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Nine groups in Colorado received federal grants to teach abstinence-only sex education. Eight programs are flourishing, but one group recently gave up. It's president explained, "Abstinence-only does not work in our community that well. … It did not teach students responsible sexual behavior." Teens were not responding to the "stern message" (Denver Post, March 13).

Those few words speak volumes about why that group's efforts failed.

Abstinence is not a "stern message."

It's positive, self-affirming, self-empowering: You can control yourself.

You are worth waiting for.

You don't have to live in fear of pregnancy, STDs, dying from AIDS.

And what exactly is "responsible sexual behavior" for students? No sex after 10 P.M. on school nights?

A local Planned Parenthood official added her opinion on the program's demise: "The abstinence message is not a responsible one nor is it reasonable or realistic."

This statement, unfortunately, sums up the thinking of those in the business of promoting "safe" sex education.

The ideology that holds abstinence unworkable and credits "sex ed plus" (plus contraception) with the declines in teen pregnancy, abortion and births is so prevalent in the public health community that these views have achieved the status of conventional wisdom.

Recently this bit of conventional wisdom was exposed as a fraud in a ground breaking report entitled "The Declines in Adolescent Pregnancy, Birth and Abortion Rates in the 1990s: What Factors Are Responsible?" Commissioned by the Consortium of State Physicians Resource Councils, representing thousands of practicing doctors, the report confirms that abstinence, not increased contraceptive use, is the "primary reason for the decline in teen pregnancy and birth rates throughout the 1990s."

Here's a look at some of the myths the research debunked.

Myth: Teens are using more and better contraceptives. "Increased contraceptive use— especially condoms—was a major factor in the decline of unintended pregnancies" (National Adolescent Reproductive Health Partnership, Winter 1998 Update).

Reality: Although condom use increased 33% among teens during the period that teen pregnancy rates were dropping, the rise in condom use did not help reduce teen pregnancy rates. Increased condom use was outweighed by a striking 45% decline from 1988 to 1995 in the use of the oral contraceptives (OCs) among females age 15-19. The net decrease in use of either method is 14.5%.

Worse, from the standpoint of "pregnancy prevention," condoms are far less effective in preventing pregnancy than OCs. And the current usage rate for injectable or implantable "contraceptives" among teens (7%) offsets only partially the reduced pregnancy protection resulting from the widespread abandonment of OCs.

So sexually experienced teenage girls are far less protected from pregnancy today than they were in 1988.

Yet, teen pregnancy rates have decreased more than 9% from 1992 to 1995 alone (to fewer than 91 pregnancies/1,000 girls from almost 100 pregnancies/1,000. Teen birthrates (age 15-19) also have dropped almost 12% between 1991 and 1996 (to under 55 births/1,000 from 62 births/1,000).

Could the decline in birthrate be due to a greater rate of abortions among teens? No. The abortion rate among females age 10-19 has dropped over 28% between 1990 and 1995, to 13.5 abortions per 1,000 from almost 19 abortions per 1,000 teens. How can all these rates be dropping if sexually experienced teenage girls are less well protected today from pregnancy?

Myth: Pregnancy and birth rates for teens are declining so the "safe sex" message must be working.

Reality: Pregnancy and birth rates are not declining among "sexually experienced" (ever had sex) and "sexually active" (sex in past 3 months) teens. In fact, they are rising sharply.

The government calculates the birthrate among adolescents by dividing the total number of births to teen mothers by all female teens. This is highly misleading because abstinent females do not become pregnant. Their rates of pregnancy/birth remain steady at zero/1,000.

Subtracting abstinent girls from the formula (and 5.7% more females age 15-19 were abstinent as of 1995 than in 1988), the nonmarital birthrate among experienced teens rose almost thirty percent, to almost 90 births per 1,000 girls from about 69/1,000 in the same period. This represents an increase of almost 30%.

The birthrate among sexually active females age 15-19 is still worse: The percentage of sexually active girls dropped to about 40% from almost 43% between 1988 and 1995, but the birthrate during this period jumped over 31% to almost 112/1,000 from 85/1,000.

If condoms and other contraceptives are not protecting sexually active or experienced girls, what could be causing the declining rates of pregnancy and birth?

Myth: Abstinence is unworkable and unrealistic. Teens are going to have sex anyway so we need to teach them "safe" sex.

Reality: Not so. The CDC's Youth Risk Behavior Surveys show an almost 20% drop in the percentage of high school boys age 15-19 who have ever had sex, to a low of under 49% in 1997 from almost 61% in 1990.

High school-aged boys have also become less sexually active, with only 1 in 3 reporting intercourse in the past 3 months (a 21% decline between 1990 and 1997) and less promiscuous, with a 34% decline in those having had four or more partners between the 1990 figure of almost 27% and the 1997 figure of almost 18%.

Using data from the National Survey of Family Growth, between 1988 and 1995, a decrease of 5.7% occurred in the percentage of all females (not just those in high school) age 15-19 who have had sex (52.6% vs. 49.6%). But those remaining sexually active have become more promiscuous. Almost 20% more high school girls 15-19 have had four or more partners in 1997 compared to 1990.

The Consortium's report points to a combination of factors as contributing to greater abstinence among teens: the AIDS epidemic, generational changes in attitudes (including greater "religiosity" and parental disapproval of premarital sex and contraceptive use), increased cultural acceptance of abstinence and the growth of abstinence-only education programs. To obtain a copy of this important report call (877) 236-5772.

There are about 4 million new cases of STDs among teens each year—striking one in four sexually experienced teens (and zero abstinent teens). A recent survey of 15-17 year olds, conducted by Kaiser Family Foundation, MTV and Teen People, found that kids are ignorant of their risk of acquiring an STD. Three-fourths of teens underestimated their risk of acquiring an STD.

Also alarming, only four percent of the sexually experienced teens reported having
had an STD, despite the probable incidence of 25% in this population.

Some may have concealed this history, but it is likely that many others were unaware of their infection. Many STDs are asymptomatic for a period of months or years, even while they are damaging the reproductive tract and being spread to other partners.

Although 80% of the teens surveyed said they learned about STDs in sex ed or health class in school, too many are also being given the false assurance that condoms will protect them.

They need to be told the truth that condoms offer little or no protection against some of the most common STDs.

And they need to be told the many benefits of remaining abstinent until marriage.
[March 1999, Life Insight, VOL. 10, no. 3