Alabama fails young people on sexual health, report finds

By Abbey Crain

Reckon Staff Writer

Alabama is failing when it comes to the sexual health of young people, according to a new report from Human Rights Watch.

In the 65-page report, The New York City-based non-profit emphasized the high rates of cervical cancer-related deaths and sexually transmitted infections are a “human rights failure.” The authors of the report cite Alabama’s emphasis on abstinence-only sex education in schools, gynecologist shortages in rural areas and the state’s failure to expand Medicaid as contributing factors.

“Young people in Alabama may be educated on risks to their sexual health, but they often lack crucial information to take steps to actually protect themselves,” the report concludes.

And young people in Alabama have more sex than the average young person in the U.S., says one federal agency.

According to the 2015 Youth Risk Behavior Survey by the U.S. Centers for Disease Control and Prevention, the most recent data available on the subject, about 46 percent of high schoolers in Alabama have had sexual intercourse, compared with approximately 41 percent nationwide from September 2014 to December 2015.

But young people in Alabama are not provided any standardized sex education. Sex ed is not mandatory in public schools, but if students do receive any sort of sexual education, it is most likely rooted in the abstinence-only curriculum developed in the 1980s.

Other Southern states also do not require sex education in schools. Louisiana is not required to offer instruction in subject matter designated as “sex education.” Tennessee only requires a “family life education program” if the teen pregnancy rate in any county exceeds 19.5 pregnancies per 1,000 females aged 11 through 18.

According to the 2018 School Health Profiles released by the Center for Disease Control, 95 percent of high schools in Alabama taught students the benefits of abstinence, as well as the existence and transmission of HIV and other STIs. The report also concluded that approximately one-third of high schools taught the importance of using a condom correctly and consistently as a method of birth control and STI prevention. 

Alabama’s outdated sex education law also includes homophobic language and requires the curriculum to teach students that homosexuality “is not a lifestyle acceptable to the general public and that homosexual conduct is a criminal offense under the laws of the state.” Because of this, students who are sexually active with the same or both sexes do not receive information on how to do so safely.

Alabama state Sen. Tom Whatley, R-Auburn, introduced a sex education bill to the legislature that would revamp the current outdated curriculum two years in a row, but both times the bill died on the Senate floor. 

However, parents in Alabama think their children need more.

According to a 2018 survey by the Alabama Campaign to Prevent Teen Pregnancy to gauge parent attitudes across the state regarding sex education in Alabama public schools, 98 percent of parents said it’s important that their children learn about the use of condoms and 74 percent of parents said it was “very important” to “talk about what sexual orientation means” as a part of sexual education in schools.

The new report also notes Alabama’s low levels of HPV vaccination rates and scarce gynecologists in rural areas impact young people’s sexual health.

Only 20 percent of children in Alabama aged 11 to 15 have received both of the recommended doses of the HPV vaccine, compared to 49 percent nationally, according to the U.S. Centers for Disease Control and Prevention.

Officials at the Alabama Department of Public health said Alabamians are at greater risk than those in other states from certain types of cancers related to the human papillomavirus — or HPV — because of lower vaccination rates among children.

Cindy Lesinger, immunization director at the Alabama Department of Public Health, said the HPV vaccination rate is the only one that hasn’t increased in the 13 years she’s worked at the agency.

One theory suggested by Mary Anne King, executive director of the Laura Crandall Brown Foundation, which raises awareness for gynecological cancers in Alabama, is that Alabama’s location in America’s Bible Belt and hesitancy to talk frankly about sex may play a role in why parents aren’t asking for the vaccine. Lesinger also said providers are simply not suggesting the vaccine enough during children’s annual physicals.

The Human Rights Watch report suggests that Alabama enact legislation mandating comprehensive sexual health education in all primary and secondary schools. This curriculum should be age-appropriate, scientifically and medically accurate, rights-based and inclusive of all young people, the report states. It also suggests enacting legislation to increase HPV vaccination rates, including requiring health insurance plans to provide coverage for the HPV vaccine.

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