What's Up With HIV In The South?

Statistically, a 16-year-old girl in Mississippi has a lot going against her. Her school will probably never provide much sexual education. If it does, the lesson plan consists of antigay, abstinence-only views, even though she and her friends have probably already had sex; it’s likely that she or one of her friends is pregnant or will become pregnant before donning a cap and gown; and because one third of the kids in her group of friends didn’t use a condom the last time they had sex, one of them probably has a sexually transmitted infection such as chlamydia, gonorrhea, or HIV.

On top of all that, this Mississippi girl also faces a high likelihood of illiteracy, and the quality of education she receives ranks among the lowest in the nation. Many of these statistics apply to young people in the surrounding states, too. Adolescents living below the Mason-Dixon Line are subject to conservative attitudes that persist when it comes to educating children and teenagers about HIV, reproduction, and safe sex.

A trip halfway up the Appalachian Mountains to the nation’s capital shows many of the same statistics. In fact, the annual rate of AIDS diagnoses in the District of Columbia—which is technically located in the American South—is astronomically higher than the rate in almost every other city in the nation, and people ages 13-25 are hit particularly hard. But one major difference between D.C. teenagers and their peers in Mississippi or Arkansas is a significant community ally, Metro Teen AIDS.

The organization, founded nearly 25 years ago, has seen many changes over the years, but the sole focus on youth has remained constant. Metro Teen AIDS executive director Adam Tenner spent the first half of his tenure at the organization turning things around. In 2001, Metro Teen AIDS was $150,000 in debt, and it had maxed out its $50,000 line of credit. Once Tenner led the organization out of the hole, big changes came. The secret has been allowing its young clientele to guide the direction of the organization.

“Teenagers can recognize when something is coming from an adult,” Tenner says. That’s why there are upwards of 40 paid young people on staff. “We know they’re the best messengers, so we arm them with the right information.”

Tenner says Metro Teen AIDS has found success by letting its army of young people lead the efforts to reach thousands of their peers each year. One of its biggest successes, lobbying for the passage of D.C.’s in-school sexual education policy in 2007, has led to the group being the main provider of sex ed in the district’s schools. That means Metro Teen AIDS directly reaches 25,000 young people every year, a rarity in a nation where, according to the National Conference of State Legislatures, 33 states require schools to educate students on HIV, but only 18 states and the District of Columbia require public schools to offer scientific, age-appropriate sexual education, which includes information on HIV.

Kevin Fenton, MD, of the Centers for Disease Control and Prevention says frank talk on sexuality and sexual health is important to any effort drive down the rate of infection and teen pregnancy. Because of programs like Metro Teen AIDS’s school outreach, the numbers in D.C. are becoming less dire. But the CDC is trying to encourage more conservative states and school districts to institute more comprehensive sexual education to reduce the transmission rate of STIs as well.

Most Southern states condemn such policies, but that’s why the CDC is now attempting to engage post–high school young adults in prevention and education efforts. Metro Teen AIDS was in the forefront of understanding what parents wanted, so it could build a parent-approved curriculum to which legislators would not object, which was key to instituting comprehensive sexual education in the school district.

“We polled parents in the city, and I feel like we understand what they want, and they believe that school is the best place to get the science-based, factual information about HIV and sex,” Tenner says. “So they take on the responsibility to talk about the ethical and emotional aspects of sex and HIV. We’re able to say that about 98% of D.C. parents say this is what they want, mostly because they have anxiety about the increasing numbers of young people with HIV.”

After that victory came a more specialized strategy for Metro Teen AIDS, says Tenner, who credits a great deal of the organization’s success to its diverse young staff, which is broken into teams that reflect who they are, including teams for young women, LGBT youth, and street kids. Freestyle, the group’s after-school drop-in center, sounds more like a hip lounge than a health educational center. It is also a place to learn about HIV with programs like the Where My Girls At? group for young women on Wednesdays, a T-shirt design group, and an open mike night for budding performers. Metro Teen AIDS also embraces social media marketing with teen-led efforts like RealTalkDC, a campaign that, as its website says, reaches teens “where they are—online, on cell phones, at school, and in the streets.”

“The thing that makes me smile is giving young people the tools to be able to go out into their networks and go to parties that I’m certainly not getting invited to, and bring the information out to where the traditional messaging doesn’t work,” Tenner says.

It also helps that the Metro Teen AIDS materials are designed to catch a teenager’s eye, and the messaging is heavily guided by young people in order to maintain a decidedly unstodgy voice.

“Our materials are very youth-friendly and well-designed and colorful,” Tenner says. “We also use a texting feature so kids can get texted to find out where to get tested, where to get a condom, and where to get information.”

Tenner reminds health policy advocates that young people need to be represented when it comes to making decisions that could affect their futures.

“We can’t be afraid to be advocates,” he says. “I think our success, in no small part, is not only being a consistent provider, but we’ve been critical, even of our supporters, when talking about the needs of young people. It’s especially easy for politicians to gloss over the needs of older teenagers and young adults.”

Programs like Metro Teen AIDS not only educate teens and young adults about HIV and sexuality but also provide community-wide improvements.

“Young people’s grades increase when they can give back to their community,” Tenner says. “It’s like an investment in your community as well as their futures. Engaging and improving their communities helps them in ways that aren’t even visible.”