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HEALTH: On the Cusp of SCOTUS decision, African Americans Urged to Take Advantage of Recommended Preventive Sexual Health Services Now Available at No to Low Cost

Today, the National Coalition for Sexual Health (NCSH), which consists of over 50 leading health and medical organizations, issued a call-to-action to increase the uptake of essential preventive sexual health care services in the African American community.  These vital services can protect and improve sexual health, and even save lives.

With historic levels of insurance coverage, most African Americans can now access recommended preventive sexual health services for free, including the HPV vaccine, female contraceptives (including the IUD, implant, and pill), pap smears, and screening for sexually transmitted diseases (STDs), such as chlamydia and HIV.  Unfortunately, many African Americans are not currently benefitting from these important services, which are vital to the overall health and well-being of the community. For example:

In 2013, only 34% of African American girls and 16% of African American boys received all three doses of the HPV vaccine, the only cancer prevention vaccine currently available;

  • Approximately 44% of sexually active African American women (ages 15 -21) were not screened annually for chlamydia, which, when left undiagnosed and untreated, is a leading cause of preventable infertility;
  • More than a third (35%) of African Americans have never been tested for HIV, even though it is recommended that all sexually active people be tested at least once, and that many be tested at least annually if they’re at increased risk.

“You and your health matter.  We know you have a lot on your plate, but we all need to make room for our sexual health.  Just like protecting your heart health, managing your blood pressure, and exercising regularly – it’s worth your time,” said Christian J. Thrasher, M.A., Director, The Center of Excellence for Sexual Health, Morehouse School of Medicine.  “We have a tremendous opportunity here.  An unprecedented number of people now have access—at no cost—to these safe and effective preventive services that have been endorsed by leading medical organizations nationwide. We need to take advantage of these services.”

Recommended for all Americans by the Centers for Disease Control and Prevention (CDC) and the U.S. Preventive Services Task Force, these preventive services can help you prevent many male and female cancers, plan your pregnancies, and detect and treat common STDs before they cause serious problems.

“Knowledge is power. It’s important to take charge of your own sexual health, and get informed about the services that are recommended for you. Don’t assume that you are automatically getting these services when you go to your health care provider. You need to ask your provider to be sure,” said NCSH Co-Director, Susan Gilbert.

To help Americans get the services they need, a free guide and website are available from the NCSH, which features action steps for good sexual health, charts of recommended services for men and women, questions to ask health care providers, and other resources.

The guide, “Take Charge of Your Sexual Health: What you need to know about preventive services,” is accessible at: 

HPV is the most common sexually transmitted disease in the United States.  In fact, nearly all sexually active men and women will get at least one type of HPV at some point in their lives.  The HPV vaccine is the first and only vaccine available that can protect both women and men against multiple types of HPV-associated cancers including cervical, penile, throat and mouth and anal cancer as well as genital warts.

“Since nearly everyone will be exposed to HPV at some point in their life, it’s essential that everyone who is eligible gets vaccinated.  Parents, it’s particularly important to get your kids vaccinated before they become sexually active,” said Yolanda Wimberly, M.D., M.S., FAAP, pediatrician and adolescent medicine specialist, Morehouse School of Medicine.  “Talking with your kids about the HPV vaccine presents a great opportunity to talk with them about their sexual health. Studies show that kids who talk with their parents about sex are more likely to delay having sex and more likely to use condoms when they do have sex.  However, if you’re not ready for that conversation, you can simply tell them it’s a cancer-prevention vaccine.  How many kids ever ask what shots are for, anyway?” said Dr. Wimberly.

Strongly endorsed by leading medical groups, such as the American Academy of Pediatrics and the American Academy of Family Physicians, the HPV vaccine is recommended for all boys and girls at ages 11-12, but can be given to males up to age 21 and females up to age 26.  HPV vaccination is particularly important for black women since they are 34% more likely to develop cervical cancer, and twice as likely to die from cervical cancer as white women.

For African American women, the cost of and access to contraceptives have historically been key barriers to their use. In fact, a recent study revealed that over half of African American women said they had trouble purchasing birth control and using it consistently due to cost. For example, Long-Acting Reversible Contraceptives (LARCs), which include the Intrauterine Device (IUD) and the implant, are 99% effective in preventing pregnancy and are the methods that most female physicians use themselves. Yet, only 5% of African American women currently use them.  This is not surprising since before the Affordable Care Act (ACA), the average cost of an IUD was approximately $900 per insertion.

“Increased access to free, highly effective contraceptives empowers more women to take charge of their reproductive health. They can plan their pregnancies, and have children, if and when they want to,” said Nerys Benfield, MD, MPH, assistant professor, Department of Obstetrics & Gynecology and Women’s Health, Albert Einstein College of Medicine/Montefiore Medical Center. Most women can choose from a wide variety of highly effective birth control methods at no cost, including LARCs and other methods, such as the pill, ring, and patch.

Women who don’t use contraception are highly likely to experience an unplanned pregnancy.  In fact, approximately 85 percent of women who don’t use contraception will become pregnant within one year.  “So, if you’re not ready to be a mother, it’s important to find a birth control method that is right for you,“ said Dr. Benfield.  “And remember, condoms are the only method that protect you from STDs, so we recommend using condoms in addition to your chosen birth control method, to give you the highest level of protection during sex.”

There are more cases of STDs than diabetes, heart disease, breast cancer, and asthma combined. Each year, there are an estimated 110 million cases of STDs, which includes approximately 20 million new cases and 90 million existing cases.

“We need to change our thinking about STDs. These are incredibly common infections. Half of all sexually active Americans will contract at least one STD by the age of 25. Anyone who has sex is at risk, regardless of who you are, where you come from, or how many partners you have had,” said Deborah Arrindell, Vice President, Health Policy, American Sexual Health Association.  “Our sexual health is an important part of our overall health and well-being. We in the African American community must try to prevent STDs, just as we must try to prevent diabetes.”

Prevention and regular screening are key since many STDs don’t have any symptoms. As a result, many people do not know they are infected and may be unintentionally passing these infections onto their partners.  If left untreated, STDs can cause infertility, pelvic pain and fetal illnesses, and increase your risk of contracting HIV.  But, there’s good news — if detected early, STDs can often be easily cured with antibiotics, or effectively managed, before they cause serious problems.  For example, annual chlamydia screening is recommended for all sexually active women ages 24 and younger and for older women at risk.  If caught early, chlamydia can usually be cured with simple antibiotics.

Also, it is recommended that all Americans get tested for HIV at least once, and that individuals at higher risk be tested at least annually (e.g. those who have had sex without a condom, have an STD, have multiple partners, share injection-drug equipment, or are a man who has sex with men). “Screening for HIV is particularly important for African Americans since our community bears the biggest burden of infection, due to many social and economic disadvantages.  In fact, it is estimated that one in 16 black men and one in 32 black women will contract HIV,” said Dr. Wimberly.

“HIV testing is the gateway to care and treatment.  It is estimated that nearly 75,000 African Americans don’t know they have HIV,” said Dana Van Gorder, Executive Director, Project Inform.  “With highly effective treatments now available, often at low or no cost, people can live longer and healthier lives with HIV, just like they live with other chronic conditions.  And, if you’re not infected, you can take steps to protect yourself, and keep you and your partners safe.”

With HIV, early detection and treatment are key. But unfortunately, one-third of diagnoses are made late, and result in missed opportunities to get medical care.  According to a recent major international study conducted in 35 countries (the Strategic Timing of AntiRetroviral Treatment Study), people who received treatment immediately after an HIV diagnosis were 53% less likely to die during the trial or to develop AIDS or a serious illness.

Today, more African Americans have health insurance, and access to these services than ever before. Through the Affordable Care Act, an estimated 2.3 million African American adults have gained health insurance coverage, bringing the total insured to 87% of all African Americans. Under the ACA, health plans must now cover specific preventive services without charging a fee, copayment or coinsurance, including all FDA-approved contraceptive methods (except for condoms).  Specifically,

  • If you have private health insurance, most health plans now cover these services free-of-charge, but check with your health plan before you make an appointment.
  • If you have Medicaid, most plans will also cover these services, but coverage can vary by state; check with your health plan or provider to find out what’s covered.
  • If there are fees under your plan or you don’t have insurance, check out the cost of services at community health centers, family planning clinics, STD clinics, or HIV testing centers. Most clinics offer a sliding fee scale, which means your fees are based on your income.  Services could be available at low or no cost.

For more information:

FACT SHEET: How to access preventive sexual health services – with or without insurance


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