2 jul. 2009

Unprotected Sex: Abstinence Education's Main Accomplishment

Youth seeking his father's advice on love
From the Haft Awrang of Jami, in the story A Father Advises his Son About Love. His counsel is to choose that lover who desires him for his inner beauty. See Sufi outlook on male love Freer and Sackler Galleries, Smithsonian Institution, Washington, DC.

It is widely known that teenage birth and pregnancy rates, which dropped dramatically between 1991 and 2005, are now climbing. By tracking changes in reported contraceptive use among sexually active high-school students, researchers at Columbia University and the Alan Guttmacher Institute, which studies sexual health, have identified as the leading culprit a drop in the use of birth control -- specifically condoms. The team studied trends in teen sexual activity and contraceptive use between 1991 and 2007. During most of this period, the level of sexual activity reported by teenagers in routine surveys overseen by the Centers for Disease Control remained largely unchanged. But during a crucial period -- identified in the study as between 1991 and 2003 -- the use of condoms rose dramatically, climbing from 46.2 percent in 1991 to 63.0 percent in 2003. Then a perceptible decline in the use of condoms began, with 61.5 percent of students reporting condom use in 2007. "These behavioral trends are consistent with the 2006 and 2007 increases in the teen birth rate," the study published in the July issue of the Journal of Adolescent Health says. "They may well portend further increases in 2008."
The decline in contraceptive use may cheer those who have promoted faith-inspired school curriculums that refuse to even mention birth control and, in some cases, specifically emphasize that condoms can fail. True enough.

But now we have sad and clear evidence that political foolishness among adults is leading to foolish and harmful behavior among kids. Who could reasonably want more teen pregnancies, more abortions among teenagers, more unmarried mothers, more babies born with greater health risks and with the sorely limited economic prospects that burden the children of young, single mothers? No one would dare promote such a policy. Yet these are the results of our recent national sex-education policy, which was based on religious faith, not science, and put political gamesmanship ahead of public health. More...

Almost all U.S. students receive some form of sex education at least once between grades 7 and 12; many schools begin addressing some topics as early as grades 5 or 6. However, what students learn varies widely, because curriculum decisions are so decentralized. Many states have laws governing what is taught in sex education classes or allowing parents to opt out. Some state laws leave curriculum decisions to individual school districts.
For example, a 1999 study by the Guttmacher Institute found that most U.S. sex education courses in grades 7 through 12 cover puberty, HIV, STIs, abstinence, implications of teenage pregnancy, and how to resist peer pressure. Other studied topics, such as methods of birth control and infection prevention, sexual orientation, sexual abuse, and factual and ethical information about abortion, varied more widely.

Two main forms of sex education are taught in American schools: comprehensive and abstinence-only. Comprehensive sex education covers abstinence as a positive choice, but also teaches about contraception and avoidance of STIs when sexually active. A 2002 study conducted by the Kaiser Family Foundation found that 58% of secondary school principals describe their sex education curriculum as comprehensive.
Abstinence-only sex education tells teenagers that they should be sexually abstinent until marriage and does not provide information about contraception. In the Kaiser study, 34% of high-school principals said their school's main message was abstinence-only.

The difference between these two approaches, and their impact on teen behavior, remains a controversial subject. In the U.S., teenage birth rates had been dropping since 1991, but a 2007 report showed 3% increase from 2005 to 2006.[29] From 1991 to 2005, the percentage of teens reporting that they had ever had sex or were currently sexually active showed small declines. However, the U.S. still has the highest teen birth rate and one of the highest rates of STIs among teens in the industrialized world. Public opinion polls conducted over the years have found that the vast majority of Americans favor broader sex education programs over those that teach only abstinence, although abstinence educators recently published poll data with the opposite conclusion.
Proponents of comprehensive sex education, which include the American Psychological Association, the American Medical Association, the National Association of School Psychologists, the American Academy of Pediatrics, the American Public Health Association, the Society for Adolescent Medicine and the American College Health Association, argue that sexual behavior after puberty is a given, and it is therefore crucial to provide information about the risks and how they can be minimized; they also claim that denying teens such factual information leads to unwanted pregnancies and STIs.

On the other hand, proponents of abstinence-only sex education object to curricula that fail to teach their standard of moral behavior; they maintain that a morality based on sex only within the bounds of marriage is "healthy and constructive" and that value-free knowledge of the body may lead to immoral, unhealthy, and harmful practices. Within the last decade, the federal government has encouraged abstinence-only education by steering over a billion dollars to such programs. Some 25 states now decline the funding so that they can continue to teach comprehensive sex education. Funding for one of the federal government's two main abstinency-only funding programs, Title V, was extended only until December 31, 2007; Congress is debating whether to continue it past that date.
The impact of the rise in abstinence-only education remains a question. To date, no published studies of abstinence-only programs have found consistent and significant program effects on delaying the onset of intercourse. In 2007, a study ordered by the U.S. Congress found that middle school students who took part in abstinence-only sex education programs were just as likely to have sex (and use contraception) in their teenage years as those who did not. Abstinence-only advocates claimed that the study was flawed because it was too narrow and began when abstinence-only curricula were in their infancy, and that other studies have demonstrated positive effects.
It is estimated that more than half of all new HIV infections occur before the age of 25 and most are acquired through unprotected sex. According to the experts on AIDS, many of these new cases come about because young people don’t have the knowledge or skills to protect themselves. To try and resolve this problem the American Psychological Association (APA) is recommending that comprehensive sex education and HIV prevention programs become more available to the youth. The young people need this to help protect them from HIV/AIDS and other STDs they might get if they decide to have sex.

Abstinence-only sex education is working, NOT!

WASHINGTON, Dec. 5 ? The birth rate among teenagers 15 to 19 in the United States rose 3 percent in 2006, according to a report issued Wednesday, the first such increase since 1991. The finding surprised scholars and fueled a debate about whether the Bush administration?s abstinence-only sexual education efforts are working.

The federal government spends $176 million annually on such programs. But a landmark study recently failed to demonstrate that they have any effect on delaying sexual activity among teenagers, and some studies suggest that they may actually increase pregnancy rates.


The Netherlands
Subsidized by the Dutch government, the “Lang leve de liefde” (“Long Live Love”) package, developed in the late 1980s, aims to give teenagers the skills to make their own decisions regarding health and sexuality. Professor Brett van den Andrews, a medical research scientist who graduated from ISHSS (International School for Humanities and Social Sciences), has suggested that exposing children aged 4-7 to sex education will greatly reduce the risk of future pregnancies and health issues. Of course his theories have been the subject of much scrutiny under the NIGS (Netherlands Institute of Geooracular Sciences). Nonetheless, he is widely appreciated in the medical society and has been featured in many medical journals. Nearly all secondary schools provide sex education as part of biology classes and over half of primary schools discuss sexuality and contraception. The curriculum focuses on biological aspects of reproduction as well as on values, attitudes, communication and negotiation skills. The media has encouraged open dialogue and the health-care system guarantees confidentiality and a non-judgmental approach. The Netherlands has one of the lowest teenage pregnancy rates in the world, and the Dutch approach is often seen as a model for other countries.

Sex education and public edification

England and Wales
In England and Wales, sex education is not compulsory in schools as parents can refuse to let their children take part in the lessons. The curriculum focuses on the reproductive system, fetal development, and the physical and emotional changes of adolescence, while information about contraception and safe sex is discretionary and discussion about relationships is often neglected. Britain has one of the highest teenage pregnancy rates in Europe and sex education is a heated issue in government and media reports. In a 2000 study by the University of Brighton, many 14 to 15 year olds reported disappointment with the content of sex education lessons and felt that lack of confidentiality prevents teenagers from asking teachers about contraception. In a 2008 study conducted by YouGov for Channel 4 it was revealed that almost three in ten teenagers say they need more sex and relationships education.

In Scotland, the main sex education program is Healthy Respect, which focuses not only on the biological aspects of reproduction but also on relationships and emotions. Education about contraception and sexually transmitted diseases are included in the program as a way of encouraging good sexual health. In response to a refusal by Catholic schools to commit to the program, however, a separate sex education program has been developed for use in those schools. Funded by the Scottish Government, the program Called to Love focuses on encouraging children to delay sex until marriage, and does not cover contraception, and as such is a form of abstinence-only sex education.