School abstinence programs bad for teens?

By STEVE MITCHELL, Medical Correspondent  |  Sept. 4, 2003 at 5:17 PM
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WASHINGTON, Sept. 4 (UPI) -- As the new school year starts, students across the nation are more likely than in years past to receive sex education that focuses only on abstinence and does not give them information about contraceptives. As a result, some groups are concerned this growing trend could portend a rise in teen pregnancy and sexually transmitted diseases.

Since 1998 there has been a dramatic increase in the number of schools and community organizations teaching abstinence-only sex ed. programs. This is due largely to several measures passed by Congress that, in total, dole out more than $100 million annually for these programs, although they have not been shown to be effective at reducing pregnancy or risky sexual behavior.

As a condition of receiving the federal funds, schools must promote abstinence until marriage exclusively and are prohibited from mentioning contraceptives as a way to prevent pregnancy or disease, except to discuss their failure rate. Schools also are required to emphasize sex before marriage is likely to have harmful psychological and physical effects.

Teen pregnancy rates have been declining since 1990 but studies have indicated the decrease was due to both increased use of contraceptives along with an increase in the number of teens practicing abstinence.

"We fear these types of programs and the denial of information about contraception to young people may expose them to unintended pregnancies and sexually transmitted diseases," Cynthia Dailard, senior public policy associate with the nonprofit Alan Guttmacher Institute in Washington, D.C., told United Press International.

Comprehensive sex ed. programs encourage abstinence. But they also discuss contraceptives and other aspects of sexuality. Although they are endorsed by many major medical groups and have been shown to delay the age at which teens first have sex, reduce the number of sexual partners and increase the use of contraceptives, there is no comparable federal program to support them.

In contrast, abstinence-only programs have the support of both Congress and the White House. President Bush has urged Congress to increase support for the abstinence-only programs by tens of millions of dollars for fiscal year 2004 and the legislative body looks likely to heed his request when it takes up the issue, which could be as early as this month.

Despite the federal support, abstinence-based programs have not been shown to delay having intercourse or reduce the number of sexual partners, according to the Sexuality Information and Education Council of the United States in New York City. In fact, SIECUS says, some evidence suggests abstinence programs actually might be riskier than comprehensive programs because kids who have received only the abstinence message are less likely to use contraceptive when they do become sexually active.

"Everyone is very fearful that we're going to see these positive trends in teen pregnancy reduction be reversed in the future," SIECUS spokeswoman Adrienne Verrilli told UPI.

There already are some indications the programs are having a negative impact, Verrilli said. Recent analyses have indicated condom use might be leveling off among youth, compared to past years when it was increasing, she said. In addition, AIDS cases have increased in several southern states at a time when the disease is declining or leveling off in other parts of the country. Abstinence-only programs are most predominant in the South and although cause and effect is difficult to show, there is some concern the programs could be contributing to the increase in AIDS in that region.

Libby Gray, of Project Reality, an abstinence advocacy group in Golf, Ill., with programs in more than 20 states, said her group's abstinence program has been shown to be highly effective in changing sexual behavior of teens.

"There has been comprehensive sex ed. that has been going on in this country for many, many years and we have not seen a reduction in teen pregnancies until federal funding for abstinence programs" was put in place, Gray said.

David Landry, Senior Research Associate with AGI, noted the decline in teen pregnancy actually began prior to federal funding for abstinence programs.

"There's a very strong research base which shows that comprehensive programs that promote a strong delay message as well as giving students the skills to avoid pregnancy and STDs when they are sexually active are the most effective and we should continue to invest in those programs and improve upon them," Landry said.

Gray said a comprehensive-based program is unnecessary because "teens are aware that contraception is out there, they know it's available." A better message, she said, "is to teach them you can say 'no' -- that you can control your sexual urges." Abstinence programs also give teens strategies to help resist peer pressure and how to have healthy relationships, she said.

Comprehensive sex education programs seem to have their own positive influence, however, because they are associated with lower teen pregnancy rates in other industrialized countries, where such programs are taught in schools. The U.S. teen pregnancy rate -- totaling about 900,000 pregnant teens each year -- is twice as high as the rate in the United Kingdom and Canada and four times that of France and Sweden -- all countries that teach comprehensive sex ed. to their youth.

Yet as a consequence of the federal funds for abstinence-only programs, 86 percent of public school districts that teach sex ed. in the United State require that abstinence be promoted. Thirty-five percent require abstinence to be taught as the only option. This is most prevalent in the South, where more than half of all school districts employ an abstinence-only sex ed. policy.

In addition, teachers themselves are more likely to focus on abstinence compared with 15 years ago. They also are less likely to give students information on contraceptives and how to obtain them and abortion.

Bill Albert of the National Campaign to Prevent Teen Pregnancy, said focusing on the content of sex ed. programs could ignore other important factors in a teen's decision to have sex. Other elements, such as peer pressure, sexual messages in the media and parental influence might have a bigger impact and these also should be addressed, Albert said. "It's probably a combination of all those things and probably 500 other things ... no single one is going to make the difference," he added.

Still, teens should be armed with all the relevant information on both abstinence and contraceptives, he said. "It would give me great concern if young people decided their only option for preventing teen pregnancy is abstinence because we know many young people are or will become sexually active," he said.

The majority of U.S. teens -- about two-thirds -- have engaged in sex by the time they are 18. In addition, about 4 million teens each year acquire sexual diseases such as chlamydia, gonorrhea and AIDS.

The Bush administration proposed increasing funding for abstinence programs by $33 million in FY 2004 to bring total funding to about $135 million annually. Bills introduced in the Senate and House chambers of Congress have called for a $10-18 million increase in 2004.

"It's certain there will be some increase, it's just the size right now that's the question," Dailard said.

Bush recently was accused of misrepresenting the effectiveness of abstinence-only programs in a report released by the minority (Democratic) staff of the House Committee on Government Reform's special investigations division. The report, titled, "Politics and Science in the Bush Administration," accuses the president of using ideology to drive his science policy decisions.

The administration also is accused of altering performance measures to evaluate abstinence-only sex ed. programs to make them appear more effective than they are. The report also noted the administration removed from the Web site of the Centers for Disease Control and Prevention in Atlanta a section called "Programs That Work," which included information on comprehensive sexual education programs that had been evaluated scientifically and shown to be effective.

White House officials did not return UPI's phone call seeking comment.

The Department of Health and Human Services recently doled out $15 million in grants to schools and community organizations for abstinence programs and more money is expected to be distributed this fall. The Alan Guttmacher Institute is concerned by the groups receiving the funding because it says many of them are self-described, Christian faith-based organizations and they will use religious influence, misinformation, and shame and fear to promote their abstinence message. An example is The Life Choices Pregnancy Support Center of Dyersburg, Tenn., which includes a six-week Bible study in its abstinence program, the institute reported.

Support by both the administration and Congress for the abstinence-only programs is in direct contrast to surveys by the Kaiser Family Foundation of Menlo Park, Calif., that show the majority of Americans and most parents favor including discussion of contraceptives, abortion and other sexuality issues along with abstinence in school-based sex ed. programs.

A bill expected to be introduced in Congress soon could help level the playing field for comprehensive sex ed. programs. The Family Life Education Act, sponsored by Reps. Barbara Lee, D-Calif., and James Greenwood, R-Pa., would authorize $100 million annually for 5 years to support state programs that present information on both abstinence and contraceptives.

The bill was introduced last year but stalled in the legislative process. Lee plans to re-introduce the bill next month, her spokesman, Stuart Chapman, told UPI.

In the meantime, some states are advancing comprehensive sex programs on their own. "Some individual school districts and states are moving in that direction," AGI's Landry said. There are model programs in California and New Jersey "and in many states you can point to individual school districts or even state leadership that is advancing more comprehensive programs," he said.

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