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The decision was sparked by rising rates of sexually transmitted infections in the county.
Students at four high schools in Montgomery County, Maryland can receive condoms from school health clinics this year, part of a larger sexual health initiative designed to tackle rising rates of sexually transmitted infections.
“When we noticed that the trends were increasing for STIs, we said, ‘We’ve got to develop a comprehensive county-wide strategy that looks at all the different components and aspects that contribute to this rise,’” said Dr. Travis Gayles, health officer and chief of public health services for Montgomery County. “In our efforts to increase access to contraceptives, screening and treatment, what are things specific to that adolescent or young adult population that we can do? Out of that came the discussion of increasing access for kids in high school to be able to get condoms.”
Discussions among public health and school officials began this summer, after data from the Maryland Department of Health showed sharp spikes in cases of gonorrhea and chlamydia in Montgomery County, particularly among teenagers.
Chlamydia cases jumped 17.5 percent in 2017, while gonorrhea cases rose by 29 percent, both nearly twice the statewide increase. In Montgomery County, nearly a quarter of the 4,029 cases of chlamydia were among residents between the ages of 15 and 19, as were 18 percent of the 726 cases of gonorrhea.
Gayles declared the situation a public health crisis, though the numbers put the county in step with national trends. Nearly 2.3 million cases of chlamydia, gonorrhea and syphilis were diagnosed across the country last year, surpassing the previous record by more than 200,000 cases and marking the fourth consecutive year of sharp increases, according to the Centers for Disease Control and Prevention. Half of those cases were among people between the ages of 15 and 24.
Condoms will initially be available at four Montgomery County high schools—Gaithersburg, Northwood, Watkins Mill, and Wheaton—that have on-site wellness centers staffed and maintained by health department employees. Students must come in and speak to a nurse to get the condoms, though that policy could change later.
“This is something that’s not been done before, so we’re starting from scratch in many ways,” Gayles said. “We’re using that as a way to start the program and we may find out that doesn’t work, that kids get messaging in different ways. That’s part of the challenge when we don’t have any background data to suggest what’s worked before or been successful.”
The condoms are just one part of a county-wide strategy aimed at improving sexual health in the community through prevention, education, screening and treatment. Officials are discussing how to best use technology, including social media, to disseminate information and communicate broader health trends, and are also examining ways to expand existing programs, including after-hours screening tests and follow-up visits with people who test positive for STIs.
But the availability of condoms has gained the most widespread attention, and could soon spread to other county schools. In a memo dated Aug. 28, Montgomery County officials called for access to contraceptives at all district high schools along with a study to see if a similar initiative would be feasible at middle schools.
The memo, authored by Montgomery County Council member George Leventhal and Board of Education member Jill Ortman-Fouse, acknowledges that the subject is a sensitive one among some students and parents who believe that increased access to contraceptives leads to increased sexual activity. But research has shown that those fears are unfounded, it notes.
“As stewards of children, we have a moral obligation to create an environment that meets not only their educational, but their physical and medical needs as well,” the memo says. “Parents entrust the county to nurture their children’s minds and bodies, and we would be doing them a disservice if we did not make every effort to provide these sexual health resources to every adolescent in the county.”
In a tweet, Ortman-Fouse urged parents to review the health data before forming an opinion on the proposal.
“I know some parents & staff may be uncomfortable w this, but please see the alarming stats,” she wrote. “Untreated STIs can have lifelong health consequences—esp. for adolescents & young women.”
Officials are expected to vote on the matter next week. Thus far, public feedback on the existing pilot program has been mixed.
“There are some parents who have pushed back and aren’t supportive. I’ve seen positive feedback as well,” Gayles said. “The thing that’s really exciting is that even though a lot of attention is focusing on the condom aspect, it’s great from the public health perspective to see the community engaging in these conversations.”
Kate Elizabeth Queram is a Staff Correspondent for Government Executive’s Route Fifty and is based in Washington, D.C.