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Condoms aren’t a fact of life for young Americans. They’re an afterthought

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mississippitoday.org – Devna Bose, AP Health Writer – 2024-10-02 13:00:11

OXFORD, Miss. (AP) — It’s hard to miss the overflowing bowl of condoms at the entrance of the gym.

Some University of Mississippi students walking past after their workout snicker and point, and the few who step forward to consider grabbing a condom rethink it when their friends catch up, laughter trailing behind them. Almost no one actually reaches in to take one.

Though officials say they refill the bowl multiple times a day, and condoms are available at multiple places on campus, Ole Miss students say the disinterest is indicative of changing attitudes.

Fewer young people are having sex, but the teens and young adults who are sexually active aren’t using condoms as regularly, if at all. And people ages 15 to 24 made up half of new chlamydia, gonorrhea and syphilis cases in 2022.

The downward trend in condom usage is due to a few things: medical advancements like long-term birth control options and drugs that prevent sexually transmitted infections; a fading fear of contracting HIV; and widely varying degrees of sex education in high schools.

Is this the end of condoms? Not exactly. But it does have some public health experts thinking about how to help younger generations have safe sex, be aware of their options — condoms included — and get tested for STIs regularly.

“Old condom ads were meant to scare you, and all of us were scared for the longest time,” said Dr. Joseph Cherabie, medical director of the St. Louis HIV Prevention Training Center. “Now we’re trying to move away from that and focus more on what works for you.”

A shift in attitudes

Downtown Oxford was thrumming the day before the first football game of the season. The fall semester had just started.

Lines of college students with tequila-soda breath waited to be let in dim bars with loud music. Hands wandered, drifting into back pockets of jeans, and they leaned on one another.

It’s likely that many of those students didn’t use a condom, said Magan Perry, president of the college’s Public Health Student Association.

“Using a condom is just a big, ‘uh, no,’” the senior said.

Young women often have to initiate using condoms with men, she said, adding that she’s heard of men who tell a sexual partner they’ll just buy emergency contraception the next day instead.

“I’ve had friends who go home with a guy and say they’re not having sex unless they use a condom, and immediately the reaction is either a reluctant, ‘OK, fine,’ or ‘If you don’t trust me, then I shouldn’t even be here,’” Perry said. “They’re like, ‘Well, I’m not dirty, so why would I use them?’”

Women have long had the onus of preventing pregnancy or STIs, Cherabie said, and buying condoms or emergency contraceptives — which are often in a locked cabinet or behind a counter — can be an uncomfortable experience and “inserts a certain amount of shame,” Cherabie said.

If pregnancy risk has been the driving factor for condom usage among heterosexual couples, the fear of contracting HIV was the motivation for condom use among men who have sex with men.

But as that fear has subsided, so has condom use, according to a recent study that focused on a population of HIV-negative men who have sex with men.

Grindr, a popular gay dating app, even lists condom use under “kinks” instead of “health.” Things like that make Steven Goodreau, an HIV expert at the University of Washington who led the study, worry that the change in attitudes toward condoms is trickling down to younger generations.

Goodreau believes the promotion of pre-exposure prophylaxis (PrEP), a drug that prevents HIV, is overshadowing condoms as a prevention strategy. A strategic plan for federal HIV research through 2025 doesn’t mention condoms, and neither does the national Ending the HIV Epidemic plan.

The Centers for Disease Control and Prevention acknowledges that condoms are still an effective tool that can be used “alongside newer prevention strategies.”

“We know that condom use has declined among some groups, but they still have an important role to play in STI prevention,” said Dr. Bradley Stoner, director of the CDC’s Division of STD Prevention. “Condoms can be accessed without navigating the health care system, can be used on-demand, are generally affordable and most importantly – they are effective at preventing HIV and STIs when used consistently and correctly.”

Students walk around the University of Mississippi campus in Oxford, Miss., Wednesday, Aug. 28, 2024. Credit: AP Photo/Karen Pulfer Focht

Medical advances allow for more options

Pleasure — for both men and women — has long been an undeniable factor for the lack of condom use, according to Dr. Cynthia Graham, a member of the Kinsey Institute team that studies condoms.

But more so, advances in medicine have expanded the options for both STI and pregnancy prevention.

Young cisgender women have been turning to contraceptive implants like intrauterine devices and birth control pills to keep from getting pregnant. And researchers say that once women are in committed relationships or have one sexual partner for a significant amount of time, they often switch to longer-term birth control methods.

Ole Miss junior Madeline Webb said she and her partner seem like outliers — they have been seeing each other for four years, but still use condoms. They also share the responsibility of buying condoms.

“People see condoms as an inconvenience … but they do serve a purpose even if you’re on birth control because there is always a chance of an STD,” Webb said.

A new drug on the market could mean even more STI prevention options for men and possibly women.

Doxycycline post-exposure prophylaxis, or doxy PEP, can be taken within 72 hours after unprotected sex and can help prevent chlamydia, gonorrhea and syphilis. It has to be prescribed by a doctor. Trials are still being conducted for women, but the drug is gaining traction among men who have sex with men and transgender women.

With widespread uptake, the drug has the potential to make a significant impact in STI prevention strategies.

“When PrEP came out, everyone was excited because it was one less thing to worry about in terms of HIV acquisition,” Cherabie said. “With another thing on board that can help decrease our likelihood of getting other STIs, on top of not having to worry about HIV, it gives our community and patients a little less anxiety about their sex lives.”

And in just a decade, PrEP has become a main preventive measure against HIV and other STIs for men who have sex with men – though it is disproportionately used by white men.

Condom use now is “pretty much a thing of the past” for men who have sex with men compared to the 1980s and early 1990s during the AIDS epidemic, said Andres Acosta Ardilla, a community outreach director at an Orlando-based nonprofit primary care clinic that focuses on Latinos with HIV.

“Part of what we have to talk about is that there is something enticing about having condomless sex,” Acosta Ardilla said. “And we have to, as people who are working in public health, plan for the fact that people will choose to have condomless sex.”

The fight over sex ed

Despite the relentless Southern sun, a handful of people representing various student organizations sat at tables in the heart of Ole Miss’ campus. Students walked past and grabbed buttons, wristbands and fidget toys. One table offered gold-packaged condoms – for cups to prevent drinks from being spiked.

Actual condoms are noticeably absent. They’re also absent in the state’s public schools.

Condom demonstrations are banned in Mississippi classrooms, and school districts can provide abstinence-only or “abstinence-plus” sexual education — both of which can involve discussing condoms and contraceptives.

Focus on the Family, an Christian organization that advocates for teaching abstinence until marriage, is concerned that comprehensive sex education “exposes students to explicit materials.” Abstinence-centered education is “age-appropriate” and keeps students safe and healthy, Focus on the Family analyst Jeff Johnston said in an emailed statement.

But Josh McCawley, deputy director of Teen Health Mississippi, an organization that works with youth to increase access to health resources, said the effects are clear.

“The obvious consequence is the rise of sexually transmitted infections, which is what we’re seeing right now, which can be a burden on the health care system,” he said, “but also there could be long-term consequences for young people in terms of thinking about what it means to be healthy and how to protect themselves, and that goes beyond a person’s sexual health.”

The latest CDC data from 2022 shows Mississippi has the highest teen birth rate in the country.

Scott Clements, who oversees health information for the state education department, was hesitant to criticize Mississippi’s sex education standards because they’re “legislatively mandated.”

“If the legislature wants to make changes to this, we will certainly follow their lead,” he added — though attempts to pass more advanced sexual education standards have died repeatedly in the Mississippi statehouse over the past eight years.

Nationally, there is no set standard for sex education, according to Michelle Slaybaugh, policy and advocacy director for the Sexuality Information and Education Council for the United States, which advocates for comprehensive sex ed.

Not every state mandates sex education. Some states emphasize abstinence. Less than half of states require information on contraception.

“There is no definitive way to describe what sex ed looks like from classroom to classroom, even in the same state, even in the same district,” Slaybaugh said, “because it will really be determined by who teaches it.”

Compare Mississippi to Oregon, which has extensive state standards that require all public school districts to teach medically accurate and comprehensive sexual education. Students in Portland are shown how to put on a condom starting in middle school and have access to free condoms at most high schools.

Lori Kuykendall of Dallas, who helped write abstinence-focused standards, said condom demonstrations like those in Portland “normalize sexual activity in a classroom full of young people who the majority of are not sexually active.” She also points to increasingly easy access to pornography — in which people typically do not wear condoms — is a contributing factor to the decline in condom use among young people.

Jenny Withycombe, the assistant director for health and physical education at Portland Public Schools, acknowledged the standards see pushback in the more conservative and rural parts of Oregon. But the idea is to prepare students for future interactions.

“Our job is to hopefully build the skills so that even if it’s been a while since the (condom) demo … the person has the skills to go seek out that information, whether it’s from the health center or other reliable and reputable resources,” Withycombe said.

Those standards seem to contribute to a more progressive view of condoms and sex in young adults, said Gavin Leonard, a senior at Reed College in Portland and a former peer advocate for the school’s sexual health and relationship program.

Leonard, who grew up in Memphis – not far from Oxford, Mississippi, said his peers at Reed may not consistently use condoms, but, in his experience, better understand the consequences of not doing so. They know their options, and they know how to access them.

Slaybaugh wants that level of education for Mississippi students — and the rest of the country.

“We would never send a soldier into war without training or the resources they need to keep themselves safe,” she said. “We would not send them into a battle without a helmet or a bulletproof vest. So why is it OK for us to send young people off to college without the information that they need to protect themselves?”

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The Associated Press Health and Science Department receives support from the Robert Wood Johnson Foundation. The AP is solely responsible for all content.

This article first appeared on Mississippi Today and is republished here under a Creative Commons license.

Mississippi Today

All eyes on Mississippi’s Rep. Guest as his committee considers releasing Gaetz report

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mississippitoday.org – Taylor Vance – 2024-11-19 16:00:00

President-elect Donald Trump’s announcement to nominate former U.S. Rep. Matt Gaetz as attorney general has, again, thrust Mississippi Congressman Michael Guest, chairman of the House Ethics Committee, into the national spotlight. 

Guest’s committee will potentially vote at its Wednesday meeting whether to release an ethics report on Gaetz. The committee, which was investigating Florida’s Gaetz over allegations of sexual misconduct and illicit drug use, was set to release the report before Gaetz abruptly resigned from Congress.

Guest is a Republican who represents Mississippi’s 3rd Congressional District and has chaired the bipartisan House committee that investigates whether House members have committed ethics violations since January 2023. 

Gaetz resigned last week shortly after Trump announced he planned to nominate him to lead the Department of Justice, despite having been previously investigated by the department for alleged sex trafficking crimes. The department declined to pursue criminal charges against Gaetz. 

After the resignation, House Speaker Mike Johnson announced that he does not want the House to make the committee’s report public because Gaetz is no longer in office. 

Guest declined to comment to Mississippi Today about recent developments with the committee’s investigation into Gaetz. But the Mississippi Republican told Politico that the panel will make its own decision about releasing the report, regardless of Johnson’s opinion that it should be kept under wraps. Lawmakers on both sides of the aisle have called for the report to be provided to senators before a confirmation vote on Gaetz and-or to the public.

Guest is the former district attorney of Rankin and Madison counties. He also gained national attention when he introduced a resolution last year to expel New York Congressman George Santos from the House. 

Some U.S. senators such as Republican John Cornyn of Texas have publicly called for the Ethics Committee to hand over its report of the Gaetz investigation. Neither of Mississippi’s two U.S. senators, Roger Wicker and Cindy Hyde-Smith, sit on the Senate Judiciary Committee, but they will get to vote on the nomination if it reaches the full Senate. 

Wicker, a Republican from Tupelo, told Mississippi Today that the Senate has the constitutional obligation to “provide the president with advice and consent on executive and judicial branch nominations” and he takes that responsibility seriously. He did not comment on Gaetz.

“I think that we are in a position to give President-elect Trump good advice on what is likely to work,” Wicker said.  We are going to fulfill our constitutional role, and we are going to do so as friends of the president-elect and as members of a team who want him to be as successful as possible.”

Hyde-Smith, a Republican from Brookhaven, did not respond to a request for comment. 

This article first appeared on Mississippi Today and is republished here under a Creative Commons license.

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Mississippi Today

Exploring all the many facets of Mississippi College’s decision to end football

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mississippitoday.org – Rick Cleveland – 2024-11-19 15:47:00

Fred McAfee runs for yardage in the snow in Mississippi College’s 3-0 victory over Jacksonville State in the 1989 Division II National Championship game at Florence, Ala. The championship was later vacated because the Choctaws far exceeded NCAA Division II scholarship limitations. (Photo courtesy Mississippi Sports Hall of Fame)

Monday’s news that Mississippi College – soon to be Mississippi Christian University – will no longer field a football team seemed to come out of nowhere. “Shocking” is the word many have used to describe the news.

Rick Cleveland

“I feel like I just lost a family member,” said Mississippi Sports Hall of Famer Fred “Fast Freddie” McAfee, one of the two most famous football players in Mississippi College history. “I remember playing my last regular season game against Delta State before an overflow crowd. I remember winning a national championship. I just can’t believe it has come to this.”

Many readers might wonder who the other most famous Mississippi College player was. That would have been the remarkable Edwin “Goat” Hale, a College Football Hall of Famer who in 1916 led the Choctaws to a 74-6 victory over Ole Miss. You read that correctly. Mississippi College 74, Ole Miss 6. MC also defeated Mississippi State, Southern Miss, Tulane and many other southern football powers early in the 20th century.

Mississippi College competed in football for 117 years. There’s a lot of history there, both good and bad, including that 1989 NCAA Division II National Championship, later vacated for scholarship violations. McAfee, a star player on that team, says he never was on more than a half scholarship in his four years at MC.

Fred McAfee was a special teams ace.

And McAfee, who later made All-Pro in the NFL, surely didn’t receive any NIL (name, image and likeness) money, which is one stated reason why Mississippi College made its decision to drop the sport. We will get to that.

First, this: There are many losers with this decision: the coaches, who no longer have a job; long-time Mississippi College football fans who no longer have a favorite team; and even Delta State, which loses its arch-rival. Delta State football coach Todd Cooley, whose Statesman defeated MC 20-14 on Nov. 16 in what apparently is the last football game MC will ever play, called the MC decision “very disappointing” and added, “I just hate it for the players and the coaches.”

But make no mistake: The biggest losers are the MC football players, who really do play for the love of the game. They must decide if they love it enough to play it somewhere else and, if so, then find a school that will take them.

Dr. Blake Thompson, the Mississippi College president in his seventh year at the helm, says he hurts for those players but at the same time strongly believes that the decision to drop football – along with the name change – are in the best, long-term interest of the school. One primary reason is economics.

“I don’t have the exact numbers in front of me, but we’re looking at close to $2 million that we can save to put into our other sports programs, upgrade our facilities, and also put into other areas, including, of course, academics,” Thompson said. “We have a long standing tradition of academic excellence. We have the highest incoming ACT scores of any school in the state. We’re proud of that.”

Dr. Blake Thompson

Thompson continued, “We also have bold aspirations for the future. I like the model of schools like Belmont University (Nashville), which doesn’t play football but has become quite competitive at the Division I level in baseball and basketball and other sports. Dallas Baptist, like us a faith-based school, has become a Division I baseball power.”

Thompson, who formerly worked at Ohio State, is in the middle of a seven-year term on the powerful NCAA Division II Presidents Council, and, consequently, is familiar with all aspects of of college athletics. “We’ve tried to look at the overall landscape of college athletics and determine where we stand and where we want to stand in that landscape,” he said. “We want to excel in everything we do. Sometimes, that requires tough decisions.”

One firm decision, Thompson says, “We are not in a place where we are going to be paying players. We are not going to play in that space.”

Over its last 10 full seasons, MC has won just 28 games, lost 74. Since the 1989 “championship” season MC has won 144, lost 200 and tied four. Those numbers will never be confused with Thompson’s goal of “excellence” in all MC does. None of that changes the fact, Thompson says, that this has been a gut-wrenching, quite emotional decision.

“My commitment since I got here seven years ago has been to care for these students,” he said. “All scholarship arrangements will be the same through the end of this school year. For those players who want to remain in school here, we will work with them, find scholarship money where we can from other sources. For those who want to continue playing football, we will help them every way we can with the transfer portal.”

The rest of the Gulf South Conference, including Delta State, faces a different and difficult situation. MC’s decision now leaves the league with only four football playing members: Delta State, No. 1 ranked Valdosta State, West Alabama and West Florida. The GSC was once known as the SEC of Division II football conferences. And, indeed, the four remaining football members all play the sport at a high level and all have won at least one national championship. But can four teams really be called a conference?

This article first appeared on Mississippi Today and is republished here under a Creative Commons license.

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Mississippi Today

Bill to provide prenatal care to low-income women still inaccessible as 2025 legislative session looms

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mississippitoday.org – Sophia Paffenroth – 2024-11-19 12:32:00

Nearly five months after a new law to make prenatal care more accessible to low-income women was supposed to go into effect, its fate remains unclear. 

The state is still in negotiations with the Centers for Medicare and Medicaid Services – the federal agency responsible for approving the state plan – according to Matt Westerfield, spokesperson for the Mississippi Division of Medicaid. CMS is supposed to take no more than 90 days to approve or reject a plan, but that 90-day clock has been suspended indefinitely since issues have been raised with legislation Mississippi lawmakers wrote last session. 

Presumptive eligibility for pregnant women allows temporary and immediate Medicaid coverage for low-income expectant mothers while they wait for their official Medicaid application to be approved – a process that can take months. 

Strict Medicaid eligibility requirements in Mississippi mean that a majority of low-income women are only eligible for Medicaid once they become pregnant. If a woman applies when she finds out she’s pregnant, that means a lengthy application process could cut well into her pregnancy and delay her seeking prenatal care, which is proven to lead to poor outcomes such as preterm birth – in which Mississippi leads the nation

Senators Nicole Boyd, R-Oxford, takes notes during a presentation by Mississippi Department of Child Services Commissioner Andrea Sanders, during a study group on women, children and family, held at the State Capitol, Wednesday, Oct. 2, 2024 in Jackson. Credit: Vickie D. King/Mississippi Today

Nicole Boyd, R-Oxford, who leads the Senate Study Group for Women, Children and Families, has been checking in weekly with Medicaid about the status of the policy. In a committee hearing Monday, Boyd followed up twice with newly appointed Medicaid Executive Director Cindy Bradshaw at the beginning and end of the meeting to try to gain clarity on the status of the policy. 

Boyd asked Bradshaw whether the 2024 legislation could be salvaged or whether lawmakers would need to redo legislation to enact the policy in 2025. Bradshaw said both that she hopes the state and federal agencies can come to an agreement, and also that she’d feel better with new legislation. 

“Well, I think we can come to a reasonable place that we will be able to get it,” Bradshaw said. “Am I 100% comfortable with that? No. I would prefer that we have legislation to shore up the concessions that we’ve had to make.”

It’s not clear what concessions the Mississippi Division of Medicaid has had to make, but it’s likely that CMS is requiring Medicaid to take out a proof of income and proof of requirement lawmakers included in the original bill. 

Federal guidelines state that while the agency may require proof of citizenship or residency, it should not “require verification of the conditions for presumptive eligibility.”

CMS will not comment on ongoing negotiations with individual states.

If 2024 legislation can’t be salvaged, lawmakers would have two options for rewriting the law next session. They could take out the requirements with which CMS has an issue, or they could take their chances hoping a Trump administration would grant a waiver allowing them to keep requirements at odds with federal guidelines – something lawmakers will likely bank on with a Medicaid expansion bill next session, as well. 

Insisting on the proof of pregnancy requirement doesn’t serve much of a purpose, since it wouldn’t be possible for a woman to fake a pregnancy and receive prenatal care, such as ultrasounds. As for the proof of income requirement, it can be cumbersome on low-income women already facing socioeconomic hurdles, explained Tricia Brooks, a research professor at the Center for Children and Families at Georgetown University and the lead author on the KFF Annual Survey on Medicaid and CHIP Eligibility, Enrollment and Renewal Policies.

“I remember when I first got pregnant, I thought I had the flu because I was nauseous for days on end,” Brooks said. “If I go to the doctor and find out that lo and behold maybe I am pregnant, and you want me to get enrolled, but now you’re asking me for paystubs … So now I have to come back in or somehow communicate or transmit proof of income to the provider. That just gives everybody pause of, ‘Oh my god, is this even worth it?’”

In the meantime, the Division of Medicaid is continuing to accept providers who wish to participate in the program and conduct eligibility determination trainings, according to Westerfield. Until CMS approves the state plan, none of the providers that have been approved will be able to provide care under the policy to eligible women.

Below is a list of the 13 providers that have been approved to participate as of Oct. 18: 

  • Physicians & Surgeons Clinic – Amory
  • Mississippi Department of Health, Dr. Renia Dotson – County Health Department (Family Planning Clinic)
  • Family Health Center – Laurel
  • Delta Health Center Inc (Dr. H. Jack Geiger Medical Center) – Mound Bayou
  • G.A. Carmichael Family Health Center Providers – Belzoni, Canton, Yazoo City
  • Coastal Family Health Center Inc. – Biloxi 
  • Delta Health System – Greenville
  • Delta Medical Group – Women’s Specialty Clinic – Greenville
  • Southeast MS Rural Health Initiative Inc. – Women’s Health Center – Hattiesburg
  • University of Mississippi Medical Center – Jackson
  • Jackson Hinds Comprehensive Health Center – Jackson
  • Central MS Health Service – Jackson
  • Northwest MS Regional Medical Center – Clarksdale

An expectant mother would need to fall under the following income levels to qualify for presumptive eligibility:

This article first appeared on Mississippi Today and is republished here under a Creative Commons license.

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