Daring to talk about sex and disease

Public health - At a dinner, black youths are urged to take charge of their sexual health

Friday, April 27, 2007

NIKOLE HANNAH-JONES

Chlamydia and gonorrhea hardly seem polite topics for dinner conversation. But important discussions in the black community often revolve around meals.

So when the Multnomah County Health Department wanted to talk about disproportionate rates of sexually transmitted disease among young black people, it brought out mac and cheese, shrimp and sweet tea. Someone beat an African drum, and dancers performed a step routine.

Then the conversation got serious. Deadly serious.

Chlamydia and gonorrhea infection rates for black people in Multnomah County ages 15 to 24 are nearly six times those of white people in the same category. Black people account for nearly 9 percent of HIV/AIDS cases in the Portland metropolitan area but less than 2 percent of the population. As the statistics were read, one young man muttered under his breath, "Damn."

"We have to ask why these numbers exist," said Tricia Tillman, who manages the sexually transmitted diseases disparity project for the county health department. "We haven't talked about sex, and it doesn't serve us. It just lets this continue to get worse."

Wednesday's meeting brought young people, parents and elders in the black community together to talk about the problem and come up with solutions that will work within the culture.

Several factors contribute to the high rates of sexually transmitted disease among black teens and young adults, Tillman said. Underlying injustices such as poverty and poor access to health care play a role. So does the disproportionate number of black men in the criminal-justice system. Sexually transmitted diseases are passed around prison populations. After men are released, they spread those diseases into the heterosexual population.

Even for black youth engaging in low-risk sexual behavior -- they're heterosexual with few sexual partners -- rates of infection remain disproportionate, Tillman said, because the black population is so small that disease gets passed around more. Just as when you're in a small town, you're more likely to run into somebody you know. In a small community, you're more likely to encounter a disease that's being circulated.

But the strong message Wednesday night was that black youths must take charge of their own sexual health.

Social scientist Doug Kirby presented research showing several comprehensive sexual-education programs targeted toward African Americans that successfully raised age at first intercourse, lowered teen pregnancy rates and increased condom use. Programs that worked for black teens focused not just on the individual, but also on teens' sense of responsibility to their community. Kirby told the crowd of more than 100 that research shows abstinence-only programs don't seem to work with youth of any ethnic background.

That wasn't what Pam Gaines, who leads a rite-of-passage group for black girls, wanted to hear.

"We preach abstinence," she said. "We don't want to give up on that, but we've got to be realistic."

But what caught the attention of the young people was when Kirby revealed charts that show how small increases in the number of sexual partners can cause sexual networks to explode.

"It was crazy," said BenTia Andrews, a 17-year-old De La Salle North Catholic High student. "How we all can be connected sexually without knowing each other. If one person protects themselves, it protects the rest of the community."

 

The conversation got most lively when the moderator asked the crowd to gather into small groups and come up with three of the top sexual-health problems among young black people, along with three solutions.

Peer pressure, hypersexual media images and adult reluctance to talk candidly with kids topped the lists.

Their solutions: realistic sex education that teaches abstinence as well as contraception and sexual decision-making, campaigns against media that portray black women as promiscuous video vixens, and classes to help adults learn to talk to their kids about sex.

Marquis Johnson, a De La Salle sophomore, said it felt good to be asked.

"Most of the time, they just look over at us and think we don't have an opinion," Johnson said. "If you're going to do this, do it the right way."

Nikole Hannah-Jones: 503-294-5968; nhannahjones@ news.oregonian.com