Teens Most Vulnerable to Sexually Transmitted Diseases in Tom Green County

Now that school is underway, many Tom Green County teenagers have a lot on their minds and things to juggle in their lives, including homework, tests, planning for college, adjusting to college life, determining who to take on a date to Homecoming and avoiding the wrong choices that can affect their lives for years to come. Unfortunately, those choices, in relation to sexually transmitted diseases, have the County and Texas in a continual rut since the numbers of teens diagnosed with STDs began to spike in 2009.

According to the Texas STD and HIV (Human Immunodeficiency Virus) Surveillance Reports provided by the Texas Department of State Health Services, Tom Green County Chlamydia Cases jumped from 2009 to 2010 by 92 percent; Gonorrhea cases went up by 79 percent; and from 2010 to 2011, Syphilis Cases spiked by 50 percent. Not to mention, the cases of HIV went up by 30 percent from 2012 to 2013. Since these spikes, the numbers have remained steady despite a minor downturn in some areas in 2014.

Registered Nurse Marie Aguilar, who is also the nurse manager for the City of San Angelo-Tom Green County Health Department, said, “We see [people] of all ages walk through our doors coming in for our services. I have been with the City for 18.5 years, and through those years, I have seen a gradual increase.”

Granted, the statistics and cases Aguilar referred to relate to people of all ages, but in Texas, some of the highest numbers of sexually transmitted disease affect 15 to 19-year-old males and females. Out of the two groups, teenage girls have a much higher rate of infection; however, the statistics may be somewhat skewed said Kathe A. Conner, R.N., FMP.

Conner, who has worked at the University Health Clinic and Counseling Services at Angelo State University for 18 years, said, “I’m going to guess the reason why you’re seeing more girls is because they’re going in to see their OBGYN, and they’re getting regular pap smears and regular checkups; so that means more girls are getting tested. That doesn’t mean though that there are necessarily more girls with STDs than guys.”

If that’s the case, then many male teenagers in Tom Green County may not know they have an STD, may not have the health resources, or may be afraid to get tested, which leaves their partners and future partners at risk.

To understand the numbers medical professionals in the County and Texas diagnose and treat annually, the following table lists the common types of STDs (Chlamydia, Gonorrhea and Syphilis), HIV, and the number of cases associated with pre-teen and teenagers from 10 to 19 years for the past five years. It also addresses gender and race in Texas and overall numbers for Tom Green County. This information was provided by Texas Department of State Health Services.

STD Cases in Texas: Years 2009 to 2014

Based on the numbers in this chart, females lead in STDs four and five times more than males, but have much less cases of HIV. Additionally, Hispanics and Blacks tend to have higher numbers than whites, and the numbers for the age 15-19 are staggering compared to the younger 10-14 group. The biggest increases in STDs occurred in 2010, with those numbers continually increasing, and somewhat decreasing along the way. In 2014, the numbers for STDs continue to show a decline, except where males are concerned.

In the 2013 Texas STD and HIV Epidemiologic Profile (*pdf), Rebecca Filipowics and Shelley Lucas with the Department of State Health Services, wrote that scientific evidence shows the differences in rates in STDs and HIV infection in racial/ethnic minorities are only partially explained by differences in risk behaviors and risk factors. Therefore, the reason the numbers for Blacks and Hispanics tend to be higher than their white counterparts has to do with “the economic and social conditions that influence the health of individuals and communities.” Overall, for optimal health, people need to possess physical, social and personal resources, the profile noted.

“For example, poverty and low levels of educational attainment are related to employment and housing instability, incarceration, lack of access to healthcare, and greater exposure to violence and environmental health threats,” the authors wrote. In addition, one in four Hispanics and Blacks in Texas have incomes below the federal poverty level; educational attainment is lower for Hispanics and Blacks than for Whites; and, one in three Hispanics and one in five Blacks lack health insurance, which contributes to vulnerabilities to STD and HIV, Filipowics and Lucas noted.

Despite the racial and gender disparities, Texas ranked third in 2013 for congenital syphilis, and 13^th among states for primary and secondary syphilis cases, noted Health Services. At this time, Tom Green County doesn’t top the list for cases, but the problem facing teenagers today keeps area agencies busy.

In fact, the City’s Health Department offers STD testing three days a week: Mondays, Wednesdays and Thursdays by appointment, Aguilar stated. The fee is $25. Aguilar and her staff test in all areas mentioned in the table. Because getting tested can be scary and overwhelming for teenagers, the Health Department staff does what it can to ensure visitors feel as comfortable as possible.

“Everything is confidential in our clinic. The only person taken to the back is the patient to ensure that confidentiality and comfort,” Aguilar said.

As for students at ASU, Conner said the staff at the Health Clinic also works hard to ensure students feel secure.

She stated, “We try to make [our clinic] a friendly place. We have two secretaries in the front who are very warm and welcoming when students come to help allay their fears. When they come to the window, whoever else is in the lobby won’t know what they’re in for. We don’t treat them any differently.”

Conner added that students who are being tested get taken into a room like any other student, and staff will close the door to provide them with a feeling of confidentiality. Conner said staff wants students to feel their visit is valid, and treatment available.

“We’re not judging them, either,” Conner added. “We’re just talking to them matter-of-factly, asking them questions, answering their questions and giving them information to empower them to take better care of themselves.”

For this service, students at ASU pay a $10 fee because of an agreement the university has with the State of Texas.

“They send us the supplies and ASU takes the specimens. We then send them to the state lab for results,” Conner said.

As for whether or not Conner and her staff have noticed an increase of STDs at ASU, the nurse practitioner said, “In 18 years, things really haven’t changed overall. Freshman still come in and they’re really anxious about starting a new phase in their lives, and all they need is someone to kind of direct them in things that they might not know how to do, or how they might need to go about taking care of themselves. It’s always new faces, but the same thing.”

For more information on STD symptoms and testing centers in San Angelo, click here.

Sources:

1. “Congenital Syphilis in Texas.” Texas Department of State Health Services.
2. Filipowics, Rebecca and Shelley Lucas. "2013 Texas STD and HIV Epidemiologic Profile. Texas Department of State Health Services.
3.  “Texas HIV Surveillance Report.” Texas Department of State Health Services.
4. “Texas STD Surveillance Report.” Texas Department of State Health Services.