Story by: Olivia Clark
Photo by: Olivia Clark
CHAPEL HILL, NC— Daniela Sostaita answers every question about sexually transmitted diseases that middle school and high school students ask.
What are the different types of STDs? Which ones are treatable? How can they be prevented?
She teaches her students about condom use, about abstinence and about the importance of getting tested.
“We’re very much normalizing STIs,” Sostaita said, using the acronym for sexually transmitted infections. “It’s part of being sexually active. It doesn’t mean that someone did anything wrong or was irresponsible or is now dirty. It’s nothing to be ashamed of.”
As a community health educator for Planned Parenthood South Atlantic, Sostaita always includes STD prevention in her sexual education curriculum.
Through sexual education, she works to combat the unfortunate reality that the United States is facing—an all-time high in STDs.
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In 2018, there were more than 2.4 million reported cases of chlamydia, gonorrhea and syphilis in the United States, according to the U.S. Centers for Disease Control and Prevention. This is the fifth consecutive year these combined infection counts have risen.
For chlamydia and gonorrhea last year, these rates were highest among teens and young adults.
In North Carolina, 19,244 people ages 10-19 were reported as having chlamydia, and 4,288 had gonorrhea, according to the 2018 North Carolina STD Surveillance Report. It was the seventh-highest state in terms of reported chlamydia cases.
“It’s very scary to see in the news that STIs are on such a big rise,” Sostaita said. “We should take this and say, ‘OK, I should do a better job of informing myself and take this information and apply it to my life.’”
Some of the consequences of the continuous rise in STDs include drug-resistance of gonorrhea, infertility and congenital syphilis, which can cause death of newborns.
Dr. Toni Darville, the chief of pediatric infectious disease at UNC Children’s Research Institute, has been studying chlamydia for more than 20 years and is working to develop a chlamydia vaccine with funding from the National Institutes of Health.
“Because these STDs continue to rise in the United States and across the world, despite screening, I think that really does show that vaccines are desperately needed,” Darville said. “Because people aren’t protecting themselves, they’re not using condoms and they’re continuing to acquire these infections.
“Sex is part of life. So the more we can do to prevent and educate,—education is one of the ways to prevent these infections—the better off we’ll all be.”
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Dr. Dana Riger, a clinical assistant professor in the Human Development and Family Studies program at UNC, teaches her university students how to deliver comprehensive sexual education, how to address these topics with children at various levels of development and how best to promote safe sex.
She says that, unlike in a lot of Western European countries, sexual education in the United States is not always compulsory, doesn’t start early enough and is mainly problem-focused.
North Carolina is one of 24 states that requires public schools to teach sexual education. It is also one of 35 states that allows parents to opt-out of their child’s sexual education courses.
“If students are not getting any sex ed or learning about it in school at all, that’s hugely problematic,” Riger said. “We know that the rates of teen pregnancy and STIs are correlated to a kind of exposure to sex ed.”
In 2009, the Healthy Youth Act altered sexual education in North Carolina. Referred to as Reproductive Health and Safety Education, the curriculum under the act must be medically accurate and include information on a list of topics, one of which is STD prevention. As to how these topics are taught, school systems are given creative liberty.
Sostaita said that although children are receiving some sexual education, not all curriculums are comprehensive enough.
“Sex ed is still very much abstinence-focused,” Sostaita said. “This doesn’t give teens all the information that there is and, at the same time, it shames students who maybe aren’t abstinent or it sends the message that this is the only correct or right thing to do. We need to talk about how you make that decision for yourself.”
As both a teacher and therapist on the topic, Riger said that to truly address and instill the prevention of STDs in children, sexual education must be compulsory in all states and begin as early as kindergarten to varying degrees.
“Something that people can really do to help destigmatize STIs is just to talk about their experiences,” Riger said. “I think people who’ve had experiences with STIs, whether they’re something that’s been treated or something like a viral STI that never goes away but can be managed, should really be more vocal about talking about their experience and kind of destigmatizing it.”
This is exactly what Liz Chen and Cristina Leos were thinking when they created their app.
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Chen and Leos created the app Real Talk to bring sexual education storytelling directly to the smartphones of middle school students.
Through a feed similar to that of Instagram, Real Talk delivers story tiles with pieces of users’ personal stories about various topics related to puberty, sex, bullying and more. When users find topics they want to learn more about, they can follow a link to online sex ed resources within the app to learn factual information about the topic, in addition to reading the personal stories that people share.
“We want to encourage that we know many of these topics are stigmatized or taboo, and so we want to make it easier,” Chen said. “We think that them actually going through and sharing these stories in the app encourages them to practice sharing, so that they can hopefully also share with people outside of the app.”
Another purpose of the app is to ensure adolescents of all ages and backgrounds that they are not alone in their experiences, their questions or their confusion.
“We feel like many of our users feel really lonely, and so they are looking for a platform where they can both share their experiences in the hopes that other people can benefit from them, but then also want to read other stories to know that they’re not alone in what they’re feeling and going through,” Chen said.
The technological aspect of Real Talk, Chen said, is also a way to bring sexual education directly to more teens, since many curriculums require either subscriptions or schools to teach them.
“This recent spike in the STI rates across the country, especially in the Southeast, reminds us that the tried and true methods, or what we were using as a status quo for prevention, might not be what’s best for young people today, and so I think that more innovation will soon come with regards to technology and STI prevention,” Chen said.
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After having lost funding this year, Planned Parenthood can no longer provide many of the free STD testing services that it once did. However, educators such as Sostaita are helping to inform people of where they can go since, without access to care, sexual education about testing and treatment can only do so much.
Darville said that the lack of consistent access is one of the many challenges that a vaccine could help people to overcome.
“People can’t access care, especially with all the stigma that comes with sexually transmitted infections,” Darville said. “If they can’t access care, then they can’t get condoms, they can’t get screened, they can’t get tested, and then what happens is more unknowing spread of their infections occurs. So it’s clearly important to have physician and healthcare providers available to screen people when they’re concerned they’ve had unprotected sex and then to be able to provide them with therapy when they find that they’re infected.”
Despite the current rise in STDs, Riger is optimistic about improving education on the topic and that the next generation of sexual education professionals, many of whom she is teaching, can help prevent future infections and lead the country down a healthier and safer path.
“We are making a lot of progress in treatments for STIs,” Riger said. “I’m hopeful about the future of our relationships with STIs and what it means to have them.”
