Let’s Talk!: Adolescent Sexual Health in Michigan

1. Let’s Talk!: Adolescent Sexual Health in Michigan The Michigan Coalition on Adolescent Sexual Health Jackson Community Conversation November 9, 2010 Facilitators: KARA ANDERSON, Michigan Department of Community Health, andersonk10@michigan.gov KERI BENNETT, School-Community Health Alliance of Michigan, keri.bennett@scha-mi.org

2. Our Hosts… MiCASH –a statewide coalition MOASH – a statewide 501(c)3 organization Jackson County Teen Pregnancy Prevention Initiative (JCTPPI) – a local coalition Funding generously provided by: The Michigan Department of Community Health

3. The Relationship State-Level Program, Policy and Procedure-Making Bodies MOASH Ideas Recommendations MICASH Community and State Organizations The Department of Education State and Local Health Departments Parents Youth

4. Goals For Today • Gather local input to inform future statewide initiatives to address adolescent sexual health. • Raise awareness about risk behaviors and sexual health issues for adolescents. • Gather information about local needs and gaps in services and local perspectives. • Share information about state and local initiatives. • Support current local programs and services.

5. Who’s Here Today? Work with teens in school settings? Work with teens in clinical settings? Work with teens in community settings? Administer programs that work with teens? Are or have been a parent/caregiver of a teen? Are a teen? Other?

6. What’s Happening Around Adolescent Sexual Health? Data Review

7. A Little Data… • Youth Risk Behavior Survey • Sexually Transmitted Infections • Chlamydia • Gonorrhea • HIV • Teen Pregnancy and Birth • Sexual Assault and Domestic Violence 1 2 County or Local Community

13. Chlamydia by Age2009 Michigan 76% of cases are among 15-24 year olds Source: MDCH Bureau of Epidemiology

14. Gonorrhea by Age2009 Michigan 66% of cases are among 15-24 year olds Source: MDCH Bureau of Epidemiology

15. Major Disparities in STI (2009) Among 15-19 year olds: The Chlamydia, the rate was over 12Xhigher for Black than White youth. For Gonorrhea, the rate was over 31Xhigher for Black than White youth. The locales with the highest rates for Chlamydia and gonorrhea among youth were City of Detroit, counties of Genesee, Muskegon, Calhoun, and Kalamazoo.

16. Region 1: Clinton, Eaton, Gratiot, Hillsdale, Ingham, Jackson, Lenawee Livingston, Shiawassee

17. HIV and Teens Michigan youth, ages 13-19, are becoming a significantly larger proportion of those newly diagnosed with HIV. Currently 2,980 people living with HIV or AIDS in Michigan who were between 13-24 when initially diagnosed. Source: 2008 Epidemiologic Profile of HIV/AIDS in Michigan

18. 13-24 Year Olds Recently Diagnosed with HIV (2004-2008) 871 cases of HIV among 13-24 year olds Of those 81% were male 76% were Black Among males, 78% were MSM 65% were Black MSM about 2/3 live in the Detroit metro area The face of HIV/AIDS among Michigan youth has been largely and disproportionately urban, male, and Black, with the primary risk being male-to-male sex. Source: MDCH Bureau of Epidemiology

19. Teen Birth RatesMichigan v. U.S., 1992-2008 Source: Michigan-MDCH Vital Statistics, National-National Center for Health Statistics

20. Major Disparities in Teen • Birth Rates • Black teens in Michigan are more than 2X as likely to give birth as white teens • 34 counties, plus Detroit, exceed Michigan statewide teen birth rate • 18 counties, plus Detroit, exceed the national teen birth rate

21. Teen Births:Percent of Total Births by Race/Ancestry Source: MDCH Vital Statistics, 2008

23. Jackson County Teen Birth Rate (2008) 13 – 19 year olds: Total = 249 teen births (14% of all births) 17th highest teen birth rate in Michigan out of 83 counties Birth rate for Caucasian Teens Ages 15-19 is 38.9 per 1,000 females; for African American Teens is 96.4 (2.5 times higher) 57% of teen births take place in the City of Jackson The City of Jackson has the 3rd highestteen birth rate of cities in Michigan

24. Realities of Teen Pregnancy in Michigan 58% of teen mothers under 18, got late (after first trimester) or no prenatal care. Nearly 85% of births to mothers under age 18 were unintended. These infants are more likely to have low birth weight, and long terms negative health consequences.

25. Costs of Teen Pregnancy A child born to an unmarried teen who has not yet completed high school is 9X more likely to grow up in poverty. <50% of mothers who have a child before they turn 18 ever graduate high school. <2% of mothers who have children before 18 have a college degree by age 30. Children of teen parents are 2X more likely to suffer abuse and/or neglect than would occur if their mothers had delayed childbearing.

26. Costs of Teen Pregnancy Teen childbearing in Michigan cost taxpayers (federal, state, and local) at least $302 million in 2004. (Source: National Campaign to Prevent Teen and Unplanned Pregnancy)

27. Health Disparities for Sexual Minority Youth (SMY) SMY were ___ more likely to have: 3.1times—been threatened or injured with a weapon at school(19% vs. 6) 3.2times—skipped school because they felt unsafe(15% vs. 5%) 8.6times—used injected drugs(12% vs. 1%) 4.0times—attempted suicide(28% vs. 7%) 3.2times—had four or more sexual partners(34% vs. 11%) 3.7 times—ever been or gotten someone pregnant(16% versus 4%) Source: Massachusetts Youth Risk Behavior Survey, 1997-2007

28. 2010, In the Headlines… Raymond Chase Commits Suicide, Fifth Gay Youth to Take Life in Three Weeks Suicide Surge: Schools Confront Anti-Gay Bulling Fifth Gay Teen Suicide in Three Weeks Sparks Debate Tyler Clementi Suicide Result of Hate Crime? Obama expresses concerns over wave of gay suicides. Bullied Tehachapi gay teen Seth Walsh dies after suicide attempt

29. Michigan Youth Risk Behavior Survey (YRBS) In 2009… 10.4% of MI HS students reported they had ever been physically forced to have sexual intercourse when they did not want to. Nationwide, 7.4% of students had ever been physically forced to have sexual intercourse when they did not want to.

30. CDC Morbidity and Mortality Weekly Report, February 2008; Silverman et al, 2001 1 in 4(25%) U.S. women and 1 in 5(20%) U.S. teen girls report ever experiencing physical and/or sexual IPV.

31. ABUSE AND SEXUAL RISK BEHAVIORS Wu et al, 2003 Women who experienced past or current Intimate Partner Violence (IPV) are more likely to: • Have multiple sexual partners • Have a past or current sexually transmitted infection • Report inconsistent use or nonuse of condoms • Have a partner with known HIV risk factors

32. Women or girls forced to have sex are more likely to experience: Pelvic Inflammatory disease Vaginal and anal tearing Bladder infections Sexual dysfunction Pelvic pain Gynecological problems Invasive cervical cancer and preinvasive cervical neoplasia Bergman & Brismar, 1991; Schei, 1991, Campbell & Lewandowski, 1997; Campbell & Alford, 1989; Chapman JD, 1989; Coker et al, 2000 ,Dienemann et al, 2000; Domino & Haber, 19878; Plichta, 1996.

33. Who’s In Your Group?M & M Game

34. Red -What brought you to the Community Conversation today? Blue– What would you say your role in this community is? Green– Where did you receive most of your sexual health information  growing up? Orange -What didn’t you learn about sexual health as a young person that you wish you had? Purple or Brown – What do you think is a barrier facing young people today? Yellow– In an ideal world what would Sex Ed. in Michigan look like?

35. Sound Off Small Group Activity: Let’s Talk! Large Group Activity: Talk Back!

36. 1. What are your initial reactions (thoughts and/or feelings) to the information that has been presented?

37. 2. What information do you think young people need in order to make healthy and informed decisions about relationships, sexual behavior, and preventing risks? • Who do you think should be involved in providing this information? • Who is involved in providing this information in your community? • What is needed to better support the provision of this information to youth in your community?

38. 3. In terms of current activities educational programs, clinical services, community programs, etc. that are taking place around sexual health (i.e., pregnancy prevention, STIs, HIV)… • What is being done right and/or • what can be improved?

39. 4. What do you think gets in the way of healthy decision making around sexual behavior and risks for the youth in this community?

40. 5. What type of event would you like to see the Jackson County Teen Pregnancy Prevention Initiative (JCTPPI) hold in the future to promote this issue?

41. 6. What can we (JCTPPI) do to support parents in educating their children about sexual health?  What obstacles might they be facing that we (JCTPPI) can assist them with?

42. 7. Do you think teens in our community face barriers in accessing contraception services in areas outside the City of Jackson?  If so, what can be done to address this problem?

43. Improving Sexual Health in Michigan – Statewide Initiatives • School-based programs • Community-based programs • Clinical programs • Parent programs (e.g., Talk Early & Talk Often) • Youth councils • Statewide and regional trainings • MDCH, MDE, MOASH, SCHA-MI, CSHCA • Programs that Cut Across Programs • Project Connect • STI Screening • Statewide and community coalitions and organizations (MOASH, MiCASH, SCHA-MI, local coalitions, etc.)

44. Local Initiatives

45. Next Steps • Activity: Your Opinion Matters! • Staying in touch and informed about adolescent sexual health issues. • Statewide plan development • Resources

46. Questions and Thanks! Door Prize Drawing!