STDs on the rise despite sex education

Baptist Press
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Posted: Nov 25, 2009 1:15 PM
WASHINGTON (BP)--The rates of sexually transmitted diseases in the United States are among the highest of any developed country in the world, a spokesman for the Centers for Disease Control and Prevention said after a study found that STD cases continue to rise.

The CDC study released Nov. 16 said chlamydia and gonorrhea are stable at unacceptably high levels, while syphilis, a life-threatening disease that was on the verge of being eliminated a decade ago, is resurgent.

Overall, the CDC estimates that 19 million new sexually transmitted infections occur each year and almost half are among 15-24-year-olds, but the study found that 63 percent of syphilis cases were among men who have sex with men. Syphilis cases increased by nearly 18 percent since 2007, the study said.

Valerie Huber, executive director of the National Abstinence Education Association, said the high rates of STDs among teenagers likely stem from a combination of causes.

"If you look at chlamydia and gonorrhea, we know that up to 80 percent of those who have the disease don't even know it, so they can easily spread it to others," Huber told Baptist Press. "Chlamydia especially is asymptomatic. Gonorrhea is to a lesser degree. Even if a partner says, 'I'm clean,' they might think they are, but they're not."

Also, Huber noted the highly sexualized culture in America where teen sex is depicted as expected and without consequences, and she said the cultural view of teen sex may place undue pressure on that age group.

"Teens are risk takers, and they know people can get STDs, but they're sure they aren't going to be one of them who gets it," she said. "I think that's another thing. A third is that trust is really a major issue when teens decide whether or not to have sex. So if a boyfriend or a girlfriend says that they don't have an STD, they're going to believe them. In the meantime, they've just engaged in a very risky behavior and have in all likelihood acquired an STD as a result."

Huber said about 68 percent of sex education programs across the country teach contraceptive education.

"Contraceptive promotion education probably is more accurately stated. They give a green light to a lot of gateway sexual activities that put teens at risk for STDs, and all the while the programs are implying that these gateway activities are not risky and completely ignoring the fact that these behaviors usually lead to sexual intercourse," she said. "Even when they don't, teens can acquire some of the most widely transmitted STDs."

Huber mentioned a Reuters report which said abstinence education was promoted by former President George W. Bush but President Obama has proposed the elimination of federal funding for such programs.

"The fact that President Obama is seeking to zero out all funding for abstinence education is a mistake, particularly when we look at these STD rates," Huber said. "We know that the earlier a person becomes sexually active, the more lifetime partners they're likely to have, and the more lifetime partners they have, the more likely they will be to be infected with an STD.

"Our primary goal should be to give young people the skills they need to delay sexual activity, which are exactly the skills that an abstinence program provides rather than zeroing those out," she said.

Abstinence education supporters were encouraged Nov. 18 when funding was partially restored within the Senate Health Care Bill as a result of Sen. Harry Reid, D.-Nev., reconciling versions offered by the Health, Education, Labor and Pensions committee and the Finance Committee.

Earlier this fall, the Senate Finance Committee voted to restore $50 million in funding for abstinence education, which Obama had cut from his budget proposal to Congress. Huber acknowledged that the survival of the funding in the current Senate bill is "only an intermediate victory" because much work remains on health care.

"We certainly hope that remains in the bill. But the president has not supported that, and heretofore, Congress has been making policy decisions based on the president's recommendations," Huber said.

In the debate over which approach is most effective at curbing the STD and teen pregnancy epidemic, Huber said it's important to tell teens the truth about the risks involved in sexual activity rather than sugarcoating it by implying they're safe as long as they use a condom.

"For the Reuters report to imply that we just need to increase condom education and that's going to stem this, that's looking shortsightedly and it's also not taking into consideration the total medical impact and transmissibility of these diseases," she said.

In early November, the CDC released a report saying sex education programs that teach teenagers about contraception result in increased condom use and lower chances of contracting HIV and other infections. The report also said there was insufficient evidence to determine whether abstinence education programs, which teach teens to delay sexual activity, actually worked.

There was, however, a minority report released along with the CDC study in which two members of the independent panel of 19 experts cited "serious limitations" which "lead us to conclude that the statements about the general effectiveness of the comprehensive risk reduction (CRR) strategy are not warranted by the data."

The dissenting voices said the CDC recommendations "also fail to acknowledge the evidence for the effectiveness of abstinence education (AE) programs at reducing teen sexual activity, and invite conclusions that CRR is a superior approach to AE, which is not supported by the evidence."

Among their concerns is that in the meta-analysis of 83 studies of sex education programs the CRR category was created by collecting everything that was not a study of "abstinence-only" sex education, resulting in what they called a "very heterogeneous category that exceeds the limits of good meta-analysis design." This problem, the duo said, undermines the validity of the entire study.

"The resulting internal inconsistency in the results indicates there are many types of CSE programs that don't work, yet the study concludes that CSE programs are broadly effective," Irene Ericksen, one of the minority report authors, said.

"This, along with the lack of evidence for school-based programs, makes the study's recommendations potentially misleading to policy-makers who want to implement evidence-based programs, especially in schools," Ericksen added. "Unfortunately, the statistical evidence that demonstrates the above discrepancies was not released to the public along with the study's recommendations statement."

Huber said the fact that the main CDC report said evidence regarding abstinence education is inconclusive should not be misconstrued or interpreted as not effective.

"What that's actually saying is something that's consistent with any research for any relatively new program and that is it takes about a generation before you begin to acquire research for effectiveness," she said.

"That generation is about 10 years, and we're just barely beyond that mark for abstinence education. I think what the minority report points out is that although this is a young field in research years, there is already some data that shows that abstinence programs are effective at helping teens delay sex, which is exactly what they would say that their goal is," Huber said.

Huber said it's "astounding and disconcerting" that the CDC missed an opportunity to highlight the value of abstinence education programs.

"I think it's really important that that minority report be given credibility and that their concerns and comments be taken seriously because they were privy to all of the raw data," she said. "They spent hours and hours around the table with the other researchers reviewing it and looking at the conclusions. They have concerns that none of the rest of us can adequately speak to because we haven't seen the raw data. So I'm very thankful that they had the courage and tenacity to make their concerns public."

Erin Roach is a staff writer for Baptist Press.

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