The latest data from the Tulsa Health Department (THD) indicates that areas of Tulsa County boast STI rates ranging from 4-9x greater than the national average.
The THD report asserted that in 2013, Tulsa County experienced gonorrhea rates of 200.5 per 100,000 people (double the national rate of 106.1), chlamydia rates of 545.5 per 100,000 (national rate, 446.6), and syphilis rates of 3.1 per 100,000 (actually lower than the national rate, 5.5).
The catch? According to the Tulsa World, North Tulsa boasts drastically higher rates than the rest of Tulsa County. The worst rates are evident in the 74106 zip code, a large chunk of North Tulsa ranging from the northern edge of the Greenwood District to East 46th St. N. The 74126 zip code, also included in the more troubling statistics, encompasses the area further north of the 74106 code and west of the Tulsa Zoo.
The 74106 and 74126 zip codes had gonorrhea rates ranging from 464.9-1,000.3 per 100,000, chlamydia rates of 1,149.1-1,892.4 per 100,000, and syphilis rates of 24.7-32.1 per 100,000. Those of you who might have just done some quick mental math will realize that these rates are several times greater than Tulsa County averages, which are already greater than national averages (with the exception of syphilis).
A Tulsa World article on the STI rates goes on to quote several doctors and nurses who work in the North Tulsa area who confirm the high frequency of STI cases they see in their workplaces. Tulsa Health Department officials make a shout-out in the article to their North Regional Health and Wellness Center, which offers STI services, educational resources, and $20 screenings. No one is refused services due to inability to pay. The OU Wayman Tisdale Clinic distributes free condoms to teens.
This is all well and good, and those resources are much appreciated and very, very needed. However, in order to solve this STI problem we need to look at the root of the problem; or, more accurately, the roots of the problem.
The fact that the highest STI rates in the county are centered in one of Tulsa’s lowest-income areas can’t be ignored. There are two major factors that play into this distribution: 1) a lack of access to affordable testing and 2) a lack of sexual health education.
1. Access to affordable testing
There are quite a few centers for STI testing in the Tulsa County area. Several are located downtown, or near downtown to the south, including Tulsa Health Department and Planned Parenthood. There are a few centers in Broken Arrow, a couple centers in Sapulpa, two in Coweta, two in Claremore, one in Wagoner, one in Okmulgee, and one in Jenks. Their zip codes cover a wide range: 74105, 74135, 74112, 74104, 74120, 74429…
This distribution of health centers doesn’t look like a huge deal at first glance, as there are several testing centers in the Tulsa area, including zip codes near the affected areas.
However, in the 74106 and 74126 zip codes — the most affected areas — I was only able to find two health centers with access to STD testing. Morton Comprehensive Services (on Lansing Ave. in the 74106 zip code) offers testing for all three of the major STIs listed above; Guiding Right Inc (on Madison Ave in the 74126 zip code) only offers syphilis testing.
In contrast, you can see that there are many centers in towns that can reasonably be considered suburban areas of Tulsa County.
For a lower-income community that likely has reduced access to personal transportation, this CAN actually be a big deal. It can be difficult and expensive to leave the family or workplace and plan an all-day public transportation excursion across Tulsa to get tested.
Affordability of testing is likely an issue as well: only Planned Parenthood and Tulsa Health Department specify that you will not be turned away due to an inability to pay, but many still charge fees for screenings. THD says on their website that they charge $20 per screening, but information about screening rates at other centers is not easy to find. Additionally, not all of the health centers offer testing for all three of the most common STIs listed above, and some only offer HIV/AIDS screenings.
On top of that, reliable information about STI testing in Tulsa was difficult to find. In order to find local STI testing centers, one must wade through a maze of ads, sketchy-looking centers that didn’t seem 100% certified, and quasi-credible search engines–and that’s if you have access to an internet connection.
If information about testing isn’t readily available, what motivates a lower-income family member to sacrifice excessive time, money and obligations to family or work in order to get sexual health testing? What prioritizes this testing over other health problems or dentist appointments, which are difficult to pay for as is?
A vital step towards lowering the ridiculous STI rates in North Tulsa is to provide people who have STIs with treatment and resources in the first place. We need health centers operating directly from the affected areas, where they can actually reach the people who need them most.
2. Lack of sexual education
The doctors and nurses in the aforementioned Tulsa World article emphasize the importance of getting tested for STIs, saying that many patients didn’t even know they were carriers of an STI. This is partly due to the fact that some STIs don’t have easily visible symptoms; however, it’s also due to the fact that many people don’t know how important it is to get tested in the first place, resulting in relationships where neither partner knows whether the other is a carrier.
Sexual education reportedly varies widely in Oklahoma public schools, which is to be expected in a mainly conservative state which is largely in favor of abstinence-based education. According to a report by the Oklahoma Watch, some of the largest public school districts in Oklahoma offer limited or no sexual education programs.
While the Oklahoma Department of Education doesn’t keep records of which of the state’s 520 districts teach sex education, we do know that Oklahoma does not mandate sex education in public schools, though it does mandate HIV/AIDS prevention education.
At this point, we need to bypass the political implications of sexual education and focus solely on Tulsans’ sexual health.
Statistically, it’s very likely that at some point teens will become sexually active: the average age for virginity loss in the US is 16.9 years old for men and 17.2 years old for women. In 2011, 50 percent of female high school students and 51 percent of male high school students in Oklahoma reported having had sexual intercourse. This was higher than the national averages of 49 and 46 percent. Oklahoma boasts one of the highest national rates of teen pregnancy as well.
With this in mind, even an abstinence-only sexual education course should include information about STIs and an emphasis on how to protect yourself from them. If we can mandate HIV/AIDS education, isn’t it just as important to expand STI prevention education?
The Tulsa World reported in 2014 that “Comprehensive sex education includes medically accurate information on topics such as relationships, human development, abstinence, the benefits and side effects of all contraception, disease prevention and how to avoid unwanted sexual advances, according to the sexuality council. HIV/AIDS education includes a discussion of the spread and prevention of the disease.”
Note that this definition includes abstinence as part of the curriculum. Tulsa Public Schools made a (positive, in my opinion) switch to this sort of comprehensive curriculum in 2014 — something never before done in the district. Union and Jenks Public Schools offer mainly abstinence-based sex education.
With all this in mind, STI education absolutely needs to be a more significant part of Tulsans’ education. This isn’t a political issue, it’s a safety issue.
In addition, Tulsa County and North Tulsa in particular could really benefit from increased access to sexual education for adults. Most Tulsa residents haven’t benefitted from the recently-introduced comprehensive sex ed program provided by Tulsa Public Schools. I imagine that the STI testing clinics offer useful information– — or at least, they would if there were any in North Tulsa to begin with.
The bottom line is that the current STI rates in Tulsa County, particularly North Tulsa, are unacceptable. Tulsa County is a community that absolutely should be able to provide the resources and the technology to ensure the sexual health of its residents. This isn’t the dark ages — while difficult to treat, STIs can absolutely be prevented through accessibility and education. I understand that advances in sexual education will be difficult to accomplish and depend entirely on the school district as well as on the mandates of the Oklahoma government.
With that said, if Tulsa County truly values the health of its residents (and that includes their sexual health), it can start by providing them with basic resources and education at easily accessible clinics, because the current rates are quite honestly an embarrassment to County officials and an injustice to the people of Tulsa.