On a recent mobile clinic in Lima, an interested student asked me what I knew about the state of sex education in Peru. Her interest was piqued by the video she had just watched in our education tent, one which attempts to underline for our patients the often misunderstood connection between the sexually transmitted Human papillomavirus and cervical cancer. My answer was that there was none.
During mobile clinics, female student volunteers often express shock that many of the young mothers they help to treat — some arriving with two to three fidgety children in tow — are frequently around their same age, if not younger. This polarization of lifestyles is for many of them one of the more impacting moments of their volunteer experience.
In a hunt for more tangible statistics, I began doing some research. Study after study corroborated a bleak picture of increasing STD transmission in Peru and other parts of Latin America, especially in large urban areas. Factors included risky sexual behavior, limited condom use, and a fundamental lack of education. The same misconceptions and cultural barriers that MEDLIFE encountered when first offering free Pap smears in Pamplona, discussed in detail in this blog entry, reappeared in my research. When it comes to information about safe sex, it seems that many communities in Peru were just never given the tools needed to identify the risks of STDs or to understand contraception options.
The numbers are discouraging. This report from 2008 estimates the number of Peruvian schools offering even rudimentary sex education to be less than five percent. The same study found that among populations living in high-risk areas for STD transmission, typically impoverished city-dwellers, only 35.8 percent of individuals under 25 were able to correctly identify effective forms of STD prevention. Among women with casual sexual partners, only 12 percent reported consistent condom use.
We see the consequences of this lack of education in studies like this one by the American Sexually Transmitted Disease Association, where doctors surveyed instances of partner notification in patients with newly diagnosed STDs. More than half of participants reported having multiple sexual partners, yet only 10.5 percent chose to inform their secondary partners of their diagnosis. Reasons given for keeping the diagnosis to themselves were fear of rejection, inability to locate their partner, embarrassment, and, not surprisingly, an incomprehension of the importance of notification.
Given the lack of access to sexual health information and the cultural taboo of discussing the topic in public, the prevalence of young mothers and increasing STD rates are not so hard to understand. Scenarios like these only reinforce the importance of education in addressing these public health issues. MEDLIFE hopes to continue to expand the educational component of our mobile clinic model in the coming months, in order to focus on an even broader range of health topics and to ultimately help our patients live healthier lives.
Laura Keen is a MEDLIFE Intern in Lima, Peru