Let’s talk about sex.
If those words grabbed your attention, it may have more to do with the reality that our nation doesn’t normalize the conversation about sex and sexual health. Verbal and visual references of sex saturate our culture through music, TV and social media, but constructive discussions about it are a different story.
“We are a very sexualized nation, but we cannot talk about it,” says Olivia Catalano, Director of Reproductive Health for Finger Lakes Community Health. “The act of discussing sex is considered more intimate than actually having sex.”
Finger Lakes Community Health (FLCH) is a federally qualified health center that provides comprehensive health care, everything from dental care to annual health checkups. At FLCH, sexual health, which covers family planning and reproductive health, is integrated into primary care.
Pap smears, breast and testicular exams, and contraception can be incorporated into a routine physical. The health center also treats and tests for sexually transmitted infections (STIs), eliminating the need for the patient to see a specialist.
By treating sexual health as a normal part of your life and body, the stigma can be broken down. At the health center, sexual health conversations are specific to our different needs and based on where we are in life.
New York State law provides confidential access to sexual health services starting at age 12. This access is helpful, but it’s also important that younger patients have trusted family members or adults in whom thay can confide their questions and feelings. This trusted resource helps promote healthy development in youth.
Teens and Young Adults
This age group ranks highest for number of new STIs, so it's important for sexually active teens and young adults to be tested regularly. Depending on who you have sex with, it's important to have preventative conversations not only about STIs, but also about pregnancy. During 2017 in Ontario County, 14.3 teens per 1,000 became pregnant.
“With so many online sources, there is so much misinformation at the touch of your fingertip,” Catalano says. “It can be challenging for an educational consumer.”
For adults, the conversation shifts more to pre-conception and lifestyle changes that promote good health, for the sake of not only the parents but the children to come. Equally important is helping people who don’t want children explore their birth control options.
Persons between 45 and 60 years old are typically finished having children of their own. Those in this age group often believe getting tested for STIs isn’t necessary because they’ve often been with the same partner for years or don’t have risk of pregnancy.
Not everyone, however, is in a long-term relationship or faifthful to his or her partner, and women can conceive — although rarely — into their late 40s or early 50s. Individuals shouldn't be complacent if there is any risk of pregnancy or contracting STIs, so discretion is advised.
This is a challenging demographic, as seniors no longer use birth control and generally don’t talk about sexual health.
They are, however, still having sex — frequently with multiple partners and outside of long-term relationships — so attention to sexual health should still be a priority, depending on one's lifestyle.
“Seniors in nursing homes have a high infection rate for STIs," Catalano says. "They are sexually active, and the pool of people is limited.”
Closer to home
FLCH is focusing on combating the rise of chlamydia, gonorrhea and syphilis in Ontario County.
Syphilis is especially problematic because it has the greatest potential to cause chronic health problems, including mental illness and mortality, and 80 percent of people don’t show the disease's typical symptoms. Furthermore, syphilis is spread fairly equitably across all age groups with the exception of ages 50 to 59, which represents 28 percent of the cases reported between 2007 and 2017.
Regarding gonnorhea, fewer than 20 cases were reported in the county each year from 2008 to 2013. That number has risen to 80 cases reported in 2018.
Chlamydia has also risen from about 225 cases reported in 2010 to 300 to 350 cases reported each year from 2013 to 2018.
Sexual health protection is about more than pregnancy. Teens and adults should be tested regularly for STIs, as some such as pubic lice and herpes can be transmitted via clothing and linens. You may also want to talk to your doctor about the human papilloma virus vaccine. It’s the only vaccine known to prevent cancer.
Catalano also notes birth control can have benefits beyond preventing pregnancy. It can help with acne, weight control, period regulation and endometriosis.
“People should be armed with tools to make good decisions,” Catalano says. “We need to normalize the sexual health conversation just like normalize every other piece of our health.”
This article was originally published in Community Health for Ontario County Employee Wellness.