Only abstinence as the answer

Teen-agers: Programs that urge chastity flourish as their effectiveness is increasingly questioned.

February 29, 2004|By David Kohn | David Kohn,SUN STAFF

Marquis Page has been tempted, plenty of times.

"I could have a baby, the situations I've been in," he says.

But so far, the witty, outgoing 19-year-old has stayed chaste. He traces his discipline to the weekly abstinence classes he attends at New Creation Christian Church in Northeast Baltimore. Led by the program's charismatic director, Anthony Allen, a group of 20 to 35 teen-agers meets every Wednesday night in the church basement.

Sitting in a large circle, they talk openly about the physical and emotional risks of premarital sex, the pull of peer pressure and the reality of hormone-fueled adolescent urges. Last year, Allen led a prom-like celebration at a downtown hotel, at which about 20 teen-agers, including Page, made a formal pledge to avoid sex until marriage.

Page, who studies business at the Community College of Baltimore County's Essex campus, is a model of "abstinence-only" education. This approach encourages young people to avoid sex until marriage, while offering little information about contraception.

Since 1998, abstinence-only instruction has proliferated, fueled by a huge increase in federal funding. Over that time, federal and state governments have given out almost $1 billion to programs such as the one at New Creation.

The Bush administration hopes to spend even more. In his State of the Union speech last month, President Bush promised to double annual funding for abstinence-only education to $270 million. "Abstinence for young people is the only certain way to avoid sexually transmitted diseases," Bush said.

But many public health researchers say the programs remain, at best, unproven. While the method works well for some, they say, it has no effect on many others, who become sexually active with little knowledge of safe sex. At the same time, some "comprehensive" approaches - which include information about condoms and contraception - have been proven, these scientists say.

"We have programs that have been demonstrated to work. There's no reason not to use them," said Douglas Kirby, a sociologist for ETR Associates, a private firm that studies and carries out public health programs. Kirby, who has studied teen-age sexual behavior for 25 years, says five comprehensive programs have been rigorously evaluated and shown to work.

Abstinence-only proponents say that providing contraceptive information undermines the no-sex message and encourages teen-agers to think that protected sex is without risk.

"It's like if I put my seat belt on and then drive 120 miles per hour," said Alma L. Golden, deputy assistant secretary for population affairs at the Department of Health and Human Services. A longtime proponent of the abstinence-only approach, she is deeply involved in the administration's efforts.

Until the late 1990s, the main approach to sex education was the comprehensive method, which encourages abstinence while also offering information on condoms and other contraception. This approach assumes that many teen-agers will have sex regardless of what adults tell them and should know how to minimize their risk.

From this perspective, abstinence-only seems illogical. "It's an ideological position, not a public health strategy," said sociologist Judy Auerbach, public policy director of the American Foundation for AIDS Research, which opposes increasing federal funds for abstinence-only programs. She says that it is unrealistic to expect people to stay abstinent until they are 26 - the average age of marriage in the United States.

Everyone agrees that teen-age sexual behavior must be changed. Although teen-age pregnancy rates in the United States have been falling for a decade, they remain much higher than in most other Western countries: Six in 10 teen-agers are sexually active by the time they finish high school; every year, almost 3 million teen-agers contract a sexually transmitted disease; and each year more than 20,000 Americans between 13 and 24 are infected with HIV.

Because it is so new, abstinence-only has received relatively little analysis. In an attempt to settle the question conclusively, the federal government has funded a major four-year, $5 million national study of 2,500 youths who are taking abstinence courses. Preliminary findings will be out this spring, but results won't arrive until next year. Unlike many sex-education studies, which only examine attitudes toward sex, this one will focus on behavior, which is more difficult to measure.

The study's leader, University of Pennsylvania social scientist Rebecca A. Maynard, underscores her objectivity: "I don't have a personal view on this. My job is to find out how well these programs work, and for whom."

The few serious studies of abstinence-only programs have generally found them ineffective. A recent evaluation of Minnesota's $5 million program reported that it made no difference among middle school students.

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