Commentary: Does the Birth Control Debate Ignore STDs and HIV/AIDS?

A recent study shows that the effect of free contraception had remarkable results on teen birth rates. Here's why the conversation can't stop at unplanned pregnancies and why it must include STD prevention.

With the war on women being duked out in this country, a new study suggests that one way to bring abortion rates down is by providing free birth control to women.

Researchers from Washington University School of Medicine in St. Louis enrolled over 9,000 poor uninsured women between the ages 14-45 and let them choose between oral birth control pills or IUDs. And what they found was interesting. According to

Over the course of the study, which lasted from 2008 to 2010, women experienced far fewer unintended pregnancies than expected: there were 4.4 to 7.5 abortions per 1,000 women in the study, after adjusting for age and race — much fewer than the national rate of 19.6 abortions per 1,000 women and lower also than the rate in the St. Louis area of 13.4 to 17 abortions per 1,000 women.

The effect of free contraception on the teen birth rate was remarkable: there were 6.3 births per 1,000 girls aged 15 to 19 in the study, compared with the national rate of 34.3 births per 1,000 teen girls.

These findings and their implications are definitely relevant to Black women. We are more likely to have unplanned pregnancies. In a 2011 report from the Centers for Disease Control and Prevention, Black women in 2007 had the highest abortion rates (32.1 abortions per 1,000 women aged 15-44 years) and account for 34.4 percent of abortions in the U.S. White women account for 37.1 percent.

And so, naturally, folks conclude that birth control and better access to it is the answer.

But when it comes to the plight of Black women, something about this doesn’t sit right with me. And not because I subscribe to any of the pro-life foolishness that claims that birth control and Planned Parenthood are a cover for controlling and reducing the amount of Black babies in the world. I’m not downplaying the importance of birth control and its ability to give women (who can afford it or don’t have access to it) control of their reproduction, either.

My main problem is that it seems like this entire conversation about the consequences of not using contraception is focused solely on pregnancy as being the unwanted outcome. And we find this to be especially true when white-managed women’s and reproductive health groups are leading that conversation. This is incredibly problematic because we all know that when it comes to sexual and reproductive health, women of color and low-income are also worrying about other issues that birth control does not protect them from: HIV/AIDS and STDs.

Black women accounted for 64 percent of new AIDS diagnoses among women, ages 13 and older, in 2010, but only 13 percent of the U.S. population of women, according to the Kaiser Family Foundation. Latinas accounted for 17 percent of new AIDS diagnoses, compared to 14 percent of the female population ages 13 and over. Black women also accounted for the majority of new HIV infections among women in 2009. Not to mention, Black women are 22 times more likely to die from HIV/AIDS compared to their white counterparts.

According to a 2009 CDC study, 48 percent of African-American female teens have been diagnosed with an STD. Gonorrhea rates among African-Americans are higher than any other racial or ethnic group and 20 times higher than that of whites. Among women, Black women 15 to 19 years of age had the highest rates of chlamydia and gonorrhea, followed by Black women ages 20 to 24.

With all of this knowledge, I look back to this Washington University study and wonder did these researchers talk to these women about condoms, condom negotiation and HIV, given that the same women participating are the same ones most at-risk for HIV in St. Louis? And did having this free birth control impact condom use by giving couples a false sense of protection?

Let’s be clear: Unplanned pregnancy and abortion rates may have gone down, but HIV and STD rates have not.

And so it’s pretty obvious that the women’s and reproductive health movements cannot just arm women, especially Black women, with pills and IUDs and walk away as if their work is done. And they can’t expect for AIDS Inc. to be responsible for the “other” stuff. And most importantly, we sure as hell cannot address these epidemics without including men in the conversation.

If the goal is to improve the lives of all women, somehow this birth control conversation must be updated to address the plethora of other issues that women of color are facing. Because for women like me, the pill isn’t the end all be all. It’s just one small tool in the toolbox.

The opinions expressed here do not necessarily reflect those of BET Networks.

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