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With New STD Statistics, State and Local Health Departments Are Instigating Change

State and local health departments across the country are reporting increasing teen pregnancy rates and soaring sexually transmitted disease (STD) rates among young people. In Florida, Texas, and Minnesota, health officials have used the data to begin instigating conversations and programming changes related to sexuality education.

In Palm Beach, FL, county health officials have been driving changes in the school district’s new sexuality education teaching materials. The health department released alarming teen pregnancy numbers in September of 2005 and with them a call to the district to improve its prevention efforts.1 The officials found that the number of births to girls ages 12–14 nearly doubled in just one year from 21 in 2003 to 41 in the 2004. In addition, a quarter of county middle-school students surveyed in 2005 reported already having had sexual intercourse.2

The school health director for the county health department has argued that the numbers reveal that schools can no longer wait until high school to talk openly about birth control and STDs.3

In response, the school district has created its first new teaching materials for sexuality education since 1996. The new five day curriculum continues to be abstinence-based but teachers have been given some flexibility to add extra days to cover STDs, birth control, and condoms. These topics, often considered more controversial, were left out of the mandated lesson plan because many instructors reported being intimidated by the subject matter. Due to budget cuts, most instructors are science teachers rather than trained sexuality educators. In order to mitigate the lack of experience, the district also held a training workshop for the teachers.4

In another step to ensure quality education in each classroom, school district officials have begun to review all materials used by outside speakers. Currently, the district allows two groups to provide sexuality education to students: the American Red Cross and Be The One, an extension of a crisis pregnancy center that emphasizes contraceptive failure rates and an abstinence-only-until-marriage message. The committee of educators and health officials performing the review of the groups’ materials is expected to finish in time for the beginning of the 2006–07 school year.5


The Lubbock , TX and San Antonio , TX health departments have offered similar advice to school districts after watching consistently high STD numbers. Health officials in both localities are encouraging more comprehensive sexuality education programming in schools.

For ten years running, Lubbock has recorded the highest number of Chlamydia and gonorrhea infections in the nation and 36% of the cases are in 15–19 year-olds.6 Health department officials say the public schools are not talking enough about STDs.7

Texas law requires an abstinence-only-until-marriage approach in all sexuality education classes, but the community of Lubbock has been engaged in a debate over the appropriateness of this message since 2001.8 The law prevents the Lubbock Independent School District (LISD) from providing the more comprehensive approach that the health department recommends, but some changes are being made. According to a LISD spokesperson, the new health textbooks place more of a focus on STDs and mention unintended pregnancies. In addition, teachers can now answer questions about birth control options, where they had been censored in the past.9

The San Antonio Metropolitan Health District has also noticed alarming STD rates with 26.4 Chlamydia cases reported per 1,000 girls ages 13–18 in 2004.10 A San Antonio official explained that education needs to start earlier, saying, “we know that it’s difficult, but this is not just talking about the birds and the bees. It starts when they’re little in order to gain their trust, and we want that communication with the parents to start as early as possible. We know that it’s a difficult topic, but the fact is that these (STDs) rates are going up.”11

Rather than waiting for change from the school district, the San Antonio Metropolitan Health District proposed using its Project WORTH (Working on Real Teen Health) to facilitate meetings on the topic of “Sexually Transmitted Diseases and San Antonio Teens.” The program is first presented to parents and then, the next day the same information is presented to students.

District officials accepted the Metropolitan Health District’s proposal and tried to maximize the number of high school students enrolled in the program. “We agreed to it because it was something that we believe is important to offer our community,” said the district health coordinator. “We have a high risk here in the district,” she continued.12


In Minnesota, new STD numbers have sparked a state-wide conversation about the appropriateness of abstinence-only-until-marriage programs. The Minnesota Department of Health reported striking increases in cases of Chlamydia (5%) and gonorrhea (18%), and early syphilis cases more than doubled. The majority of people infected with Chlamydia and gonorrhea are young people ages 15–24 and the health department is particularly concerned by youth infection rates in suburban areas. In one example, Chlamydia cases among suburban youth ages 15–19 increased by 48%.13

While the health department is alarmed, it has not publicly pushed for schools to move towards a more comprehensive approach to sexuality education. The department does encourage condom use as a method of prevention, but it also accepts a federal grant of nearly $500,000 to coordinate its own abstinence-only-until-marriage program, Education Now and Babies Later (ENABL).14

Still, the department of health’s new statistics have fueled a larger conversation about the state’s sexuality education policies. The Minnesota Family Council maintains that abstinence should be the only method of STD prevention taught to students and encourages schools to invite abstinence-only-until-marriage programs to present in sexuality education classes. Local health experts, however, doubt the validity of such an approach, instead calling for a full range of information in sexuality education because so many young people are sexually active. Renee Sieving, an assistant professor at the University of Minnesota’s School of Nursing pointed out that STDs are most common among young people ages 20–24,15 and though some reports suggest that the abstinence-only-until-marriage message may help some teens temporarily delay sexual activity, findings have also shown that the same programs leave them inadequately prepared for future sexual activity.16 Working to support a more comprehensive approach, the ACLU of Minnesota argues that the decade-long increase in STDs has coincided with the rise of the abstinence-only-until-marriage movement.17

“STDs and teen pregnancy rates are on the rise and abstinence-only-until-marriage programs are clearly not protecting our youth,” commented William Smith, vice president for public policy for the Sexuality Information and Education Council of the United States (SIECUS). “We applaud public health officials and advocates who are pushing this issue into the spotlight and encourage them to demand more comprehensive approaches in our public schools.”


  1. Marc Freeman, “Teen Pregnancy Rising Sharply in Palm Beach County ,” Sun Sentinel , 29 September 2005 , accessed 13 April 2006 , <,0,174090.story?coll=sfla-home-headlines>.
  2. Rani Gupta, “As Schools Revamp Sex Ed, Some Call for Teaching More Earlier,” Palm Beach Post, 8 April 2006, accessed 13 April 2006, <>.
  3. Ibid.
  4. Ibid.
  5. Ibid.
  6. “State Mandates Abstinence be Taught First, STD’s Still Discussed,” KCBD News Channel 11, 10 April 2006 , accessed 13 April 2006 , <>.
  7. Ibid.
  8. For more information see SIECUS January 2002 Controversy Report: <>.
  9. “State Mandates Abstinence be Taught First, STD’s Still Discussed.”
  10. Edmundo Conchas, “Harlandale Youth Get Info on STDs,” San Antonio Express-News , 5 April 2006 , accessed 13 April 2006 , <>.
  11. Ibid.
  12. Ibid.
  13. Jeremy Olson, “STDs Hit Record High,” St. Paul Pioneer Press, 7 April 2006, accessed 13 April 2006, <>.
  14. For more information see SIECUS Minnesota State Profile: <>.
  15. Olson.
  16. Peter Bearman and Hanah Brückner, “ After the promise: The STD consequences of adolescent virginity pledges,” Journal of Adolescent Health 36.4 (2005): 271-278.
  17. Olson.