Abstinence-Only Christian Health Clinic Receives Federal Funds Meant For STI Prevention

IRVINE, Calif. — Inside Obria Medical Clinics, conviction — not condoms — is summoned to stop the spread of chlamydia.

The Christian medical chain, which was awarded $1.7 million in federal family planning funds for the first time this year, does not offer hormonal birth control or condoms; instead, its doctors and nurses teach patients when they are likely to be fertile and advise them on contraception.

Reproductive health care providers were outraged by Obria’s inclusion in a federal program, known as Title X, established to help poor women avoid unwanted pregnancies. But the clinics that receive the money are also expected to detect, treat and prevent sexually transmitted diseases and HIV, and Obria’s ban on condoms means prevention efforts — even for single millennials or aging couples — take a break from avoidance.

In its application for federal funding, Obria pledged to follow Centers for Disease Control and Prevention guidelines and recognized medical standards for STD prevention. Used correctly and consistently, condoms are highly effective in preventing the transmission of STDs, according to the CDC, a finding echoed by the American College of Obstetricians and Gynecologists and other major medical associations.

But Obria will not promote or provide condoms. Instead, its staff will “emphasize that abstinence is the only 100-percent way to prevent pregnancy and STDs” and educate patients about “high-risk behavior” and the “dangers of using ‘safe-sex’ methods,” according to the group’s application.

Obria representatives declined a request to be interviewed for this article. But in a 2018 interview, Kathleen Bravo, CEO of the Obria Group, described the organization’s strategy.

“By reducing sexual risk, fewer women get STDs and cancer and pregnancies,” said Bravo, a devout Catholic. “In other words, teach them not to go down that path.”

Sexual health educators, tasked with reversing four straight years of record levels of gonorrhea, chlamydia and syphilis nationwide, call Obria’s condom ban reckless and dismiss its focus on -avoid as desire.

“It’s hard to understand how a health care provider can test someone for an STI [sexually transmitted infection]whether the results are negative or positive and not give them information about the effectiveness of condoms in STI protection,” said Philip Yaeger, executive director of Radiant Health Centers, a community provider in Irvine that receives Title X funds. .

From 2013 to 2017, the number of gonorrhea cases nationwide increased by 67%; syphilis increased by 76%. The number of cases of gonorrhea, syphilis and chlamydia increased 2.3 million in 2017. About 30,000 people are newly infected with HIV each year.

If left untreated, sexually transmitted diseases can lead to infertility, cervical cancer, blindness and dementia. The number of cases of pregnant women passing syphilis to their babies more than doubled from 2013 to 2017 in the US, resulting in many newborn deaths and hundreds of children with serious health complications.

In Orange County, among the wide boulevards and gleaming office towers where Obria maintains its headquarters, sexually transmitted diseases are an unstoppable force: From 2013 to 2017, gonorrhea cases rose by 129%, chlamydia by 65% ​​and syphilis by 99%.

To combat the epidemic, health educators from Radiant Health Centers set up tables with sound machines and flashing lights in nightclub parking lots on weekends. In the past year, they have given out 25,000 condoms and tons of lubricant.

Tiffany Hendrix, Radiant’s director of Education and Prevention Health — who was thinking about sexuality after becoming a teenage mother — travels from high school to high school with a penis and genital model teaching young -learning how to use a condom properly.

“It doesn’t matter what our beliefs are,” Hendrix said. “It’s our job to educate someone so they can make informed decisions, like with diabetes or cholesterol.”

But conservative Christians who are helping to promote progress in faith-based medical care in the US say that doctrinal beliefs have the right to determine the services offered in their hospitals and clinics, even if it involves of chronic sexually transmitted diseases.

“Contraception is seen as damaging the gifts God has given us,” said Theresa Notare, assistant director of the Natural Family Planning Program at the United States Conference of Catholic Bishops. “You can’t put physical barriers like condoms or chemical substances that will interfere with the natural design of the ovaries.”

“There are no exceptions,” Notare said, even for STDs and HIV.

If a spouse is infected with HIV, he said, abstaining from intercourse becomes an act of love. “The very difficult question needs to be asked: Are we not having sex again? Actually, because of a terminal illness, I would interpret it as yes.”

Catholic and evangelical Christians are promoting President Donald Trump as an unlikely champion who, after decades of shaky promises from Republican lawmakers and presidents, is delivering on their agenda.

The administration has worked methodically to appoint judges who oppose abortion rights; stake out Planned Parenthood and other abortion providers; reverse Obama-era mandates on employers to include birth control in insurance coverage; and give primacy to prevention sex education in schools.

Relaxing long-standing requirements that clinics provide a full range of birth control options, including condoms, the Trump administration has allowed the once-temporary anti-abortion crisis pregnancy centers — which typically offer of pregnancy tests and, above all, operate ultrasound machines — to become certified medical clinics.

Over the next three years, Obria could receive $5.1 million in federal family planning funds for its California clinics. But Bravo, which operates 38 clinics in six states, has bigger visions: He wants Obria to become a nationwide alternative to Planned Parenthood, which is launching a $240 million capital campaign to open more sites.

“We put a lot of money into marketing our medical clinics to make sure women know we’re here in their city and these are the services we provide,” Bravo said.

But to Obria main website and the Obria Direct app for patients does not clearly state the organization’s religious beliefs or how its religious beliefs limit its medical offerings.

The organization’s homepage describes a prosaic medical practice that is “committed to caring for you as a whole” and provides “the support and answers you need about your sexual health.” The list of services includes STD testing and treatment, HIV testing, gynecological care and health education. Embedded in a lengthy description of the failure rates and possible complications of intrauterine devices, birth control pills, condoms and patches on Obria’s “Birth Control” page are the notes that “Obria Medical Clinics do not prescribe birth control” and natural family planning “are not effective in preventing STDs.”

Medical facilities are not required to inform patients about religion or the limitations of health care options.

The number of Catholic-affiliated hospitals across the country has grown rapidly in recent years, especially as hospital systems have been consolidated. Five of the top 10 hospital systems by net patient revenue are affiliated with the Roman Catholic Church. But more than a third of women who visit a Catholic hospital for reproductive care do not know the religious affiliation, according to researchers from the University of Chicago and the University of California-San Francisco.

David Magnus, director of the Stanford Center for Biomedical Ethics, said clinics like Obria are essentially taking a “bait and switch” and raised the specter of potential liability for religiously oriented clinics, which are funded by public dollars, if a patient is given incomplete advice and then contracts an STD.

“Pretending you’ve given adequate advice is misleading and lying,” he said.

Kaiser Health News (KHN) is a nonprofit news service covering health issues. This is an editorially independent program of the Kaiser Family Foundation that is not affiliated with Kaiser Permanente.