Friday, December 15, 2006

The Failure of Abstinence-Only Sex Education Programs - Indira Nsiah Nketiah

In America today, Abstinence-Only Sex Education Programs are being offered all through public school systems in hopes of encouraging youth to abstain from sexual intercourse until marriage. These programs are government funded interventions that aims to reduce the number of youth engaging in sexual acts. Unfortunately these programs have received harsh criticism from the public and research has proven that they are ineffective and a misuse of government tax dollars. The Society for Adolescent Medicine has currently rejected the administration policy that promotes abstinence as the only sexual health prevention strategy for young people publishing a report that stated:“… federal abstinence-only-until-marriage policy is ethically problematic, as it excludes accurate information about contraception, misinforms by overemphasizing or misstating the risks of contraception, and fails to require the use of scientifically accurate information while promoting approaches of questionable value…. Abstinence-only programs threaten fundamental human rights to health, information, and life.” (1) An MSNBC news contributor, Arthur Caplan, PhD stated that “There may be a sillier strategy for dealing with sex among teens than promoting the choice of "abstinence-only-until-marriage," but I am not quite sure what it is.” He also goes on to explain in his article that such approaches designed for youth contradict what medicine and science proves about teens and sex. (2) If ineffective, why have these programs been created, and why are government officials and administration, with the assistance of the education board and school systems, promoting this ineffective strategy?

Sex among teens is more common in America today than ever before with the excessive exposure of sexual contents on TV screens, radios and magazines. Sex is no longer the private act between married couples but now an acceptable societal behavior. Society has acknowledged sex before marriage and has viewed it as acceptable. The young people are exposed to sex at early stages of life and are therefore engaging in sexual behaviors before they hit maturity and also sooner than marriage. The youth are at a curiosity period in their years and want to experience a range of things. Since sex is publicized everywhere, they are almost forced into this lifestyle. The values and importance of sexual behaviors have been lost and some educators along with Congress are hoping to re-establish its purpose by designing programs to educate the youth and aid in the prevention of sexual activities before marriage.

Abstinence-Only sex education is defined as an educational or motivational program which teaches the social, psychological, and health gains which comes as a result of abstaining from sexual activity. (3) It also teaches that abstinence is the only certain way to avoid out of wedlock pregnancy, STDs, and other health related problems and those children born outside of wedlock will have harmful upbringing for the child, the parents and the society. (3) It further explains that sexual activities outside marriage are likely to create harmful psychological and physical side effects. The program also teaches teenagers how to reject sexual advances and also how the usage of drugs and alcohol can increase chances of engaging in sexual activities. (3) The program is heavily dedicated to abstinence only as the only safe way and does not include education of contraception or condom use unless they are condemning its failures and limitations. (4) This is harmful because when teenagers decide to engage in sexual activity, there may not be aware of the precautions such as protection and contraception. But there are diverse groups of Abstinence-Only programs. Some may educate on abstinence and contraception which others are strictly on no-sex-before-marriage agenda.

Abstinence Only Sex Education programs have failed to reduce the number of teens engaging in sexual behaviors because they are based on the Health Belief Model. These programs do not also take into relation other factors such as peer and cultural social norms and have mistakenly relied on the usage of the normative-reeducation approach to encouraging abstinence without educating the youth on sexual safety. The designed program is very constricted and uses forceful tactics in its educational practices. Three main arguments supporting this criticism are; lack of support from researchers and activists, failure to mention other safer sex practices, and the contradiction of what science and medicine explains about teen sex.

The Health Belief Model is used to make judgments on costs and benefits on an issue which is in turn used to adapt an intervention that goes on to be the perceived behavior. The behavior in which public health officials hoped is abstinence and looked at perceived severity, harm, benefits and barriers that possibly will cause the need for this program. The supposed severity and harm of sexual intercourse were pregnancy, testing positive for HIV/AIDS, contracting Sexually Transmitted Diseases, and having emotional crashes such as suicide. Teenagers are seen as rational decision-makers who would weigh different options regarding sexual behavior, when presented with the information about harms of sexual intercourse. The program’s innovators hoped that once they provide the youth with the information, they will think twice about perhaps the benefits of sexual intercourse and rationally choose to abstain. They hoped this program will help and not constrain when it comes to making choices about sex. This strategy does not take into account the psychology of the teenager. It does not consider if the teenager may end up being rebellious towards this program, or have social norms that may prohibit them from benefiting from the program.

These programs should have considered the Social Learning Theory which looks at the health outcome expectancies along with self efficacy to make judgments on a behavior. This theory would have allowed the public health officials to reason if they believed teenagers participating in the programs would portray the expected health outcome. They should have thought if the teenagers would be able to do this behavior without any temptation. Using this theory, they would have understood that self efficacy plays a major role and that many youth receiving this course may believe that they cannot perform the behavior and this would influence whether they can actually accomplish it. Many of the teens may have already engaged in sexual intercourse and therefore believed they could not become abstinent. It could also be that some of the kids were products of teen pregnancy and may see it as ok for them to also engage in sex at such young ages as well. Also it has been shown that when teens reach a certain age, parents end up explaining to them that it is ok for them to engage in sexual activities as long as they use protection. All these point to why the program is not as successful as government and some organizations would have anticipated.

One argument why this program has failed is the lack of support from researchers and activists. There have been numerous research and studies that has surveyed adolescents participating in the program and some of the results have shown the ineffectiveness of the intervention. In Texas for instance, the program has had little impact on the behaviors of the teenagers according to an ongoing study developed by the Texas Department of Health. (5) The Health Department examined five abstinence only programs at 24 schools and presented to the students a questionnaire on their sexual behavior. The results of the study showed there was little or no change in sexual behaviors among students participating in the program and may have possibly helped increase the number of youth engaging in pre marital sex. There was no result that showed strong evidence of the usefulness of the program. This is just one example of research done to prove the ineffectiveness of these abstinence-only programs. There have been several other studies that have confirmed that there are many other reasons that cause the increasing numbers in teenage pregnancy and spread of diseases and that the program should cover all foundation and not concentrate heavily on abstinence as the only gain. Researchers worry about the over funding these programs receive from the federal government and the lack of thorough research funding to effectively conduct efficient studies.

Organizations such as The American Medical Association, the American Academy of Pediatrics, the American Public Health Association, and the American College of Obstetricians and Gynecologists all support comprehensive sex education programs that encourage abstinence while also providing adolescents with information on how to protect themselves against sexually transmitted diseases. (6) This leads into another reason for the failure of this program. Researchers are also afraid of the lack of science and medicine in the education of the programs may cause for the flop of the intervention. Some of the programs are giving false information on sexual safety. The educational curriculum may not include the teaching on the use of condoms and contraception which helps prevent unwanted pregnancy and diseases. They are not teaching responsible sexual behaviors which could have benefited in positive results such as delayed initiation of sex, reduction in frequency of sex, and an increase in the usage of contraceptives.

According to reports shown, the United States has among one of the highest rates of teenage pregnancy in a developed region and also has the fastest growing cases of HIV among the youth in a demographic group (7). With this known, just educating on abstention will not result in the lowering of these numbers. It will require the teaching of proper sexual education which should include the use of contraception and condoms which the abstinence only program lacks. They believe in no sex before marriage as the only acceptable measure. These programs then lie to the teenagers and tell them outrageous stories such as HIV can be spread via sweat and tears, condoms fail to prevent HIV transmission as often as 31 percent of the time especially in heterosexual intercourse, abortion can lead to sterility and suicide, half gay male teenagers in the US have tested positive for AIDS, and the last but not least false, misleading, and distorted information in the program’s teaching material is that touching a person's genitals can result in pregnancy.(8) This information given to the teenagers are faulty and gives wrong educational information to young adults. This makes the program ineffective because false information is ground for more danger because once a kid engages in sexual intercourse, after going through the program, could have unprotected sex which could cause pregnancy, diseases, or emotional damage.

In conclusion, Abstinence-Only programs need to be revised in order to properly educate the youth on safer sex practice. They can teach and promote abstinence since it is the safest way to prevent pregnancy and diseases but failure to mention other safer sexual habits only harms the teenagers than benefits them. The program has to include truthful facts about teenage sex and run several other researches before teaching the programs to the youth communities. There are other options such as Comprehensive sexual education programs that have shown that their programs show there is a delay in sexual activity and an increase in the likelihood of using contraceptives when individuals become sexually active(9). These are better ways to reducing the number of teenage pregnancies and sexually transmitted diseases in America in addition to the practice of abstinence.

References
1. Advocate for Youth; "Effective Sex Education", http://www.advocatesforyouth.org/publications/factsheet/fssexcur.htm accessed November 25th 2006
2. Caplan, Arthur Ph.D., 'Abstinence-only sex Ed defies common sense', http://www.msnbc.msn.com/id/9504871/ accessed November 25th 2006
3. Advocate for Youth; 'Point Definition of Abstinence-Only Education as Defined by Section 510(b) of Title V of the Social Security Act, P.L. 104-193' http://www.advocatesforyouth.org/abonlydefinition.htm Accessed December 1st 2006
4. Crystal Phend, Aangus, Zalman MD. 'Abstinence-Only Sex Education not Good Enough' University of Pennsylvania School of Medicine. http://www.medpagetoday.com/OBGYN/STDs/tb/4449
5. Medical News Today, Abstinence-Only Sex Education Programs Have Little Effect on Texas Teenagers' Behavior, Study Says, http://www.medicalnewstoday.com/medicalnews.php?newsid=19531 Accessed December 2nd 2006
6. Welfare Reform: A Review of Abstinence Education and Transitional Medical Assistance, April 23, 2002: Hearing before the Subcommittee on Health, House Committee on Energy and Commerce, 107th Congress, 2002, testimony of David W. Kaplan, MD.http://www.ucsusa.org/scientific_integrity/interference/abstinenceonly-education.html
7. Planned Parenthood; Sex & Censorship Committee, National Coalition Against Censorship, Published by the Katharine Dexter McCormick Library http://www.plannedparenthood.org/news-articles-press/politics-policy-issues/teen-pregnancy-sex-education/abstinence-6236.htm
8. Ceci Connolly, Some Abstinence Programs Mislead Teens, Report Says, http://www.washingtonpost.com/wp-dyn/articles/A26623-2004Dec1.html
9. Sierra Club; Global Population and Environment. http://www.sierraclub.org/population/abstinenceonly/ accessed December 10th 2006

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