Jasmin Collado (left and right) works as a Health Advisor at the Plaza del Sol Family Health Center (center) in Corona, Queens. (Photographs: Simon Bouvier, nycitylens.com)
Part of Jasmin Collado’s job is to demonstrate the application of condoms to a rapt audience of curious teenagers. She has lived in the same house in Corona, Queens, since she was born, and still works in Corona today as a Health Advisor at the Plaza del Sol Family Health Center. Her title is vague, but Collado has a very specific mission: teaching Corona’s teenagers about sex, birth control, and how to say “no.” She is on the front line of the battle against teen pregnancy in the neighborhood.
Part of Queens Community District 4, Corona is almost entirely populated by Hispanics, the minority worst affected by teen pregnancies nationwide. According to the Center for Disease Control’s Vital Signs statistical study, the national birth rate per one thousand teenage Latinas aged fifteen to seventeen in 2012 was 25.5—twice the national average. The study found that one in four teenagers in this age category “never spoke to their parents or guardians about sex.” In New York City, overall teen pregnancy rates have fallen by 30% in the last decade, but the issue continues to affect blacks and Latinos disproportionately.
For this reason, a burden of particular significance rests upon the back of health workers like Collado. She must engage not just the teens of their community, but their parents as well, in an attempt to start conversations about sexual activity and safe sex practices. Collado tries to insure that high school students are aware of their right to anonymous counseling and the risks that unprotected sex entail, and also where they can find things like condoms and answers to their questions. She must also convince parents to be at the center of their child’s sexual education by opening channels of communication between them and their teens.
Collado is twenty-seven, but the spectacles she wears and her introverted smile make her look younger. Even though she comes off as shy at first, her passion for her mission is evident, and her voice carries further when she speaks of her job . When asked what she liked best about it, Collado said: “I like to get down in the mud where you are, and pull you out. I want to rescue you.” She knows the possible futures of her community’s youth, for whom becoming parents early in life can mean putting plans for higher education on indefinite hold and working grueling hours in low paying jobs to provide for their children.
The part of her job that involves condom demonstrations and rapt audiences takes Collado to local high school classrooms.
At the moment, Collado is seeing six classes of high school students every Monday, teaching each of these classes a module of a sex education curriculum called “Be Proud. Be Responsible,” which she had taught the previous year as well.
She starts the module by establishing a set of ground rules for the sessions, which are meant to allow the students to feel comfortable interacting with her and each other. “I tell them: ‘What happens here stays here’,” Collado said. “Kind of like a Vegas thing.”
The program teaches teens how to handle pressure to engage in sexual activity through scenario roleplaying. In these negotiation drills, Collado has boys play the role of girls and vice versa, to keep her students amused and stimulate thinking around the way they interact. “Most of what you say is your behavior,” she recalled telling her classes. “When you speak, do you speak with authority?”
Over the six interactive, fifty minute sessions, Collado also gives her audience a comprehensive explanation of the different birth control methods available to them, and brings to class both male and female condoms, which the students have a chance to manipulate. Time is short, and the curriculum guidelines make for dull reading, which can sometimes make it difficult to keep her teenage audience listening.
“I try not to talk like a machine, she said. “By the end, they usually say “Oh my god, No! We’re not going to talk about sex anymore!”
She hopes the students’ next such conversation is with their parents, though the odds against that are daunting. On October 14th, the NYU Center for Latino Adolescent and Family Health and Planned Parenthood Federation of America published the results of a poll conducted in July 2014 to gauge how open Latino parents were in talking about sex. One in five parents polled had “never talked with their teen about strategies for saying no to sex, birth control methods, or where to get accurate sexual information” before their children were twenty one. More than a third had “never talked with their teens about where to get reproductive health care services.”
The results of the poll also showed more than 60% of parents “wanting young people to wait to have sex until they are ready to handle the responsibilities that come from having a sexual relationship” and 91% knowing when their teens were engaged in a sexual relationship. Parents know, parents worry, but few ever speak up, leaving health workers like Collado to fill the vacuum in communication on their own.
“It’s all about the culture,” said Vanessa Guerrero, a colleague of Collado’s who works as a Family Planning Counselor at Plaza del Sol. “A lot of Hispanic parents were raised without their parents talking about this. One Ecuadorian patient told me: “It’s great that you have all this set up for the youth here. I didn’t know what a period was until I bled. “ She had to use one of her brother’s Pampers!”
When she is not teaching “Be Proud, Be Responsible,” Collado sees teenagers at her office in the Plaza del Sol Family Health Center’s pediatric ward. (“It gets loud when they’re doing immunizations,” she said.)
Every day, she pulls every doctor’s schedule to check for patients aged thirteen to nineteen, and has a conversation about sexuality with every single one of Plaza del Sol’s patients in that age bracket. New York State law protects minors from parental interference when they talk to educators like Collado, which means these conversations are mostly one-on-one.
“I let them know: ‘By the way, there is not one question you could ask me that I don’t know about’,” she said of interacting with the teens, who are often curious about a variety of sex-related topics that they are ashamed to discuss with their parents. “We need to establish openness,” Collado said. “They need to know we want to give them what they need.”
Although parents are banned from forcing themselves into their children’s conversations about sex, Collado thinks they are the key to bringing teens around to making more responsible reproductive health choices.
Collado said the openness of her relationship with her mother was a crucial part of her making healthy decisions about her sexuality growing up. “I come from a very religious background, I was told to cross my legs when I sit down, but our relationship was really open when it came to talking about my body,” she said. “No topic is left ignored in our relationship.”
Experts agree that teen pregnancy prevention programs must include parental involvement in their children’s sexual education if they are to be effective.
“Three factors that we think are critical are comprehensive sexual education, to allow teenagers to make informed decisions about sexual activity; access to resources like councilors; and parental involvement,” said Randa Dean, Planned Parenthood of New York City’s Director of Capacity building and Professional Development. “When teens are having good conversations with their parents about sex, they’re more likely to delay sex, and more likely to use condoms and other birth control methods once they do become sexually active.”
Professor Vincent Guillamo-Ramos is the Co-Director of the Center for Latino Adolescent and Family Health, run out of New York University’s Silver School of Social Work. He and his team of researchers have been working on outreach-based sex education programs encompassing safe sex, abstinence, access to information, and parental involvement for the past fifteen years, in a variety of different Latino communities around the country, from New York to California.
“Study after study has shown that parents are influential when it comes to making decisions about sex,” Guillamo-Ramos said. Speaking of the years he and his team spent researching the effectiveness of sex education methods that involve parents in the conversation, he said: “The most important finding is that we can delay the start of sexual activity and decrease the likelihood of risky sexual behavior.”
Because health workers like Collado are not a constant in the daily lives of their patients, they cannot, for all their determination, bridge the gap in teen pregnancy rates if they remain Latino youth’s sole educators on all matters sexual. The parents must play a part, as well as the teens themselves.
“I like that, in a moment of desperation, I meet with a teen and they leave with some hope, or the answer they wanted,” Collado said. “But in the end, I don’t have control over their behavior. It’s in their hands.”
