The Washington PostDemocracy Dies in Darkness

To fight sexually transmitted diseases, Montgomery Co. offers condoms in some high school clinics


With sexually transmitted infections surging in Montgomery County, leaders in the Maryland suburb are for the first time offering condoms in several high school health clinics and considering expanding to more than 20 other schools.

The move comes as Montgomery looks to reverse a spike in gonorrhea and chlamydia that the county’s health officer has called “a public health crisis,” with the jump in cases in the county outstripping statewide in­creases.

School and county officials say access to condoms is being paired with education about sexually transmitted infections. The rise in infections mirrors national trends, officials said, and puts Montgomery at its highest level in a decade.

“When you’re seeing numbers increase in the double digits and young people involved, that increases the sense of urgency,” said Travis Gayles, the county’s chief of public health services.

Providing condoms in school clinics is part of a broader strategy focused on prevention, screening and treatment. Some elected leaders and parents expect the initiative to spark controversy in the state’s largest school system, where years ago views were divided about condoms on campus amid the HIV/AIDS crisis.

But signs of early support for the measure have emerged.

“I’m going to be loud and clear about the importance of doing this: giving our kids tools and education, not burying our heads in the sand,” said Sunil Dasgupta, a father of three who chairs the health and safety committee for the countywide council of PTAs.

The issue has come to wide attention just ahead of Tuesday’s start of the school year.

Last week, two elected officials cited the increase in sexually transmitted infections as they called for access to condoms at all high schools and a study of whether a similar effort is feasible for middle schools. They noted that condoms are available at schools in Baltimore and on Maryland’s Eastern Shore, in Dorchester County.

“As stewards of children, we have a moral obligation to create an environment that meets not only their educational, but their physical and medical needs as well,” wrote school board member Jill Ortman-Fouse (At Large) and County Council member George Leventhal (D-At Large) in a memo to other county officials that they posted on Facebook.

The elected leaders said they recognized that the issue is sensitive but cited research showing that offering condoms along with educational efforts leads to a decrease in sexual activity.

Ortman-Fouse on Thursday sought the support of other school board members to bring condoms into the health rooms of all high schools in the sprawling district, which enrolls more than 161,000 students. A vote is expected next week.

“It’s overdue, and I think also having it in all of the high schools is important,” said board member Jeanette E. Dixon (At Large).

As classes begin this week, students at four high schools with clinics — Gaithersburg, Northwood, Watkins Mill and Wheaton — will be able to get condoms after having a conversation with a nurse that could include information about sexually transmitted infections, ­Gayles said.

Kimberly Miner, a mother of two in North Potomac, said she wished the community had been able to weigh in first, adding that the issue presents “a fine line” for schools to navigate. “Schools are there to teach our children,” she said. “I’m not sure they are there to provide contraceptives.”

Miner said having a counselor or other adult interact with students is important. “I just hope we’re going to sit down with these kids and say, ‘Hey, do you have any questions? Is there anything you want to discuss?’ I would hope we wouldn’t just be having a bowl of condoms out for them to take.”

And she doesn’t want to see them at all in middle schools. “It’s just too young,” she said.

Others who support making condoms available questioned whether students will be put off by the thought of having an involved conversation.

“I hope it helps, but I don’t see a lot of kids going there to ask for it,” said state Sen. Nancy J. King (D-Montgomery), who served on the school board when condoms were at issue in the 1990s. “It sounds good and there’s well-meaning intentions, but I don’t think it will be effective.”

Some in Montgomery said they would like to make access easier over time — with condoms perhaps available in a basket on a clinic counter, next to materials describing the risks associated with sexually transmitted dis­eases.

Gayles, the county health chief, described the approach in place as a starting point.

“We look forward to exploring other ways to expand our program and make it work for young people,” he said.

Federal data makes it clear that many adolescents forgo condoms.

Nearly half of high school students nationally reported in 2017 not using a condom the last time they had sex. In Maryland, 43 percent of high school students reported not using a condom — up from 39 percent two years earlier.

Geoff Egnal, a father of three in Bethesda, said he was surprised that health rooms don’t already offer condoms — and backs the idea. “There’s a heath risk for kids, and they have no other way to get access to help,” he said.

Chlamydia cases countywide climbed 17.5 percent from 2016 to 2017, and gonorrhea 29 percent, according to health officials. Those one-year jumps were nearly twice as high as the state’s increases. Syphilis cases shot up, too, but chlamydia and gonorrhea are the major concerns among young people, Gayles said.

In Montgomery, more than 900 of those who developed chlamydia last year were ages 15 to 19, along with nearly 130 who developed gonorrhea.

The overall rates of chlamydia, syphilis and gonorrhea in Montgomery are significantly lower than in Baltimore, Prince George’s County and some other areas.

In the 1990s, a proposal in Montgomery to offer condoms at schools failed because of community resistance, said Patricia O’Neill (District 3), a school board member for 20 years who recalled controversy flaring a few years before she took office.

“We live in different times now,” she said. “It’s a more open atmosphere — and there’s also a health crisis.”

O’Neill said she supports making condoms available at clinics or health rooms, but views that as different from distributing them at schools. “It’s not teachers handing out condoms in classrooms,” she said.

Not far from Montgomery, condoms are widely available at high schools in the District — given out in clinics and by teachers who get training and by students designated as peer educators.

That broad approach started nearly a decade ago, driven by the HIV/AIDS crisis, said Veronica Urquilla, manager of STD education and outreach for the D.C. Department of Health.

Urquilla noted that federal data shows that condom use by District high school students exceeds the national average. But lately that has been slipping, prompting more efforts to highlight the option.

“Everyone is struggling with the same thing, these rising rates of STDs,” she said.

Efforts to slash HIV infections in D.C. stall, while other STD cases are rising

Research shows that condom availability programs can make a difference, said Mark Lurie, an associate professor of epidemiology at Brown University and co-author of a recent paper examining studies on condom-availability programs at schools.

“If our goal is to prevent HIV and STI infections in the next generation, this would be one of many programs worth investing in,” he said.

Another researcher, John Santelli, a professor at Columbia University, said school-based programs are not as common as some people might think. Proposals for school-based condom access programs “have often gotten tied up in culture-war politics about whether schools should provide contraceptives to students,” he said.

STD rates hit record high in U.S. as screening clinics close

Officials from Virginia’s Fairfax, Loudoun and Prince William counties said their schools do not offer condoms. In Prince George’s County, condoms are available at four county-operated high school clinics. In Alexandria, Va., officials said a clinic at T.C. Williams High School, run through the city, offers birth control.

Chlamydia, gonorrhea and syphilis are curable, but because most cases go untreated, they can lead to infertility, increased HIV risk and other problems.

Ananya Tadikonda, 17, the student member of the county school board, said education about sexually transmitted infections is important because not all students might be taught about them at home. “This is a step in the right direction,” she said.