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Let's talk about sex

I took my seat as Andy, the group leader, began the week's session by addressing anonymous questions from the previous week:

How can you get AIDS?

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Can a condom burst?

Should I wear two condoms?

Andy answered without hesitation: HIV is transmitted through bodily fluids; if worn properly, a condom is unlikely to burst; never wear two condoms. Muffled laughs and a few foul-mouthed remarks filled the room at the William Donald Schaefer House, a residential substance abuse treatment center for boys ages 14 to 18.

It was my first day as a member of the Johns Hopkins University program known as CRASH, or Creating Responsibility for Adolescent Sexual Health, which is dedicated to educating Baltimore adolescents on all matters of sexual and reproductive health, from sexually transmitted infections and pregnancy to relationships and sexuality. The Schaefer House had partnered with Hopkins University, under the supervision of the Maryland Department of Juvenile Services, to provide its residents with the weekly sexual education lessons through CRASH.

At the end of every session, the boys write down five to 10 questions on index cards, so that by the end of six weeks they have each asked 30 to 60 questions. Sixty questions that prior to CRASH had been left unanswered.

Based on the nature of their questions, I could tell that the boys sitting before me did not lack sexual experience; they lacked the relevant information needed to shape their decisions responsibly.

And they are not alone: one out of seven Baltimore youth has sex before his or her 13th birthday.

According to data collected by the U.S. Centers for Disease Control and Prevention (CDC), Baltimore youth are more likely to engage in sexually risky behavior than are their national counterparts. Pronounced discrepancies exist between Baltimore and the rest of the nation regarding age of first sexual experience, number of sexual partners and rates of unprotected sex.

Biannually, the CDC manages a federally funded youth risk behavior survey that provides representative samples from high school students. Fourteen percent of Baltimore high school students reported having intercourse before age 13, according to the most recent data; the nationwide average was 6 percent.

Baltimore youth also had more sexual partners and used contraception less frequently than did students across the nation. Twenty-two percent of Baltimore students reported having four or more sexual partners, compared to 15 percent of students nationally. Twenty-one percent of Baltimore students reported not using any method of contraception during their last sexual experience, compared to 14 percent of students nationally.

Both the CDC and the Baltimore City Health Department point to education as the first step in tackling teenage pregnancy and sexually transmitted infections. Yet the boys at the William Schaefer House report little in terms of prior sexual education.

"Which ones you said the testicles was?" one of the boys asked, pointing to a diagram of the male reproductive system.

I watched as the CRASH group leader, Andy, helped the boy to correctly label the organs. After completing a lesson in anatomy and hygiene, Andy asked the boys if they had ever seen this information before.

"Yeah, in the 6th Grade."

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"Yeah, in drug class … but it was a one time thing."

"Was it helpful?" Andy asked.

"Nah, they just taught the main stuff."

I wasn't quite sure what the boy meant by "the main stuff." I didn't ask, but I suspected he was referring to a fairly limited curriculum.

As I looked around the room, into 13 young faces, I considered their questions and their sexual histories. I realized that if they were representative of their age group in Baltimore, of these boys:

Approximately two had sex before their 13th birthday.

Three had been with four or more sexual partners.

Three did not use contraception during their last sexual experience.

And together they had come up with 60 index cards worth of unanswered questions.

What does that say about the state of sexual education in Baltimore City? All I can say is — maybe it's time we talk about sex.

Anna Devon-Sand is an undergraduate at Johns Hopkins University. Her email is adevons2@jhu.edu.

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