To prevent HIV-AIDS in teens, teach abstinence

“Federal funding [for HIV-AIDS] has leveled off in the last few years, but at the same time funding for abstinence-only education has skyrocketed,” said Dr. Dora Anne Mills, director of the Maine Center for Disease Control. “In public health, we try to do what is driven by science, and this ideology-driven sex education doesn’t address HIV-AIDS.”

Bangor Daily News, Nov. 30

How can an article on people in Maine living with HIV-AIDS turn into an attack on abstinence education? Certainly we can be supportive of people with HIV-AIDS while embracing effective primary prevention of this disease, particularly with school-age teens!

Dr. Dora Anne Mills is a strong public opponent of abstinence education and a spokeswoman for the Baldacci administration. Under this administration, Maine became only the third state to refuse state block grant funds for abstinence education. Mills speaks for those who support sex education with a double message: Abstinence is best, but included is a display of condoms and contraceptives for those who decide to become sexually active.

The “emphasis on abstinence” written into Maine state law appears to be a remnant of a time when Maine parents and teachers believed young people could be effectively educated in its practice. But the new law largely reflects the view that teen sexual activity has become the norm and primary prevention is, therefore, no longer possible.

Even so, prevention applied to the cause of the problem must be the foundation of public health and education policy. Witness the effects of the federally funded tobacco campaign of recent years on high school student smoking: a drop from 39.2 percent in 1997 to 20.5 percent in 2003, a decline of 48 percent (Action on Smoking & Health, 2003). It is not hard to justify a decade of updated and renewed efforts and funding for promoting abstinence as the primary prevention strategy for teen pregnancy, sexually transmitted diseases, and the distressing emotional and relationship problems of early sexual initiation.

The medical advances over the past quarter century have brought quicker identification and more effective drug treatment to those with HIV-AIDS. The epidemic in this country turned out to be less severe then expected. Why? Along with the resources applied, awareness and information about the disease influenced sexual behavior? Education on the benefits of abstinence informs and supports behavior to avoid the negative consequences of premature sexual activity. We can inform the next generation about real sexual health that not just reduces but eliminates the risk of disease and related infertility.

Nationally, teens now represent 25 percent of new cases of HIV-AIDS. Fifteen- to 24-year-old sexually active females now represent 75 percent of chlamydia cases in Maine, rising steadily in number over the last 10 years (Maine CDC, 2005). The sexual behavior of teens includes both vaginal and oral sex. Condoms and contraceptives are not effectively preventing oral transmission of sexually transmitted infections.

And with state leadership protecting the condom-contraceptive message for teens, what are parents doing to protect their children from the toxic sexual culture and pressures that expose them to the risks of sexual activity? Parent acceptance of the “risk reduction” approach of condom-contraceptive education reinforces the acceptance of adolescent sexual activity. The Maine STD statistics do not warrant such complacency.

Sexual initiation in the teen years too often leads to multiple sexual partners and increased exposure to pregnancy and sexually transmitted diseases, especially for females on into their 20s. With at least 26 percent of children in Maine born into single-parent families, these mothers and their children will face higher rates of poverty along with educational and social problems. Abstinence education programs have developed age-appropriate, medically accurate and effective programs that delay sexual initiation among teens. Maine lags behind many states in the nation in strengthening this primary prevention effort.

Implementing a new health direction takes resources. Abstinence education funding, rising over the last decade, is a mere 12 percent of contraceptive education resources that have been available for decades to Planned Parenthood and family planning agencies. According to federal guidelines, abstinence is the expected behavior for school-age children. Abstinence is the developmentally appropriate behavior for health and wellness. Polls of 12- to 17-year-olds conducted by the National Campaign to Prevent Teen Pregnancy reveal that most teens believe that sex is unacceptable for high school teens. A total of 93 percent said it is “somewhat” or “very important” “for teens to be given a strong message from society that they should abstain from sex until they are at least out of high school.” Such views should be supported by schools, youth agencies and at the state level.

Abstinence education addresses HIV-AIDS, presenting the disease process and the behaviors that put one at risk for contracting it. Early sexual activity and multiple sexual partners multiply that risk. But to a greater extent, abstinence education presents information and activities about becoming a fully developed person with qualities that make relationships successful, all before taking on the risks and responsibilities of sexual intimacy. This represents strategic use of available physical and social information delivered by adults who truly care about each teenager, their health and future success.

Meg Yates RN, MA, is the program coordinator for Heritage of Maine in Portland.