowledge, access to birth control and access to condoms. Access is important; that’s non-negotiable,” Schob said. “It’s a necessary thing and it shouldn’t be political, people make it political. So that’s where I come from, because my feeling is always from a perspective of safety.”
And from her experience in the community, it’s not that the young people most affected by the recent STD crisis don’t want help, it’s that they don’t know where to get it.
That’s a divide that starts at home.
“A lot of parents are afraid for their teens to receive this knowledge, and a lot of teens are desperate for it,” Schob said. “Don’t be scared of comprehensive sex education. Having an open dialogue is important because keeping your kids away from this information doesn’t mean they’re not going to get it, it just means that there’s going to be a delay, and more opportunities for them to make unsafe choices up until they get that information.”
Ignorance may be bliss, but knowledge is power. Get yourself tested.