Q: Should Congress be giving more financial support to abstinence-only sex education? NO: Withholding information about contraception and teaching only abstinence puts sexually active teens at risk

0 Comments | Insight on the News, Nov 10, 2003

Byline: Cory Richards, SPECIAL TO INSIGHT

Helping young people to understand the benefits of delaying sexual activity and to resist peer pressure is, and clearly should be, a cornerstone of sex education in the United States. Virtually no one disputes the importance of abstinence education. But support for abstinence-only education which ignores or actually denigrates the effectiveness of contraceptives and condoms is not based on scientific evidence; rather it is driven by a subjective moral and, for many, religious agenda. The nation's leading medical, public-health and educational organizations endorse sex education that includes positive messages about the value of delaying sexual activity along with information about condoms and contraceptive use to avoid sexually transmitted diseases (STDs) and unintended pregnancy. Public-opinion polls show that this also is the position of parents, teachers and young people themselves in the United States.

What does the evidence show?

* Teen-agers and young adults are at risk of unintended pregnancies and STDs for almost a decade between the time they initiate sexual activity and when they get married. By their 18th birthday, six in 10 teen-age women and nearly seven in 10 teen-age men have had sexual intercourse.

* Teen-age pregnancy happens. Nearly 900,000 American teen-agers (ages 15-19) become pregnant each year, and almost four in five (78 percent) of these pregnancies are unintended.

* Other countries do better. Despite recent declines, the United States has one of the highest teen-age pregnancy rates in the developed world. U.S. teen-agers are twice as likely to become pregnant as teen-agers in England, Wales or Canada and nine times as likely as those in the Netherlands and Japan.

* Teen-agers and young adults are at risk of STDs and HIV/AIDS. Four million teen-agers acquire an STD annually. Half of the 40,000 new cases of HIV infection in the United States each year occur to individuals younger than age 25. This means that every hour of every day an average of two young people become infected with HIV.

* Contraceptives and condoms are effective. While it is true that successfully abstaining from sexual activity is the only 100 percent guaranteed way of preventing pregnancy and disease, abstinence can and does fail. Extensive research demonstrates that correct and consistent use of contraceptives, including condoms, radically reduces one's risk of pregnancy and disease among those who are sexually active.

Despite the clear need to help young people make safe decisions regarding sexual activity so that they can delay the initiation of sexual intercourse and protect themselves from unintended pregnancy and STDs when they become sexually active, U.S. policymakers continue to promote school-based, abstinence-until-marriage education that fails to provide accurate and complete information about condoms or other contraceptives.

Overall, federal and matching funding from states for abstinence education that excludes information about contraception has totaled more than $700 million since 1996. There is, on the other hand, no federal program dedicated to supporting comprehensive sex education. Federal law contains an extremely narrow eight-point definition of abstinence-only education that sets forth specific messages to be taught, including that sex outside of marriage for people of any age is likely to have harmful physical and psychological effects. Because funded programs must promote abstinence exclusively, they are prohibited from advocating contraceptive use. They thus have a choice: They either must refrain from discussing contraceptive methods altogether or limit their discussion to contraceptive failure rates. Further, in many cases federal law prevents these programs from using their private funds to provide young people with information about contraception or safer-sex practices. Yet even today, many policymakers remain unfamiliar with this extremely restrictive brand of abstinence-only education required by federal law.

Considerable scientific evidence shows that certain programs that include information about both abstinence and contraception help teen-agers delay the onset of sexual activity, reduce their number of sexual partners and increase contraceptive use when they do become sexually active. Indeed, leading medical, public-health and educational organizations, including the American Medical Association, the American Academy of Pediatrics, the American College of Obstetricians and Gynecologists and the National Institutes of Health, support sex-education programs that both stress abstinence and teach young people about the importance of protecting themselves against unintended pregnancy and disease when they become sexually active.

In contrast, there have been few rigorous evaluations of programs focusing exclusively on abstinence. None of these has found evidence that these programs either delay sexual activity or reduce teen pregnancy. Finally, research on virginity-pledge programs and HIV-prevention efforts suggests that education and strategies that promote abstinence but withhold information about contraceptives (and condoms, in particular) may have harmful health consequences by deterring the use of contraceptives when teens become sexually active.