Teen pregnancy, STD war fought on tricky terrain

June 04, 2000|By MICHAEL OLESKER

IN CASE YOU hadn't noticed, the talk around here got very sexy last week. Kathleen Kennedy Townsend, in her intimate way, talked about everyone's most delicate subject. And then, offering his own embrace, so did Peter Beilenson. By the end of the week, some of us practically needed a cigarette.

Townsend, the lieutenant governor, brought us the breathless news about Maryland's rate of teen pregnancy, which has dropped for the seventh straight year. And Dr. Beilenson, the Baltimore health commissioner, told us that the city no longer leads the nation in the rate of venereal disease.

Reader, if this is not a grand distinction and a shot of emotional Viagra, then what is?

In Baltimore, the rate of syphilis dropped by 65 percent between 1997 and 1999 -- it's the biggest drop of any American city -- and the rate of gonorrhea dropped 45 percent.

Meanwhile, according to Maryland health department figures, only 4.3 percent of girls statewide ages 15 to 19 gave birth in 1998 (the last year for which such figures are available), compared with the national rate of 5.1 percent -- and far below Baltimore's, which is falling faster than the rest of the state but is still 9 percent.

"It's good that [state figures have] come down seven years, but we still have to be concerned that it's too high," Townsend said at a State House news conference, adding, "We have to keep fighting."

Well, yes.

Fighting.

These results did not come from nothing. They came from health officials and school teachers and responsible parents getting the message across to young people, and they also came from health officials finding new ways to reach previously unreachable drug addicts who trade sex for crack and don't stop to imagine the consequences, or no longer particularly care.

We live in a time of great alarm over our sexual behavior because it sometimes translates to sexual disaster. Previous generations worried mainly about sex leading to new and unanticipated (and often unwanted) life. This generation worries about it leading to death.

And right there, amid the general applause for falling rates of teen pregnancy, and falling rates of venereal disease, do we have one slight murmur of concern: Are we winning these wars at the expense of our own, and our young people's, emotional health? At a time when their sex glands are going off like time capsules, are we creating new levels of anxiety by making the connection too strong between love (or lust) and death?

"Yes, it is a tricky balancing act," Beilenson was saying at week's end. "It is. You worry about finding the right message to send, and you wonder about liberal and conservative cultural swings. The message has definitely gotten out that sex can be deadly. You don't want kids getting pregnant, and generally, you don't want them to be sexually active. However, you don't want to equate sex with death."

Among the methods used to discourage teen-age sexual activity, for example, are what Beilenson calls "peer-based abstinence support groups." This involves kids who were previously sexually active, but have seen the error of their ways. Now, says Beilenson, "They give presentations on why they're no longer sexually active. They're scared because of sexually transmitted diseases. Or they've been emotionally burned. They tell their stories to other teen-agers."

But, sex being the delicate un-zipped code that it is, the emotional terrain is awkward. In all the lecturing, and all the information overload, and all the scare tactics, where does love fit into the equation if sex may equal catastrophe? Where does the need for affection fit in, or the need for a sense of security in an awkward time of life?

"That is one of our concerns," Beilenson says. "What we're seeing, though, is that teen-age sexual activity is not actually going down. If there's a drop, it's small. We're still seeing about 75 percent of high school seniors with some sexual history. The difference is, they're being more careful. Almost half are using condoms. That figure used to be 10 or 12 percent."

As for that other previously unreachable population, hard-core drug abusers, Beilenson says inroads have been made by increasing the number of clinicians at area clinics for sexually transmitted diseases, and intensifying the information given to patients -- many of whom imagined syphilis and gonorrhea were diseases of the past.

Also, says Beilenson, "We've gone to crack houses and drug corners and talked to them about the epidemic. We discovered that 20 percent of our positives on sexually transmitted diseases were coming from Central Booking. Some of these things can be handled with a shot of penicillin. So we're reaching these folks in ways we never did before."

The information is getting out, and numbers are going down. What happens in that tricky emotional terrain is another matter. Sex can sometimes equal death, but its joy and love and fulfillment are also part of the human equation.

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