Barriers to effective sexual health care in an underserved school-based health center in the Bronx

Marginalized youth, specifically youth of color, impoverished youth, LGBTQ youth, and intersections of these, are well known to have the worst sexual health outcomes – higher rates of teenage pregnancy and HIV/STIs as compared to their privileged counterparts. Access to sexual health education and care is a huge part of this problem, and school-based health centers are trying to close this gap. How well do these centers do in reducing these health disparities? What could be done better? I will be discussing the barriers and best practices I encountered over my year working with AmeriCorps as a school-based reproductive health educator in the Bronx. Learning objectives will include identifying barriers and best practices to effective adolescent sexual health care, and explaining how intersecting marginalized identities play into these barriers and best practices. These will be based on the youth’s identities and their context in school, in the community, and in their home as well as the practices and values of the school-based clinic’s staff. Specific topics will include nonjudgmental and context-specific HIV & STI education and disclosure, best practices for shame-free discussions around sexual partners and activities, how to engage disinterested youth in conversations around sexual health, and how to empower marginalized youth in sexual health education. Lastly, I will discuss the positive outcomes of engaging in these practices in adolescent and school-based health settings. This presentation will benefit public health workers and medical professionals who work in schools and/or with marginalized adolescents.