Sex and the Media: Teens Learn About the Birds and the Bees in Cyberspace

Sexual health education has taken on a whole new venue. Public health programs are offering teens the ability to ask  questions anonymously and get personalized answers through text messaging services and web sites.

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The text comes in: I’m 14 and am going to lose my virginity but am not on birth control. Am I at high risk for pregnancy?

The response: Yes. A sexually active teen who does not use birth control has a 90% change of becoming pregnant within a year. You need to use protection. Even if you don’t become pregnant you are still at risk of an STD.

This actual interchange is an example of information provided through the Birds and Bees Text Line, funded by the state of North Carolina. Teens can text a question about sexuality and get an answer usually within 24 hours. The phone numbers are deleted and the entire process is anonymous.

Communicating information about sexual relationships, pregnancy and sexually transmitted diseases has come a long way from the days when teenagers learned about those topics through sex education textbooks or pamphlets in school, or, if they were fortunate, through face-to-face conversations with their parents in their living rooms after dinner.

Even the more recent and increasingly graphic sexual health information published in teen magazines or broadcast on television networks appear to be passé. Now, a growing number of teenagers send and receive text messages by the dozens, belong to multiple online social networking sites, and use blogs, widgets and twitter, which have only recently joined the lexicon of tech-speak. These media have become new avenues to send or receive sexual information.

As teenagers turn to these digital sources of information -- the new media -- public health officials are finding a golden opportunity to inform young people about preventing unplanned pregnancy and STDs.

BIRDS AND BEES TEXTING

In North Carolina, which has one of the nation’s highest teen pregnancy rates, the Adolescent Pregnancy Prevention Campaign of North Carolina developed the Birds and Bees Text Line to answer questions about sex, relationships and STDs. North Carolina’s General Assembly earmarked approximately $250,000 for the Campaign, and $5,000 of that funding is used to operate the Birds and Bees Text Line.

And the questions are still coming in.

Text question: Is it legal for a 17 year old to be with a 14 year old?

Text answer: It is legal but is it a good idea? …. It’s best to stick with someone your own age.

Text question: If you have sex under water do you need a condom?

Text answer: Yes, use a condom to protect against pregnancy and STD’s every time you have sex.

In its first three months, the Birds and Bees Text Line received approximately 700 questions. Kay Phillips, the line’s director, says 11 staff members are trained to provide non-judgmental answers to the queries. “Our purpose is to reduce teen pregnancies and STDs,” she said. “The purpose is not to teach kids how to have sex. ... Our purpose is to help these kids learn and make better decisions.”

PUSH BACK FROM PARENTS

Phillips acknowledges, however, she has received criticism at meetings throughout North Carolina. That criticism often comes from parents who oppose a program that enables their children to receive information about sex, including contraception, from anonymous staff working for a publicly-run program, particularly since North Carolina mandates abstinence-only sex education curriculum in schools.

“I totally agree that (talking about sex) should be done in the home, but the reality of that is that it is not being done in the home,” Phillips said. She adds, “If there is an opportunity, we … encourage them to talk to their parents. But as you know, not every person out there has a happy family life.”

Bill Albert, chief program officer for the National Campaign to Prevent Teen and Unplanned Pregnancy, also known as The National Campaign, agrees that information about sex should come from parents. But that doesn’t always happen.

“Sometimes a young person might have a question that they are too frightened to ask their parents,” Albert said, referring to the Birds and Bees Line. “And they are going to ask somebody, and I’m pleased that a responsible group is trying to answer them.”

But Albert also has pointed comments for parents who categorically oppose the use of new media to provide teens with information about sex and relationships.

“I don’t understand in this day and age this antiquated notion that a lot of parents have that ‘I can shield my kid from topic X.’ I think that is almost impossible in this day and age,” he said.

The National Campaign has launched a Website for teenagers, which provides information about sex, pregnancy, relationships and STDs. During May 2009, the Web site, www.stayteen.org, included situational quiz questions. More than 400,000 people participated. The Website also operates a widget, which can be embedded in a teenager’s social networking site, such as Myspace or Facebook to provide them with a link to credible sexual information every time they use their social networking pages.

The National Campaign’s Website also allows young people to ask non-medical questions about sex and relationships. Albert points out one of the values of Web 2.0 – the term used to apply to the new generation of Web development and design – is the interaction it provides, inviting comment and conversation from teenagers about sensitive subjects.

He acknowledged the Internet contains considerable misinformation about sexual health, but he believes that www.stayteen.org is a way to combat potentially harmful information.

REACHING TEENS WHERE THEY ARE

The problems of teen pregnancy and STDs among adolescents and young adults are well-documented. According to the Centers for Disease Control and Prevention, after declining steadily between 1991 and 2005, the teen pregnancy rate is again increasing nationally. In 2007, there were 42.5 births per 1,000 females in the 15-19 year-old age group. It marked the second consecutive year the teen pregnancy rate increased.

Adolescents and young adults also account for the highest reported rates of gonorrhea and Chlamydia, according to statistics from the Centers for Disease Control and Prevention. Young people ages 15 to 24 have five times the reported chlamydia rate and four times the reported gonorrhea rate as the general population, the CDC reports.

Public health officials are discovering that using forms of the media popular with young people – such as cell phones, the Internet and social networking sites – is one way to provide information that might help prevent an unwanted pregnancy or an STD.

“We’re pretty slow, especially in public health, to get on the bandwagon,” admits Rachel Kachur, health communication specialist for the CDC. “And I feel we’ve done a decent job of figuring out how to be in these spaces, because we have to put accurate, useful information out there in order to compete with all that other stuff that’s out there.”

Kachur insists that adolescents want information about sexual health, but don’t always know where to access reliable and non-judgmental facts. She believes the new media has the potential to reach many of them.

“Kids go online to get health information, and one of the main topics they’re looking for is sex and sexuality,” she said. “Kids are using the Internet for health information. … It’s up to us to provide them with reliable information and credible resources.”

Children and adolescents between the ages of eight and 18 consume an average of 44 hours of media time per week, according to Albert from the National Campaign to Prevent Teen and Unplanned Pregnancy. He points out that’s more time than they spend in school and more time than most young people spend with their parents. “Teens are already knee-deep in cyberspace. Why would you not try to reach them there?” he asks.

Kachur believes the use of new media provides young people with a way that they can “feel normal” about their sexual development.

“When kids are coming into their own sexuality and trying to figure out who they are, they can find others like them online. That’s really important when you think back at how difficult it is to be a teenager and trying to fit in,” Kachur said.

OTHER PROGRAMS JOIN THE NEW MEDIA

Deb Levine, executive director of California-based ISIS, Inc., was instrumental in the creation of GoAskAlice at Columbia University in 1993, believed to be the first Website where people could anonymously ask questions about sexual health issues. More than 15 years later, she is still encouraging policymakers to embrace technology as a means of providing sexual information to young people.

“The computer and technology is not a panacea,” she said. “It works best in combination with other ways of reaching young people. … So it’s not that this is going to replace other ways that we communicate, but it’s a complement to other services that we’re providing.”

Through a CDC-funded program, the New Media Institute at the University of Georgia led an effort in 2008 for students from seven colleges to produce videos that can be broadcast onto someone’s cell phone to fight the spread of HIV. The AIDS Personal Public Service Announcement (PPSA) project is designed to increase awareness of the importance of HIV testing and to encourage young people to get tested.

“They’re spending more time on the phone than with any other medium. It’s a device that is constantly with them,” the Institute’s director, Scott Shamp, pointed out. “That’s where they’re going for answers. That’s why we need to make sure that those answers are easily available and that they’re accurate. And that young people can make the right decisions based on that information.”

Nevertheless, technology hasn’t quite caught up with Shamp’s PPSA project. He says fewer than five percent of the population own cell phones capable of receiving the videos broadcast by his students. Currently, the videos are primarily available on YouTube. However, as technology evolves, he believes it will become easier to provide videos to young people containing information about sexual health issues.

Other projects using new media to provide information about sexual health issues include the ‘KnowIt’ campaign and HIV testing locator, a collaborative project between the CDC and the Kaiser Family Foundation. It allows users to text their zip code to “KnowIt” (566948) and receive a text message identifying the location of a nearby HIV testing center. Those without cell phones can receive the same information online at www.HIVtest.org.

In California, ISIS partnered with the California Family Health Council and the California Department of Public Health to create a text messaging program called HookUp. To use the service, users text ‘hookup’ to the phone number 365247 and are signed up for weekly health tips. Each tip provides information to help users locate local clinics for STD testing and reproductive health services.

Inspot.org, also run by ISIS, operates in 12 states and 12 metropolitan areas to allow users to find local STD testing resources. It also permits users who are diagnosed with an STD to notify past sex partners so that they can be tested. The infected person has the option of remaining anonymous, as 80 percent of the site’s users do, according to Levine of ISIS.

Kachur with the CDC believes policymakers are missing a tremendous opportunity if they don’t use new media for STD and pregnancy prevention programs.

“I think in any health promotion program that has any money going into any policy related to STD prevention or pregnancy prevention, there should be a new media component to it,” she said. “If you’re going to do a health campaign, there should be a piece that provides funding for new media. … It can’t be a novel thing anymore. It is what it is. Kids are the first ones to adopt it. If we want to reach them we’ve got to be in these places.”

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