Embracing this Moment: Is Covid-19 Creating New Opportunities to Improve Sexual Health in 2021?
A silent public health issue is plaguing young adults across America. The CDC estimates that there are approximately 20 million new Sexually Transmitted Disease (STD) infections each year — half of which occur among 15 to 25 year olds. There are many potential health issues that arise from untreated STDs. Among the most serious complications are pelvic inflammatory disease, ectopic pregnancy, infertility, and chronic pelvic pain, cervical and testicular cancer. Certain diseases are vertically transmitted, meaning that they pass from a mother to baby during pregnancy or labor. Vertically transmitted infections such as Syphilis can lead to miscarriage, stillbirth, newborn death, and severe lifelong physical and neurological problems for newborns. As Jonathan Mermin, M.D., M.P.H., director of CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention said: “Curbing STDs will improve the overall health of the nation and prevent infertility, HIV, and infant deaths.” Given the current COVID-19 climate and increased dialogues about personal health, we may be able to encourage young adults to more openly discuss their sexual health.
Why is This Issue Worse for Young Americans?
To be blunt, no one’s talking about it. Asking a partner whether they’ve been tested for STDs is awkward. This is especially true for a coming-of-age 20-year-old. Whether a person doesn’t think of it at the time, feels like it’s ruining a mood, or just doesn’t know the right words to use, most people avoid the conversation altogether. As we get older, more comfortable in our skin, and more knowledgeable about the potential adverse effects, this conversation feels more approachable. Unfortunately, we don’t have the luxury of time to let people learn this lesson for themselves. One neglected conversation can lead to a life-long issue.
What About Science’s Miraculous Medications?
Antibiotics can be used to cure many common Sexually Transmitted Infections (STIs), which is the primary infection before it becomes a disease. That being said, one has to know an STI exists to be treated. Many STIs show few symptoms and are unnoticeable to infected individuals. Primary Care Physicians (PCPs) provide routine preventative care, including STD infection screening. In America, not all constituents have a PCP. In 2002 only, 77 percent of Americans saw a PCP. Unfortunately, this trend is getting worse over time. There was a two percent drop in Americans who received primary care between 2002 and 2015 across all age groups — that’s about 6.5 million less Americans who received routine preventative care.
When you break it down by age groups, the issue looks worse. Fewer than 50% of adolescents see a PCP which means teenagers without a car may have zero access to testing. College doesn’t help, as students rely on student health as their primary source of care. Other than asking a sexual partner about their status, the most fearful moment for a college student may be walking into a room full of friends and peers and whispering: “I’m here to get an STD test.” Adults in their 20s are mostly healthy but primarily focussed on their careers and families. 20 year olds are in fact the least likely to seek routine care among any adult age bracket — less than 60% see a PCP.
Today, most Americans are focussed on our most pressing public health issue: COVID-19. The pandemic has shed a light on this huge gap in primary care provision and has shown the effects of inadequate preventative care. People without PCPs are more likely to have chronic diseases which puts them at higher risk for diseases like COVID-19. This is a complex systemic issue that the Biden administration will be pressured to address with urgency in the next four years.
While COVID-19 catastrophically overwhelms our health care systems, it is quietly restitching our social fabric. How we work, learn, and socialize have all changed. When it comes to dating in a pandemic, the jury is still out on whether these changes are for the best. That being said, there are some surprising health opportunities hidden within these new dating norms.
How has COVID-19 Created New Opportunities?
A couple of weeks ago I was talking to my friend about her date. When I asked if there was a kiss involved, she replied, “Okay I did…but only because he showed me a picture of his negative Covid test during the date.” Justifying a kiss with a COVID-19 test made me chuckle, and then it made me think: has it become normal to talk about when you last got tested on a date? We already know that COVID-19 has changed dating — I can speak to it firsthand. You most likely meet over the internet, and then FaceTime or Zoom a couple of times to ensure this person is “worth” getting out of sweatpants for. Finally, you have that in-person date and spend half the time wondering who is going to break the awkward six-foot space first.
It’s abundantly clear that the pandemic is changing dating culture in two ways. Firstly, it is creating abnormally long amounts of time to engage in conversations. Of course, this can be a blessing and a curse. Newfound time may lead to more profound and intimate conversations, allowing people to become more comfortable before meeting in-person. But I would be remiss if I didn’t mention the downside — it can leave incompatible duos with unbearable moments of uncomfortable silence. Then there’s the second shift: talking about testing. For those that are COVID-conservative, you probably ask a date if they’ve been tested before meeting up in person. Others may panic the next morning and ask about the issue after the fact. No matter where you lay in the spectrum, the pandemic has forced people to think and talk more about medical testing. Personal health has been somewhat of a taboo topic in casual dating of the past few decades, but it appears as if this is changing as COVID-19 persists.
Why do these conversations have to stop at COVID-19? If sexual partners are more comfortable with one another, and they’re already talking about testing, why couldn’t they talk more about sexual health? Now feels like the perfect moment to encourage young adults to have more transparent conversations with their sexual partners about STDs, partner testing, and even consent. Although one conversation may not seem significant, a slow but steady change in attitudes amongst young people has the potential to significantly improve the health of millions of Americans.
