Katy Janousek, who works in the health promotional department of the University of Georgia health center, specializes in sexual health education. This primarily means guest lecturing on STIs and contraceptives in classes on campus and going to programs around the university to run workshops on sexual health. She also maintains the website information on sexual health and acts as a resource for students to talk to. When students want to change contraceptives or have questions about STIs, they can come alone or with a partner to Janousek for more information.
You said that your focus is on STIs and contraception. Can you tell me a little more about what you do with that?
What’s interesting about being in the deep south is that k-12 in public schools has really struggled with comprehensive sexuality education. So a lot of basic information is lacking for UGA students because they didn’t get it in k-12. So there’re kind of some gaps that need to be filled, and that’s different for each person based on their personal beliefs and values, their comfort level and the behaviors they choose to engage in. So there’s a lot of shame and stigma first off that has to be overcome to let students know that by increasing awareness and providing education is not promoting and idea of promiscuity. That, instead, regardless of what behaviors people are currently engaging in, by providing reliable resources and accurate information, when they do decide to be sexually active or engage in whatever behavior, they kind of have the tools to pull form then and some of the basic skills…Historically, for college students maybe when they first learned about STIs scare tactics were used, which is actually proven to be ineffective in preventing transmission. So when I go into classrooms or when I’m doing programs, I do not show any scary pictures or anything that’s graphic. Instead, even in talking about the different types of infections, the main message is prevention. I’m not teaching med students to diagnose the difference between chlamydia and gonorrhea, I think for the ley college student it’s more about that they can all be prevented in the same way. So, really emphasizing, what does abstinence means and what behaviors carry different levels of risk for potential transmission.
When you discuss what abstinence means, what is that conversation?
What’s important about the abstinence conversation is defining the difference with celibacy and virginity, and again personal beliefs, values, religious teachings are really going to play into those definitions, so that’s why it’s really important to be able to use correct terminology and use the actual words to say, well are we talking about penetration or are we talking about things that can cause transmission or can cause pregnancy. To explicitly discuss oral, vaginal, and anal sex and what all that means, because there are behaviors along the spectrum that folks might not define as sex, but pregnancy can still result and STIs can still be transmitted. So I think it’s absolutely paramount to be explicit.
What sort or resources are available here to students as far as sexual health?
At the university health center we have our primary care physicians that are assigned to students so that they go to the same area every time that they have a need, but we also have a woman’s clinic. So, for folks that have a vagina or have a uterus, no matter what their gender identity might be, those services will allow for pelvic exams which may or may not include pap smears. But really that’s the source to talk about what kind of testing might be applicable for that person based on their sexual history including if they would like a prescription for birth control or if they would like one of the long acting reversible contraceptives like an implant or an IUD. We’re currently running a special in our lab for STI testing. There’s a coupon that is $10 off of $40 or more of services and it’s convenient because if people have paid their health fee, then to get a chlamydia and gonorrhea test is $40, bucks with he coupon it’s $30. That’s a test that everybody who’s sexually active should really be screened for even without presenting symptoms, every year. We also offer other STI testing including HIV testing, which is a blood test. Out in the community it’s an oral swab for HIV that’s offered at AIDS Athens. Then we have our pharmacy, and about 50% of what our pharmacy fills for prescriptions are birth control. So that’s right here in the health center. For me, the services that I offer, it’s free and anonymous to call or email, for folks to come in and sit down, and they can come in by themselves or with a partner or friend. And then we also really try to keep our website updated. Additionally what we offer are free samples of safer sex products. So, we do offer free lubricants, condoms, dental dams, and also internal condoms. So we have prepackaged packets that are available in the pharmacy, lab and health promotion department, but also in the medical clinic exam rooms people can independently, anonymously pick up those packets if they’re there for a visit.
What do you feel like is the biggest obstacle against sexual health for college aged and young people today?
I think the shame and stigma around sexuality. There are conflicting messages through media about sexuality, but then through the educational system, it’s like we don’t talk about that. And I think systemically we see a strong message based on what core classes are required in education. There are many schools that do require sex ed or health education. There are colleges that require a semester long personal health class that included sexuality education. So like many things, there’re various levels for what people are learning on their own or in their own nuclear family their peer group, but then also systemically kind of the messages that we get.
Then would you be an advocate for a different mode of sex ed in public schools?
There are approved curriculum that are comprehensive. So there are national organizations like SIECUS that approves different curriculum…lots of organizations that have done studies to prove the relationship between a certain type of curriculum and behavioral outcomes. I think that has to be articulated in order for policy makers to understand what the benefit would be. There are some really great infographics and edugraphics that can kind of even make the case around tax payer dollars and health outcomes related to comprehensive sex ed which is going to show that students have a lower [rate of early] age of first sexual initiation, lower rates of unplanned pregnancy, and lower rates of STIs.
We’re talking about how education is one of the biggest obstacles. What would the solution there be?
I think for a lot of social change to occur the public has to understand what the issue is, what the problem is, and then be motivated to communicate with their legislators, to show up to the polls and vote for candidates that do support comprehensive sex ed in schools. So then the policy can change and we can have comprehensive sex ed being taught that is age appropriate starting k-12.
Do you think there is a specific aspect that is more overlooked than other areas in sexual health?
Absolutely. I think because of the shame and stigma around sexuality often times people are most comfortable, if we must talk about sex, to talk about negative consequences. Health impacts, unplanned pregnancy, and STIs. What’s overlooked is healthy consensual sex, which is pleasurable. And that can really make people squirm when we talk about pleasure in sex education. But I think an argument can be made that not having the comfort to talk about it not have the skill set to talk about it, and then people are engaging in behaviors that maybe they aren’t truly consenting to. And it becomes a slippery slope to sexual assault and nonconsensual sex. So I think being able to talk about anatomy, sources of pleasure, the sexual response cycle, but also emphasizing, particularly for young women, that they can experience sexual pleasure on their own, that it does not have to just come from a partner, it does not just have to come from a penis, that can really empower women to embrace their sexuality that may have ramifications towards preventing nonconsensual sex.
Is there anything you’ve come across that people believe that is completely not true, any myths?
Absolutely! Some of the most held on to myths, the strongest feelings that come up when I talk, are that a lot of women and men have deep rooted feelings towards birth control that it causes cancer, that causes birth defects, that can kill women, and frankly what’s scary is often times they’ve had medical physicians and nurses tell them these things. A lot of times when students get empowered, they get the education and they’re like man, forget the pill. I’m ready for an IUD. They will go to a doctor and be turned down because that doctor is also misinformed and is perpetuating these lies and myths. So, it’s scary.
I think emergency birth control, Plan B is another thing that people just do not understand and do not understand how it is different from a medical abortion, which is a prescription pill. Very different from over the counter plan B, which is basically a super does of hormonal birth control pills that prevent pregnancy before it happens, but cannot cause an abortion in a woman who is already pregnant. That’s something that I hear myself saying a lot.
Is there anything that you see that specifically people aren’t doing that they should be to protect themselves?
It does tie into one of those myths,that is rooted from horrible scare tactics, that people will know if they have an STI. They see those scary pictures and they’re like maybe this is just razor burn. It didn’t look like that guy. What’s happening is that people don’t realize that the most common symptom is no symptom and that every single year whether people have a new partner or not they really need to come in for an annual exam or physical to talk about their sexual history with a medical provider. And especially for women under 25, they really need be getting the chlamydia, gonorrhea and HIV test every year, and for men it’s also a good Idea to have chlamydia, gonorrhea and HIV tested every year. In addition there’s some great vaccines available. A lot of folks have received Hepatitis B vaccination, but they should check with their health care provider to see if they’ve received all shots. And then also Gaurdasil, the HPV vaccine, is really exciting. What has been out for a while protects against four kinds of HPV. The same company has gotten FDA approval for the new vaccine, which protects against nine types.
Have you seen any changes or trends in what young people are doing or thinking or saying?
I’ve seen a lot more students coming forward with having acquired an STI through unprotected oral sex, and I think mainly what I’ve seen is folks with oral herpes, which society is like, it’s a cold sore, it’s a fever blister, but it’s probably herpes, and herpes can be transmitted to other parts of the body. Folks are most likes to get an STI by receiving oral sex. So a lot of times if people have a partner who maybe doesn’t know that they have herpes or maybe doesn’t even have a visible outbreak but has the herpes virus active in their body, by not using protection during oral sex they’re transmitting that virus, and viruses don’t have cures… The reality is that people are like, using protection during oral sex? What does that mean? Who does that? There’s the issue of it coming up and people seeing those negative consequences, but we don’t really see commercials for dental dams, we don’t often hear about flavored condoms or flavored lube as a preventative, so as a result we’re kind of seeing the negative consequences… If there’s money to be made companies are going to make good tasting good flavored condoms and lube, but if we don’t talk about and if they don’t think people are going to use it, we’re not going to have the products available. And same thing with dental dams. I can go to the grocery store and pick up some bread, some lube and some condoms, but where I am going to get dental dams? It’s usually a pretty seedy sex store with bongs in the corner and bars on the window, and that’s just perpetuating the stigma and shame around sex and taking care of yourself.