Menstuff® has compiled the following
information on abstinance failure. There is potential failure with all
forms of prevention, which often comes from not having the knowledge of
how to use the protection. That's why it is so important to know as much
about "safer sex" before ever experiencing even petting. Without that
knowledge, the chances of acquiring an STD or having an unplanned
pregnancy, increases dramatically.
Nonpartisan researchers have been unable to document measurable benefits
of the abstinence-only model. Columbia University researchers found that
although teenagers who take "virginity pledges" may wait longer to
initiate sexual activity, 88 percent eventually have premarital sex.
Abstinence Clearing House:
Abstinence, The Better Choice:
To be a 100% effective against HPV or
Herpes, you would have never had a sexual encounter with anyone,
maintain the abstinance after marriage, and insure that you never share
a towel, underware, etc. with anyone who has every been sexual with
anyone. There can't be one slip-up.
Implications for Individuals, Programs and Policies
The word "sex" is
commonly acknowledged to mean different things to different people. The
same can be said for "abstinence." The varied and potentially
conflicting meanings of "abstinence" have significant public health
implications now that its promotion has emerged as the Bush
administration's primary answer to pregnancy and sexually transmitted
disease (STD) prevention for all people who are not married.
For those willing to probe beneath the
surface, critical questions abound. What is abstinence in the first
place, and what does it mean to use abstinence as a method of pregnancy
or disease prevention? What constitutes abstinence "failure," and can
abstinence failure rates be measured comparably to failure rates for
other contraceptive methods? What specific behaviors are to be abstained
from? And what is known about the effectiveness and potential "side
effects" of programs that promote abstinence? Answering questions about
what abstinence means at the individual and programmatic levels, and
clarifying all of this for policymakers, remains a key challenge.
Meeting that challenge should be regarded as a prerequisite for the
development of sound and effective programs designed to protect
Americans from unintended pregnancy and STDs, including HIV.
Abstinence and Individuals
What does it mean to use abstinence?
When used conversationally, most people probably understand abstinence
to mean refraining from sexual activity—or, more specifically, vaginal
intercourse—for moral or religious reasons. But when it is promoted as a
public health strategy to avoid unintended pregnancy or STDs, it takes
on a different connotation. Indeed, President Bush has described
abstinence as "the surest way, and the only completely effective way, to
prevent unwanted pregnancies and sexually transmitted disease." So from
a scientific perspective, what does it mean to abstain from sex, and how
should the "use" of abstinence as a method of pregnancy or disease
prevention be measured?
Population and public health
researchers commonly classify people as contraceptive users if they or
their partner are consciously using at least one method to avoid
unintended pregnancy or STDs. From a scientific standpoint, a person
would be an "abstinence user" if he or she intentionally refrained from
sexual activity. Thus, the subgroup of people consciously using
abstinence as a method of pregnancy or disease prevention is obviously
much smaller than the group of people who are not having sex. The size
of the population of abstinence users, however, has never been measured,
as it has for other methods of contraception.
When does abstinence fail? The
definition of an abstinence user also has implications for determining
the effectiveness of abstinence as a method of contraception. The
president, in his July 2002 remarks to South Carolina high school
students, said "Let me just be perfectly plain. If you're worried about
teenage pregnancy, or if you're worried about sexually transmitted
disease, abstinence works every single time." In doing so, he suggested
that abstinence is 100% effective. But scientifically, is this in fact
Researchers have two different ways of
measuring the effectiveness of contraceptive methods. "Perfect use"
measures the effectiveness when a contraceptive is used exactly
according to clinical guidelines. In contrast, "typical use" measures
how effective a method is for the average person who does not always use
the method correctly or consistently. For example, women who use oral
contraceptives perfectly will experience almost complete protection
against pregnancy. However, in the real world, many women find it
difficult to take a pill every single day, and pregnancies can and do
occur to women who miss one or more pills during a cycle. Thus, while
oral contraceptives have a perfect-use effectiveness rate of over 99%,
their typical-use effectiveness is closer to 92%. As a result, eight in
100 women who use oral contraceptives will become pregnant in the first
year of use.
Were You Told Sex is Holy or Nasty?
One of the saddest
things I've ever heard from a counseling client is when I was told by a
young man in his 20's that his family drummed into him that sex is
nasty. The resulting sense of guilt, shame, sneakiness, and dishonesty
around his sex life ever since had severely hampered his life and
In a similar vein, you might recall
Colorado Senator Gary Hart who was running for President in 1988 but was
put out of the race when he was discovered having an affair with Donna
Rice. He said afterward that one of the reasons he couldn't stop himself
from having an affair (and harming his marriage and political career)
was that he was raised in a very strict household where sex was
considered nasty and secretive (which made it all the more compelling
and hard-to-resist for him).
I raise this issue of holiness or
nastiness because it seems to make an impact on so many men and women
who want to enjoy the beauty and closeness of sensuality but who are
filled with thoughts and images that sex is bad or guilt-ridden or
sinful. Does that sound true about yourself or someone you care
about--were you raised with negative images and harsh ideas that sex is
wrong or bad or sinful?
Sometimes you hear people say that
these harsh ideas about sex come from the bible. But nine years ago I
researched and wrote a book called "The Ten Challenges" (by
about the deeper meanings and original Hebrew wordings of the Ten
Commandments. For instance, even the original Hebrew words for the Ten
Commandments don't say the word "commandments." The original biblical
words from Exodus 20 say "Ahseret Hadibrot," which mean "the ten things"
or "the ten words." You can sense immediately that those translations
read more gently and lovingly. In the King James version the Hebrew
words that got mistranslated into Greek then got mistranslated into
English as harsh "Thou shalt nots" and rigid commandments. But it's
quite possible that in the original version they are more like profound
and wise principles for living rather than harsh "thou shalt nots" for
which you get struck down if you mess up on one.
I spoke with hundreds of experts,
scholars, linguists, and clergy from a number of religious and spiritual
traditions about how they translate The Ten Commandments, especially the
ones about sexuality, such as Do not commit adultery, Do not covet your
neighbor's partner, Do not steal (which literally means "lo tignove--do
not be sneaky or trick someone with a false impression of who you are"),
Do not bear false witness or lie or gossip to create a false advantage.
What I found out is that the original
Hebrew word for sexuality is "ya-da" which means to know someone fully.
Rabbis and scholars explained that if you keep your sexuality
superficial or focused on body sensations or getting your way with
another person, you never really get to know someone fully and you never
get to be known fully. So what holiness is about with regards to
sexuality is to let yourself be fully honest, vulnerable, and
trustworthy with another human being--to get to know and accept each
other's deeper selves, including their complicated sexual selves.
Several Christian, Muslim and Buddhist
scholars and clergy also agreed with this sense of sex as holy in so far
as it lets us fully know the richness of God's gifts to us. To
appreciate the beauty of the body, the beauty of a deep relationship,
and the joy of connecting with someone you love is a holy act. When it
becomes sneaky, manipulative, dishonest, or exploitative, that is when
it becomes nasty.
In other words, sexuality is one of the
greatest opportunities for finding your way into the powerful holy
energies of the universe--but it has to be treated carefully and in a
deeply honest relationship with someone you truly know and appreciate at
all levels, because otherwise it can easily slip back into sneakiness,
dishonesty, manipulation, or exploitativeness which go against the
awesomeness for which sexuality is intended.
Whatever your religious or spiritual
beliefs (or even if you are completely allergic to religion altogether),
I urge you to examine whether you are carrying guilt-ridden or
shame-filled thoughts into your sex life. If so, you are much less
likely to be able to deeply enjoy these holy moments of fully being at
peace and in a state of joy and surrender with another human being. If
your mind is filled with desires to conquer, manipulate, score, or trick
someone, you are very far away from the pleasure of being fully known
and fully appreciated for who you are.
If you start to view sexuality as a
holy and wonderful part of life that gives you awe about the greatness
of God's creation (or the beauty of nature if the word 'God' is
uncomfortable for you), you will probably find it enhances your
sensuality and the strength of your relationship. Instead of feeling
like a "bad person" who is about to get caught and punished, you will
begin to experience sexuality as a "good person" who is growing closer
to your true essence through your exploration of profound intimacy with
Contraceptive Effectiveness Rates
for Pregnancy Prevention
Female Sterilization **
IUD - Mirena
IUD - Paragard
Shot - Depo Provera
Patch - Ortho Evra
failure rate than all other forms of birth control.
** Note: We don't know why male sterilization was not
included but assume that testical removal or vacestomy would
show about the same results.
*** Depending on formulation. Sources: Perfect use--Hatcher,
RA, et al., Contraceptive Technology, 17th ed., 1998, page
216. Typical use--AGI, Fulfilling the Promise: Public Policy
and U.S. Family Planning Clinics, 2000, page 44.
Thus, when the president suggests that
abstinence is 100% effective, he is implicitly citing its perfect-use
rate—and indeed, abstinence is 100% effective if "used" with perfect
consistency. But common sense suggests that in the real world,
abstinence as a contraceptive method can and does fail. People who
intend to remain abstinent may "slip" and have sex unexpectedly.
Research is beginning to suggest how difficult abstinence can be to use
consistently over time. For example, a recent study presented at the
2003 annual meeting of the American Psychological Society (APS) found
that over 60% of college students who had pledged virginity during their
middle or high school years had broken their vow to remain abstinent
until marriage. What is not known is how many of these broken vows
represent people consciously choosing to abandon abstinence and initiate
sexual activity, and how many are simply typical-use abstinence
To promote abstinence, its proponents
frequently cite the allegedly high failure rates of other contraceptive
methods, particularly condoms. By contrasting the perfect use of
abstinence with the typical use of other contraceptive methods, however,
they are comparing apples to oranges. From a public health perspective,
it is important both to subject abstinence to the same scientific
standards that apply to other contraceptive methods and to make
consistent comparisons across methods. However, researchers have never
measured the typical-use effectiveness of abstinence. Therefore, it is
not known how frequently abstinence fails in the real world or how
effective it is compared with other contraceptive methods. This
represents a serious knowledge gap. People deserve to have consistent
and accurate information about the effectiveness of all contraceptive
methods. For example, if they are told that abstinence is 100%
effective, they should also be told that, if used correctly and
consistently, condoms are 97% effective in preventing pregnancy. If they
are told that condoms fail as much as 14% of the time, they should be
given a comparable typical-use failure rate for abstinence.
Abstinence is 100% effective if 'used'
with perfect consistency. But common sense suggests that in the real
world, it can and does fail.
What behaviors should be abstained
from? A recent nationally representative survey conducted by the Kaiser
Family Foundation and seventeen magazine found that half of all
15-17-year-olds believed that a person who has oral sex is still a
virgin. Even more striking, the APS study found that the majority (55%)
of college students pledging virginity who said they had kept their vow
reported having had oral sex. While the pledgers generally were somewhat
less likely to have had vaginal sex than nonpledgers, they were equally
likely to have had oral or anal sex. Because oral sex does not eliminate
people's risk of HIV and other STDs, and because anal sex can heighten
that risk, being technically abstinent may therefore still leave people
vulnerable to disease. While the press is increasingly reporting that
noncoital behaviors are on the rise among young people, no research data
exists to confirm this.
Abstinence Education Programs
communicating what is meant by abstinence are not just academic
exercises, but are crucial to public health efforts to reduce people's
risk of pregnancy and STDs. For example, existing federal and state
abstinence-promotion policies typically neglect to define those
behaviors to be abstained from. The federal government will provide
approximately $140 million in FY 2004 to fund education programs that
exclusively promote "abstinence from sexual activity outside of
marriage" ("Abstinence Promotion and Teen Family Planning: The Misguided
Drive for Equal Funding," TGR, February 2002, page 1). The law, however,
does not define "sexual activity." As a result, it may have the
unintended effect of promoting noncoital behaviors that leave young
people at risk. Currently, very little is known about the relationship
between abstinence-promotion activities and the prevalence of noncoital
activities. This hampers the ability of health professionals and
policymakers to shape effective public health interventions designed to
reduce people's risk.
To date, no education program focusing
exclusively on abstinence has shown success in delaying sexual activity.
There is no question, however, that
increased abstinence—meaning delayed vaginal intercourse among young
people—has played a role in reducing both teen pregnancy rates in the
United States and HIV rates in at least one developing country. Research
by The Alan Guttmacher Institute (AGI) indicates that 25% of the
decrease in the U.S. teen pregnancy rate between 1988 and 1995 was due
to a decline in the proportion of teenagers who had ever had sex (while
75% was due to improved contraceptive use among sexually active teens).
A new AGI report also shows that declines in HIV-infection rates in
Uganda were due to a combination of fewer Ugandans initiating sex at
young ages, people having fewer sexual partners and increased condom use
(see related story).
But abstinence proponents frequently
cite both U.S. teen pregnancy declines and the Uganda example as "proof"
that abstinence-only education programs, which exclude accurate and
complete information about contraception, are effective; they argue that
these programs should be expanded at home and exported overseas. Yet
neither experience, in and of itself, says anything about the
effectiveness of programmatic interventions. In fact, significant
declines in U.S. teen pregnancy rates occurred prior to the
implementation of government-funded programs supporting this
particularly restrictive brand of abstinence-only education. Similarly,
informed observers of the Ugandan experience indicate that
abstinence-only education was not a significant program intervention
during the years when Uganda's HIV prevalence rate was dropping. Thus,
any assumptions about program effectiveness, and the effectiveness of
abstinence-only education programs in particular, are misleading and
potentially dangerous, but they are nonetheless shaping U.S. policy both
here and abroad (see related story, page 13).
Accordingly, key questions arise about
how to measure the success of abstinence-promotion programs. For
example, the administration is defining program success for its
abstinence-only education grants to community and faith-based
organizations in terms of shaping young people's intentions and
attitudes with regard to future sexual activity. In contrast, most
public health experts stress the importance of achieving desired
behavioral outcomes such as delayed sexual activity.
To date, however, no education program
in this country focusing exclusively on abstinence has shown success in
delaying sexual activity. Perhaps some will in the future. In the
meantime, considerable scientific evidence already demonstrates that
certain types of programs that include information about both abstinence
and contraception help teens delay sexual activity, have fewer sexual
partners and increase contraceptive use when they begin having sex. It
is not clear what it is about these programs that leads teens to delay—a
question that researchers need to explore. What is clear, however, is
that no program of any kind has ever shown success in convincing young
people to postpone sex from age 17, when they typically first have
intercourse, until marriage, which typically occurs at age 25 for women
and 27 for men. Nor is there any evidence that the "wait until marriage"
message has any impact on young people's decisions regarding sexual
activity. This suggests that scarce public dollars could be better spent
on programs that already have been proven to achieve delays in sexual
activity of any duration, rather than on programs that stress abstinence
Finally, there is the question of
whether delays in sexual activity might come at an unacceptable price.
This is raised by research indicating that while some teens promising to
abstain from sex until marriage delayed sexual activity by an average of
18 months, they were more likely to have unprotected sex when they broke
their pledge than those who never pledged virginity in the first place.
Thus, might strategies to promote abstinence inadvertently heighten the
risks for people when they eventually become sexually active?
Difficult as it may be, answering these
key questions regarding abstinence eventually will be necessary for the
development of sound and effective programs and policies. At a minimum,
the existing lack of common understanding hampers the ability of the
public and policymakers to fully assess whether abstinence and
abstinence education are viable and realistic public health and public
policy approaches to reducing unintended pregnancies and HIV/STDs.
This is the fourth in a series of
articles examining emerging issues in sex education and related efforts
to prevent unintended pregnancy and sexually transmitted diseases. The
series is supported in part by a grant from the Program on Reproductive
Health and Rights of the Open Society Institute. The conclusions and
opinions expressed in these articles, however, are those of the author
and The Alan Guttmacher Institute.
Abstinence Is Foolproof? Think
By Acacia Stevens,
16, Staff Writer
Sixteen-year-old Sabrina grew up
believing that she’d be abstinent until marriage.
Photo by Martyna Majok
“My parents always spoke openly about
sex, but it was under the assumption that I wouldn’t do it until I’m
married. They’ve always made it clear that they want me to wait,” says
Sabrina, who lives in Edison, NJ.
But last spring, Sabrina found her
“My boyfriend and I were just so
compatible, on so many levels. We got to be so close, so fast,” she
Eventually, things started moving fast
in a physical direction.
“After a while, sex became a reality.
It’s a lot harder to abstain when you’re actually in the moment, faced
with that decision,” she says.
Sabrina’s story illustrates one rarely
publicized fact—abstinence can fail. Even though teens are taught that
abstinence is a “100-percent effective” method of preventing unplanned
pregnancy and sexually transmitted infection (STI), abstinence can fail
when teens try to practice it every day.
This fact is largely ignored by the
powers that dictate the content of abstinence-only sex education, but
it’s just common sense to many teens.
How can abstinence fail? The method can
be complicated and difficult to use, and hard to maintain for an
extended period of time, explains Clara S. Haignere, Ph.D, an associate
professor of public health at Temple University, in Philadelphia.
Haignere has published research on teens and abstinence failure in the
journal Health Education & Behavior.
As a method of pregnancy and STI
prevention, abstinence from oral, vaginal, or anal intercourse can be
100-percent effective, but only if it’s used correctly and consistently.
If a user (for example, a teen) uses a method incorrectly or
inconsistently—whether it’s condoms or abstinence—then the effectiveness
rate goes down.
By studying research on teens who
abstained for a period of time, Haignere found that abstinence has a
user-failure rate between 26 and 86 percent. This rate is higher than
the condom user-failure rate, which is between 12 and 70 percent.
“Are teens being given all the accurate
information about abstinence if they’re told that it’s ’completely safe’
and ’easy to use’?
“Abstinence is complicated to use. It
requires negotiation skills. Teens have to talk to their partners about
it, and use it all the time—every time they’re intimate,” says Haignere.
Teens at Risk
Katie, 19, of Memphis, TN, understands
how difficult it is to be abstinent. She and her boyfriend, who share
the same values and religious beliefs, decided to abstain from sex.
But, she says, “For the past three
years, we really struggled with abstinence. We did pretty much
everything except intercourse. Occasionally we’d stop and say, ’No
more,’ but then our hormones put us back into the same routines.”
“One night, things went too far,” says
Katie. “We still didn’t have intercourse, but later on, I learned there
was a possibility I could be pregnant without having intercourse,
because his semen came extremely close.”
Like Katie, some teens consider
themselves abstinent, even when they participate in other sexual
behaviors, like oral or anal intercourse. Even though they think they’ve
used abstinence properly—by avoiding vaginal intercourse—they’re still
engaging in high-risk sexual behaviors.
This is another case of abstinence
failure, since, in order to be 100-percent protected from pregnancy
and/or STIs, you have to abstain from oral, anal, and vaginal
intercourse—all the time.
Abstinence failure can be dangerous for
teens if they don’t know how to protect themselves. A recent study of
teens who took virginity pledges finds that while pledgers delayed
having intercourse, the ones who eventually did have intercourse were
less likely to use contraception—leaving them at risk for unplanned
pregnancy and/or STIs.
Need for Knowledge
But most abstinence-only sex educators
don’t consider that abstinence can fail, so they don’t prepare teens to
use contraception just in case. They continue to inform teens that
abstinence is the only, 100-percent foolproof way to avoid unplanned
pregnancy and STIs.
For the past three years of high
school, Lauren Maurer, 17, of Boca Raton, FL, received abstinence-only
“Now that I’ve been in a relationship
for over a year and we’re considering becoming sexually active, I
realize that my sex ed experiences made me terrified of sex.
“My teachers made it seem like everyone
had an STI, and that contraceptives are expected to fail. If it weren’t
for my own reading, I wouldn’t know what kinds of contraceptives are
available,” says Maurer.
Haignere thinks that schools should
prepare teens for abstinence failure by giving them medically accurate
information about contraception. And she thinks the “just say no to sex”
approach isn’t realistic, given that nearly half of all 9th…#8220;12th
graders have already had sexual intercourse, according to the 2001 Youth
Risk Behavior survey by the U.S. Centers for Disease Control and
“Look at the public health information
given on skin cancer,” says Haignere. “The only 100-percent effective
method of preventing skin cancer is to stay out of the sun, but no one
in the public health community promotes that as the only alternative,
since it’s almost impossible to avoid.”
Given the risks of abstinence failure,
many teens are speaking up for comprehensive sex education, which
teaches the benefits of abstinence plus accurate information about
contraception and STIs.
“Teach teens how to have safer sex.
Using condoms and birth control will help a majority of young people,”
says Amber, 15, of Torrington, CT. “If teens are taught that no sex is
safe sex, they’ll have sex anyway without knowing the right thing to
do.” (This web site is by teens for teens.)
Effects of Teenstar, an abstinence
only sexual education program, on adolescent sexual behavior.
Vigil P P,
Riquelme R R, Rivadeneira H R, Aranda W.
Unidad de Reproduccion y Desarrollo,
Departamento de Ciencias Fisiologicas, Facultad de Ciencias Biologicas,
Pontificia Universidad Catolica de ChileChile.
Urgent measures are required to stop
the increase in the frequency of pregnancies and sexually transmitted
diseases among teenagers. A means of facing this problem is promoting
sexual abstinence among youngsters. There are studies that confirm the
efficacy of this approach. Aim: To show the results of the application
of a holistic sexuality program (TeenSTAR) among Chilean teenagers.
Subjects and Methods: Students attending basic or high school were
divided into a control or study group. The control group (342 students)
received the usual education on sexuality given by their schools and the
study group (398 students) participated in twelve TeenSTAR sessions
lasting 1.5 hours each, given by a trained professor. Assessment of
achievements was made using an anonymous questionnaire answered at the
start and end of the program. Results: The rates of sexual initiation
among control and study groups were 15 and 6.5%, respectively. Among
sexually active students, 20% of those in the study group and 9% of
those in the control group discontinued sexual activity. Conclusions: A
higher proportion of students in the TeenSTAR program retarded their
sexual initiation or discontinued sexual activity and found more reasons
to maintain sexual abstinence than control students (Rev Med Chile 2005;
Abstinence education for rural
youth: an evaluation of the Life's Walk Program.
Barnett JE, Hurst
Northwest Missouri State University,
Maryville, MO 64468, USA. Barnett@mail.nwmissouri.edu
This paper summarizes an evaluation of
a school-based sexuality education program, an abstinence-only program,
taught in public schools to eighth- and 10th-graders. The program uses
infant simulators to provide adolescents with a realistic view of
parenting and to encourage them to delay initiation of sexual behavior
until marriage. Two evaluations are summarized here. The first
evaluation used a pretest-posttest design. Significant increases in
parent-adolescent communication, knowledge about sexuality, and sexual
behavior were found. No changes were found in attitudes toward teen
sexual activity. The second evaluation employed a quasi-experimental
design with a treatment group and a comparison group, with testing
delayed four months after the program. No group differences were found
in attitudes, behavior, or communication. Program effects were found
only for knowledge about sexuality.
Long-term reductions in sexual
initiation and sexual activity among urban middle schoolers in the reach
for health service learning program.
Stueve A, O'Donnell C, Duran R, San Doval A, Wilson RF, Haber D, Perry
E, Pleck JH.
Education Development Center, Inc.,
Newton, Massachusetts 02428, USA. email@example.com
PURPOSE: To evaluate the sustained
effectiveness of a middle school service learning intervention on
reducing sexual initiation and recent sex among urban African-American
and Latino adolescents from 7th grade through the 10th grade. METHODS:
During the fall of seventh grade and again in eighth grade, students
were randomly assigned by classroom to participate either in community
youth service (CYS) or not (controls). Service learning is an
educational strategy that couples meaningful service in the community
with classroom instruction. Students in both intervention and control
conditions received classroom health lessons. Surveys were conducted at
seventh grade baseline and at the end of 10th grade, approximately 2
years after intervention. Self-reported sexual behaviors of youths who
had participated in CYS were compared with those of controls receiving
classroom curriculum alone (n = 195). RESULTS: CYS participants were
significantly less likely than controls to report sexual initiation (2
years CYS, odds ratio [OR] = 0.32; 1 year, OR = 0.49) as well as recent
sex (2 years CYS, OR = 0.39; 1 year CYS, OR = 0.48). Among those who
were virgins at seventh grade, 80% of males in the curriculum-only
condition had initiated sex, compared with 61.5% who received 1 year of
CYS, and 50% who received 2 years. Among females, the figures were
65.2%, 48.3%, and 39.6%, respectively. CONCLUSION: A service learning
intervention that combines community involvement with health instruction
can have a long-term benefit by reducing sexual risk taking among urban
Effects of abstinence-only education
on adolescent attitudes and values concerning premarital sexual
Sather L, Zinn K.
College of Nursing, University of
Nebraska Medical Center, Omaha, USA.
This article compares the values and
attitudes of two groups of 7th and 8th grade adolescents toward
premarital sexual activity. One group received state-funded,
abstinence-only education; the other group did not receive that
education. Abstinence-only education did not significantly change
adolescents' values and attitudes about premarital sexual activity, nor
their intentions to engage in premarital sexual activity. The majority
of both the treatment and control group subjects expressed disagreement
with the statement: "It is okay for people my age to have sexual
intercourse," and they did not intend to have sexual intercourse while
an unmarried teenager.
The case for comprehensive sex
Starkman N, Rajani
American Foundation for AIDS Research (amfAR),
New York, New York 10005, USA. Naomi.firstname.lastname@example.org
Half of all new human immunodeficiency
virus (HIV) infections in the United States and two thirds of all
sexually transmitted diseases (STD) occur among young people under the
age of 25. It is estimated that by the end of high school, nearly two
thirds of American youth are sexually active, and one in five has had
four or more sexual partners. Despite these alarming statistics, less
than half of all public schools in the United States offer information
on how to obtain contraceptives and most schools increasingly teach
abstinence-only-until-marriage (or "abstinence-only") education. There
is little evidence that abstinence-only programs are successful in
encouraging teenagers from delaying sexuality activity until marriage,
and consequently, avoiding pregnancy, or STD or HIV infection.
Comprehensive sex education, which emphasizes the benefits of abstinence
while also teaching about contraception and disease-prevention methods,
has been proven to reduce rates of teen pregnancy and STD infection.
States' implementation of the
Section 510 abstinence education program, FY 1999
Sonfield A, Gold
Alan Guttmacher Institute, Washington,
CONTEXT: As part of its reworking of
the nation's welfare system in 1996, Congress enacted a major new
abstinence education initiative (Section 510 of Title V of the Social
Security Act), projected to spend $87.5 million in federal, state and
local funds per year for five years. The new program is designed to
emphasize abstinence from sexual activity outside of marriage, at any
age, rather than premarital abstinence for adolescents, which was
typical of earlier efforts. The actual message and impact of the
program, however, will depend on how it is implemented. METHODS: Program
coordinators in all 50 states, the District of Columbia and Puerto Rico
were surveyed concerning implementation of the Section 510 abstinence
education program in FY 1999. The questionnaire asked about expenditures
and activities performed, about policies established for a variety of
specific situations and about how the term "sexual activity" is defined
and what specific components of the federal definition of "abstinence
education" are emphasized. RESULTS: Forty-five jurisdictions spent a
total of $69 million through the Section 510 program in FY 1999. Of this
total, $33 million was spent through public entities, $28 million was
spent through private entities and $7million (in 22 jurisdictions) was
spent through faith-based entities. Almost all jurisdictions reported
funding school-related activities, with 38 reporting in-school
instruction and presentations. Twenty-eight jurisdictions prohibited
organizations from providing information about contraception (aside from
failure rates), even at a client's request, while only six jurisdictions
prohibited information about sexually transmitted diseases. Few reported
having a policy or rendering guidance about providing services
addressing sexual abuse, sexual orientation or existing pregnancy and
parenthood. Only six respondents said they defined "sexual activity" for
purposes of the program, and 16 reported focusing on specific portions
of the federal definition of "abstinence education." CONCLUSIONS: More
than one in 10 Section 510 dollars were spent through faith-based
entities. Programs commonly conducted in-school activities, particularly
instruction and presentations, not only through public entities, but
also through private and faith-based entities. Most jurisdictions
prohibited the provision of information about contraception, about
providers of contraceptive services or about both topics, even in
response to a direct question and when using other sources of funding.
Most also left definitions of "abstinence" and "sexual activity" as
local decisions, thus not clearly articulating what the program is
designed to encourage clients to abstain from.
Personal values and sexual
decision-making among virginal and sexually experienced urban adolescent
Paradise JE, Cote
J, Minsky S, Lourenco A, Howland J.
Department of Pediatrics, Boston
University School of Medicine, Boston, Massachusetts, USA. email@example.com
PURPOSE: To guide the development of an
intervention to reduce the incidence of sexually transmitted diseases
(STDs) in urban, adolescent girls, we investigated such girls' reasons
for deciding to have or not to have sexual intercourse. METHODS:
Consecutive girls >or=14 years of age attending an urban adolescent
clinic were invited to complete an anonymous survey about sexual
decision-making. In this pilot study, girls were asked: (a) whether they
agreed with a statement that they had or had not had sexual intercourse
"because of my values and beliefs"; and (b) to select from a list one or
more specific reasons why they had or had not had intercourse. The girls
were categorized by self-report as either "virgins," "currently
inactive" (no intercourse in the preceding 3 months), or "currently
active" (had intercourse during the preceding 3 months). RESULTS: Usable
surveys were obtained from 197 adolescents whose age (18.2 +/- 2.6
years) and race (69% black) were comparable to those of clinic attendees
in general. Forty girls (20%; age 16.1 +/- 2.1 years) were virgins, 25
girls (13%; age 17.8 +/- 2.3 years) were inactive, and 132 girls (67%;
age 18.9 +/- 2.5 years) were currently active. "Values and beliefs" were
cited as the reason for decisions about sexual behavior by 53% of the
virgins, but only by 24% of the sexually inactive and 24% of the
sexually active girls (p = .002). Virgins were more likely than inactive
girls to cite three specific reasons for not having sex: "not the right
thing for me now" (82% vs. 50%, p = .007), "waiting until I am older"
(69% vs. 8%, p = .001), and "waiting until I am married" (67% vs. 38%, p
= .02). The reason "against my religious beliefs" was cited by 23% of
virgins and 13% of inactive girls (p = not significant). Personal values
were implicit in the two specific reasons for having sex that active
girls chose most frequently, namely, "I like/love the person" (86%) and
"I like having sex" (37%), although only 24% of these girls had
explicitly cited "values and beliefs" as their reason for having sex.
CONCLUSIONS: Our data indicate that urban girls, both those who have had
sexual intercourse and those who have not, view their sexual behavior as
being based on personal (although infrequently religious) values. Many
of the virginal urban, adolescent girls we surveyed hold abstinence as a
personal value. The sexually active adolescents perceive the decision to
have sexual intercourse as being based affirmatively on their personal
values rather than on the chance occurrence of opportunities to have
intercourse. These data may be useful in the development of new
strategies for reducing urban adolescent girls' risk of acquiring
sexually transmitted diseases.
Hooking Up: Harmless Fun or Health
Drew is a
19-year-old freshman at Lafayette College, in Easton, PA, who would
rather hook up than have long-term relationships with girls. Since
becoming sexually active in his early teens, Drew says he’s had one
serious relationship and hooked up about 25 to 30 times with different
“At this point in my life, I’d rather
be having fun than tied down. The act of hooking up is exciting. It
makes me feel mainly thrilled, happy, and satisfied,” he says.
In recent years, hooking up—having
casual sexual relationships without commitment—has become a more common,
openly discussed pastime for many teens. And two-thirds of 15- to
17-year-olds report that some of their friends participate in hook-ups,
according to a recent SexSmarts national survey, by the Kaiser Family
Foundation and seventeen magazine.
Like Drew, many teens aren’t ashamed to
talk about their experiences. Why? There’s now less stigma attached to
hooking up, says Lynn Ponton, M.D., author of The Sex Lives of
Teenagers: Revealing the Secret World of Adolescent Boys and Girls.
According to Dr. Ponton, a “hook-up”
can include different sexual behaviors. In high school, it usually means
doing everything but vaginal or anal intercourse with a partner, once or
a few times. At the college level, the sexual behaviors can grow to
include all types of intercourse (oral, vaginal, and anal).
So, what’s the appeal of a short-term
or one-time only hook-up?
Brooke, 15, of Washington, NJ, who’s
hooked up about five times, says she prefers it to long-term
relationships because of the freedom it brings.
“I don’t feel restricted, and I’m free
to experience many people and relationships at the same time,” says
Brooke, who claims that “hormones and sexual attraction” (not emotional
connection) motivate her to hook up.
“Hooking up has helped me mature a lot.
I’ve really looked at who I am and what I value as a person because of
my experiences, and now I realize that I’m in control. I’m a lot more
comfortable being myself around new people, and I’m definitely more
confident with guys,” she says.
When used as a stepping-stone to
self-discovery and more mature sexual relationships, hooking up can be
beneficial, according to Marsha Levy-Warren, Ph.D., author of The
Adolescent Journey: Development, Identity Formation, and Psychotherapy.
She says that hooking up gives teens an alternate way to explore their
“Some teens learn about their bodies
through masturbation, but many are very uncomfortable with it. They
sometimes turn to hooking up as a way of getting to know how their
bodies work,” says Levy-Warren.
But Levy-Warren stresses that it’s the
way in which—and how often—teens hook up that ultimately determines
whether it has positive or negative effects. For instance, hooking up
isn’t healthy if it’s a teen’s only type of intimate relationship, for
years at a time.
“Teens can easily feel that no one
really wants them, that they’re just wanted for their bodies or sexual
expertise, and not for the whole of who they are,” explains Levy-Warren.
There also can be real differences
between how guys and girls feel after hooking up, adds Levy-Warren.
“Guys can feel more confident socially,
more mature, when they’ve had a lot of sexual encounters. Girls can
start out feeling that way, but if by the end of high school they
haven’t had a more prolonged dating relationship, they begin to feel
something’s wrong with them,” she says.
Brooke agrees that there are emotional
risks to hooking up, including “ending up feeling used and rejected.”
Aside from emotional effects, hooking
up—if done without protection—can lead to unintended pregnancy and
sexually transmitted infections (STIs), including HIV/AIDS. Without the
benefit of learning about and knowing their partners, teens that hook up
often make quick decisions about contraception and their partners’
sexual health status.
Brooke waits until she feels
“comfortable and familiar” with a guy before she hooks up with him. Drew
says he assesses the risks by “surveying the girl’s looks and getting to
know her a little before we hook up.” But, he adds, “You can’t really
find out a person’s sexual history on the spot. You kind of have to go
with your best judgment.”
Levy-Warren says that there’s “no
question” many teens put themselves at risk when they hook up,
especially when they’re not using contraception to prevent unintended
pregnancy and STIs. In fact, according to the SexSmarts survey, teens
are more likely to talk about their sexual history and STI testing, and
use birth control pills with a partner, the longer they’re in a
Aside from cautioning teens about the
physical risks, Levy-Warren encourages them to evaluate their reasons
for hooking up. She says that many teens hook up because of fear and
“They want to feel that they’re in some
way keeping up socially. They want to be on the scene, be seen and
involved with people, so they keep hooking up. But inside they may feel,
’How come no one really wants me?’ ”
A Relative Risk—Based,
Disease-Specific Definition of Sexual Abstinence Failure Rates
programs have the potential to reduce the incidence of unplanned
pregnancies and sexually transmitted diseases (STDs) among adolescents.
Effectiveness measures are needed to help researchers assess the impact
of sexual abstinence promotion programs on STD and pregnancy rates, and
to enable comparisons of abstinence effectiveness with other
contraception and STD prevention methods. Abstinence "failure rates"
have been proposed as one measure of program effectiveness. However, the
concept of abstinence failure rates has not been adequately
operationalized. The present study examines a novel mathematical
framework for estimating abstinence failure rates, both theoretically
and empirically. Examples are provided, and the advantages and
disadvantages associated with the mathematical model-based approach are
Health Education & Behavior, Vol. 28, No. 1, 10-20 (2001), Society for
Public Health Education,
When the Underlying Intent is
Even when I try to
be explicit, sometimes the underlying intent is misread. Recently I
wrote on the possibility of getting led astray by the conditions of the
problem. In particular, the wording of a puzzle can trick us into
thinking down the wrong path. To me, discussing logical issues are tools
to help us understand the real world make those decisions that will best
meet our needs. So I couldn’t let it go, but risked showing how we are
often led astray on controversial issues. From the previous article:
...but the psychological tricking us
into using the wrong mental model to solve problems is not always so
obvious. We are constantly bombarded with advertisements, religious
warnings, and political pronouncements that sound like good logical
presentations and lead us to a conclusion that might not be in our best
I read part of a presentation by an
abstinence-only anti-sexual activity speech... Another fallacy he used
in the same presentation was to say that abstinence in the only 100%
effective way to avoid unplanned births. Sounds good, you don't do it,
and you don't get pregnant. Except that when a method of birth control
is proposed, it must be tested, not as an ideal logical thing,
but as ground truth in the field, and when that is done, abstinence is
probably the least effective of the common methods of birth control. Its
failure rate as a method is greater than the failure rate of other
techniques. This is totally independent of an moral or health issues.
This example generated a series of
comments that can be summarized by one from Alan:
That's ridiculous. Human shortcomings
may drive people to change their minds about BEING abstinent, but
abstinence itself by definition is automatically 100% effective.
After thinking about the various ways
to revisit this issue, I decided the most direct way is to simply share
my response to Alan. Here it is.
Thanks for the letter. It made me
think, and that is always good.
You have been misled by falling into
the linguist trap that promotes so much misunderstanding. "Abstinence"
is commonly used in two ways with two separate meanings. As a moral
objective, abstinence is a goal that appears in various manifestations
promulgated by religionists of several, but not all, varieties.
The rub comes when abstinence is
promoted not only as a moral value (about which I have no comment here
or in the column) but also as a birth control method. When that change
takes place, then abstinence enters to realm of measurement and its
effects must be assessed just like any pill, condom, etc. In that sense,
it is a failure.
You go a step further and assign the
lack of effectiveness to a specific item: human failure. That is an
interesting, and probably correct, analysis, but not relevant to the
statistics of things as they are. It might be relevant to improving the
method, but that is another story entirely.
If you dismiss abstinence's poor
performance as a birth control method because you know why it fails,
then you must logically dismiss condoms' failures because you know latex
has certain properties. You must also dismiss the pill's occasional
failures in large part for exactly the same reason you dismiss
abstinence's failure: human shortcomings. To do otherwise would be
intellectually dishonest and biased toward one physical method - this
paragraph has nothing to do with morals!
My point is not to attack or belittle
anyone's beliefs or morals, but to try to defuse arguments by insisting
that we all know what we are discussing before calling the other guy a
fool or tool of the dark forces. If you and I argue over the effects of
abstinence on birth control, then we impede meaningful discussion on the
really interesting subject: abstinence as a moral value. My goal is to
promote understanding and mutual respect.
By sticking to artificial logical and
gaming examples, I can avoid more than academic conflict. But what is
the use of that? Issues such as birth control, abortion, violence,
personal morality, corporate greed, etc. cause much unnecessary heat and
argumentation. My goal is to help everyone of every persuasion use the
tools of logical analysis and decision theory to simplify issues by
removing false assumptions and faulty thoughts. I will not argue
pro or con whether we possess an immortal soul as long as the purported
soul has no measurable interaction with the physical world. You are free
to believe whatever you wish. I have no problem with anything. However,
if you believe in a soul that does interact with the physical world,
then we can obviously measure that interaction and put limits on it.
People have even gone so far as weighing people as they died to see if
something with mass leaves their body upon death (no reproducible
positive results attributable to a soul or significant differences
between people and animals). That is a reasonable thing to do. Propose a
hypothesis, make predictions based on it, and test them.
Similarly, if you want to propose
abstinence as a birth control method, the statistics are there for all
to see. This has nothing to do with validating or disproving any
particular belief system.
For those who wish to delve further
into decision theory without wading through a lot of equations, I have
posted a tutorial on elementary decision theory. It shows examples of
faulty physicians' diagnoses (important for those considering surgery)
and how to evaluate anti-terrorist activities (important for everyone).
That tutorial can be found here.
Chastity is curable, if detected
early: A Contraception Guide
Contraception as a
method of not only preventing pregnancy but preventing sexually
transmitted diseases (STDs) is an essential responsibility of both
partners in any sexual relationship. It is our belief that contraception
should ALWAYS be used when having any sexual encounter EXCEPT in the
case of a couple who is actually trying to get pregnant. Most common
known forms of contraception are categorized below and discussed in
detail. Use this information to learn which forms of contraception are
right for you, most effective, and what kinds of combinations of these
methods you can use to minimize your risk of pregnancy or contracting
STDs. There can also be moral or religious implications of some of the
contraception methods, however we choose to present all forms of
contraception without moral or religious bias.
Please note that the failure rates of
the contraception types listed below is given in a percentage, both for
ideal (perfect usage) and typical (actual statistical usage) situations.
This is your chance of becoming pregnant if you have regular intercourse
over the course of one year's time. For example, if you have regular
intercourse with someone every week for an entire year using condoms as
your contraception, with ideal use your chance of pregnancy is 2.0% and
with typical use it is 10.0%. Calculating failure rates for certain
combinations of contraception such as using both the pill and condoms
can be a little tricky, so we've not included those. However, combining
certain forms of contraception to maximize effectiveness is always a
No Protection - Failure rate:
No protection simply means having
sexual intercourse or contact without any form of contraception.
Obviously, choosing this option will result in your greatest chance of
becoming pregnant. Only couples who are actively trying to get pregnant
should have unprotected intercourse. There's simply no excuse otherwise.
Guys, if you really think using a condom takes THAT much away from the
feeling and insist on having raw sex, then go home and jack off. It's a
lot cheaper and takes a lot less time than raising a child. Let's
compare: Cost of raising child: Estimated $200,000 for 18 years. Cost of
jacking off: Free. Time required to jack off: Anywhere from 30 seconds
to an hour. Time required to raise a child: 18 years. Ladies, don't let
any guy convince you to do something you are not planning to do or are
not comfortable with. No man is worth compromising your values for. And
Abstinence - Failure rate: 0%.
Abstinence is complete restraint from
sexual intercourse. It is the only 100% effective form of contraception
and STD prevention. Note, however, that, in order to be 100% effective,
one must obstain from petting, oral and anal sex in addition to vaginal
intercourse. While sex can be a lot of fun between two people who love
each other, abstinence is the wisest choice and often the right one for
couples who do not want to risk pregnancy.
Withdrawal - Failure rate: 20-30%.
Withdrawal, also known as coitus
interruptus, is when a male withdraws his penis from the female's vagina
before he ejaculates. This is the most common form of birth control used
by younger people who are ignorant about how the human body works. One
reason why this form of contraception is not very effective is because
several thousands of sperm are often present in precum, the thin clear
liquid which oozes out of a penis during high arousal and especially
during the friction of intercourse. Another reason is because often the
man won't pull out before some ejaculate is left in the vagina. Pulling
out before ejaculation is not only ineffective in preventing pregnancy,
but it can be very frustrating for both partners, especially the male.
Ladies, never let a guy convince you to have unprotected intercourse
because he says he will "pull out." First of all, it's not very
effective, and second, he may not pull out in time or not at all anyway.
Rhythm Method - Ideal failure rate:
10%. Typical failure rate: 15-25%.
Also known as the safe period method,
this is another less than effective contraception method. The idea is
for the couple to have sex at a time during the woman's menstrual cycle
when she is not ovulating and not likely to get pregnant. There are
several ways to discover this "safe time" however they usually must be
taught by a family planning professional and there are a lot of
variables that must be considered and understood. Younger people and
those less conscientious about contraception may use other forms of this
method such as having sex right before or during the female's period.
This is because most woman tend to ovulate in the middle of their
cycles. This isn't always very reliable, however.
The Pill (female) - Ideal failure
rate: 0.5%. Typical failure rate: 2%.
The pill is a prescribed hormonal
medicine that prevents pregnancy in most cases by preventing ovulation.
It contains progestogen and estrogen. While this method is extremely
effective, a decrease in this effectiveness can come from several
things. For one, the woman might take the doses irregularly, forget
doses, etc. Another problem might be taking other drugs that decrease
the pill's effectiveness. Side effects that cause vomiting or diarrhea
can also decrease effectiveness. For more information about taking
contraceptive pills, please see your doctor.
Emergency Contraception (female) -
Ideal failure rate: 1%. Typical failure rate: 3-5%.
This form of contraception is known
commonly as the "morning after pill" and can be obtained by prescription
up to 72 hours after unprotected intercourse. This pill is hormonal
medication that prevents a fertilized egg from implanting in the uterus.
Four pills are taken, two immediately and two more 12 hours later. This
pill is basically the same as normal contraceptive medication, however
the dosage is much higher so some adverse side effects like nausea and
vomiting can occur. Like all medical forms of contraception, this pill
does nothing to stop STDs. If you are interested in this option please
see your doctor.
Gels and Foams - Ideal failure rate:
5%. Typical failure rate: 15%.
Gels, foams, jellies, and creams that
contain spermicides work as contraceptives by killing sperm. They
shouldn't be relied on to prevent pregnancy alone but should be used
along with other methods such as condoms or diaphragms. They can also be
used with the sponge method, although contraceptive sponges are not
terribly effective and have been discontinued from widespread
production. Most spermicides contain nonoxynol-9, which can offer
limited protection against STDs as well. some people can have allergic
reactions to nonoxynol-9 and thus should use other contraception methods
or find spermicides with other active ingredients.
Condom (male) - Ideal failure rate:
2%. Typical failure rate: 10%.
The condom is perhaps the most common
form of contraception. It can also be fairly effective against both STDs
and pregnancy, if used properly. Most condoms are made of thin latex
rubber, but polyurethane condoms are also available for those who have
allergic reactions to latex. It is unrolled on the man's erect penis to
contain ejaculate during intercourse. Using one carefully and properly
is extremely effective to maintain their effectiveness. The man should
hold the condom at the base and withdraw immediately after ejaculation
in order to keep semen from spilling into the vagina. Condoms should
never be reused. Only water-based lubricants should be used with latex
condoms because oil based lubricants break down the composition of
For more detailed information about
condoms please see our
Female Condom - Ideal failure rate:
3%. Typical failure rate: 10-15%.
First introduced in 1992 as "Reality."
This is a loose polyurethane condom designed for the female to insert
into her vagina before intercourse. It has a wide open ring at the
bottom and a smaller, closed ring at the top that is designed to fit
over the cervix. It is effective against pregnancy and STDs but because
some women may not learn how to insert them correctly before they have
intercourse with them, they can fail.
For more detailed information about
condoms please see our
Cervical Caps and Diaphragms
(female) - Ideal failure rate: 2%. Typical failure rate: 10-15%.
Unlike condoms, cervical caps and
diaphragms (pronounced "diafram") allow semen to enter the vagina, but
they prevent it from entering the cervix, traveling up the uterus, and
fertilizing an egg in the fallopian tube. They are made of small round
pieces of latex rubber that fit securely over the cervix. Caps merely
fit over the cervix, while diaphragms cover the cervix and are held in
place by bracing against the pubic bone. They come in a few different
varieties. They must be fitted by a doctor or nurse and take some
knowledge and practice in order to be used effectively. They are also
usually used with spermicides to increase effectiveness. The caps and
diaphragms must be inserted prior to sexual activity or intercourse and
must remain in place for at least 6 hours afterwards. They're relatively
durable can last years if properly cared for. While they have some
drawbacks, this is a suitable contraceptive option for women who are
unable to use pills for whatever reason. Once again these need to be
purchased and fitted by a doctor, so if you are interested in this
method please see yours.
IUD (Intrauterine Device) - Ideal
failure rate: 1-2%. Typical failure rate: 4%.
IUD's are small, t-shaped, plastic
devices that are inserted into the uterus by a doctor. There are 2
types, those containing a thin coil wrap of copper, and those containing
progestogen. They generally prevent pregnancy by creating a hostile
environment in the uterus for fertilized eggs and in the case of the
copper variety, sperm as well. While they are regarded as highly
effective, they have some possible side effects such as infection,
spotting, cramps, acne, and tenderness. They can last up to 5 years. See
your doctor if you are interested in this method of contraception.
The Sponge (female) - Ideal failure
rate: 5%. Typical failure rate: 15-20%.
The sponge is a small spongy ball with
a string attached that is meant to be inserted deep in the vagina before
intercourse and prevent semen from reaching the cervix and uterus. It is
often soaked in spermicides to increase effectiveness. While widespread
production of contraceptive sponges has been discontinued, it is still
available in some areas and some women still swear by its use. It is not
highly effective but does provide much more protection against pregnancy
than using no protection at all.
Vasectomy (male) - Failure rate:
A vasectomy involves a simple
outpatient surgical procedure in which the male's vas deferens are
clipped. The vas deferens are the small tubes that carry sperm up from
the testicles to the prostate. After this procedure, the man can still
ejaculate and orgasm, however no sperm is present in his semen. The only
possibility for failure exists if the man has unprotected intercourse
within a few weeks after having the procedure, as some sperm can remain
in his semen until then before it is all "flushed out." There is some
discomfort shortly following the procedure, however this is by far the
simplest and most effective form of permanent contraception available
for the male.
Tubal Litigation (female) - Failure
This involves a surgical procedure in
which the fallopian tubes of the female are cut and cauterized. This
prevents sperm from reaching an ovum, and prevents an ovum from
traveling into the uterus. The woman will still continue to menstruate,
and after healing has occurred little decrease in sexual enjoyment is
felt. Conception can still occur if an ovum has passed the point of
litigation before surgery and intercourse takes place, so women who have
had this operation are advised to use other protection if they have
intercourse before their next menstrual cycle after the operation.
Of course there are other forms of
birth control available, however we have presented only the most
well-known and most popular methods in this guide. New additions may
show up later, and if they do we will be sure to keep you updated. If
you have any other questions or comments about any of the methods
described, please contact us by writing.
Facts of Life
Abstinence-based sex education programs
for school children are multiplying across the nation, due in no small
part to a 1996 change in the federal welfare law outlining a specific
abstinence curriculum that the programs must follow to receive federal
funding.1 According to the law, acceptable programs should teach
abstinence from sex outside of marriage as “the expected standard” and
that “sexual activity outside the context of marriage is likely to have
harmful psychological and physical effects.” Since 1996, programs
meeting these and other criteria have received more than $50 million in
federal funds. 2
Despite their increasing popularity and
government support, there are few randomized controlled trials – the
gold standard in health research – or systematic reviews of how
abstinence-based programs affect outcomes such as postponement of sex
until marriage, rates of sexually transmitted diseases among young
adults or teen pregnancy rates. Program curricula vary from state to
state and school district to school district, making comparison and
Abstinence After Sex
According to 2003 data from the Centers
for Disease Control and Prevention’s Youth Risk Behavior Surveillance
System, more than 45 percent of high school students have had sex at
least once.3 Some abstinence programs have tailored their messages to
reach sexually experienced youth, but few studies examine the effects of
abstinence messages in this group of teens.4
A 2001 policy statement from the
American Academy of Pediatrics, reaffirmed in 2005, encourages
pediatricians to make information on contraception available at local
schools where the sex education curriculum does not discuss
In a 2004 survey of 1,000 Americans
conducted by the Kaiser Family Foundation, only 15 percent said schools
should teach a strict abstinence-only curriculum without any mention of
condoms or other contraceptives. 5
Public school districts in the South
were almost five times more likely than districts in the Northeast to
offer abstinence-only sex education curricula, according to a 1999
survey of 825 districts nationwide. 6
A review of 21 abstinence-only
education programs in Texas found that masturbation, “sexual identity
and orientation” and “the common occurrence of sexual fantasies” were
among the topics least likely to be discussed. 8
A report on federally funded
abstinence-only programs found that the programs increased students’
favorable attitudes about abstinence but did not significantly affect
their attitudes about marriage or change their perceptions about peer
pressure to have sex. 9
AIDS education programs do not affect
abstinence rates among adolescents, but they do boost the likelihood
that the teens will have condom-protected versus unprotected sexual
intercourse, according to a 2005 study. 10
Teens who made a “virginity pledge” but
later had sexual intercourse before marriage were less likely to use
contraception during their first sexual encounter than those who did not
pledge, according to a 2001 study. 11
Rates of sexually transmitted diseases
do not differ between those who have taken a virginity pledge and those
who have not taken the pledge, according to a 2005 study. 12
A 2000 review found black adolescent
boys are less likely than white and Hispanic peers to receive sex
education before their first sexual intercourse. 13
A 1998 randomized trial comparing
abstinence and safe sex programs for black adolescents concluded that
teens in the abstinence groups were less likely than those in the safe
sex group to have sex in the three months after the trial, but this
difference disappeared 6 months and 12 months later. 14
Sexually active middle school students
had fewer sexual partners after participating in an abstinence-only
education program compared to their peers who did not go through the
program, according to a 2005 Ohio study. 4
Briefings for Health Reporters, Vol. 10, No. 10, October 2005
How To Measure Abstinence
professionals, parents, teachers and lawmakers want to know whether
abstinence programs will help children delay sex until marriage and
protect them from pregnancy and sexually transmitted diseases, and
which, if, any of the abstinence-based curricula are the most deserving
of federal funding. However, measuring the successes and failures of
abstinence education has proved difficult for several reasons:
Defining the Terms: It seems easy to
define but a 2003 15 review of Texas abstinence-only programs by Texas
A&M University professor Patricia Goodson concluded that students,
program instructors and program directors all emphasized different ideas
when asked to describe abstinence. Program directors defined abstinence
as refraining from sexual intercourse, oral and anal sex, while
instructors were more likely to include any type of “petting”. The
researchers were also surprised by how many students thought of
abstinence in positive terms, emphasizing self-control, greater choice
and future opportunities in their definitions.
Asking the Right Questions: Researchers
try to measure the effects of abstinence programs by comparing teen
pregnancy rates, the onset of sexual activity or STD rates between teens
who participate in the programs and those who do not. It can be tricky
to gather the essential data for those questions because of “the
controversy surrounding asking teens about sex, pregnancy and abortion,”
says Sylvana Bennett, M.D., of the University of California, San Diego
Medical Center. Bennett conducted one of the few systematic reviews of
school teen pregnancy programs in the United States, published in
2005.16 Because of pressure from parents who did not want their children
interviewed about such sensitive topics, “Several of the studies I
reviewed stated that they were required to drop some of their
questions,” Bennett says.
Making Useful Comparisons: Abstinence
curricula are often tailored for a specific state’s school district’s
requirements, making it difficult to compare outcomes across programs.
“One pregnancy prevention program that worked great in inner city
Chicago may not have worked in a suburban school in Utah and vice
versa,” says Bennett.
In school districts where most of the
students come from the same background, abstinence strategies that have
proven successful elsewhere can be thwarted. A recent study of an
abstinence program for Ohio middle schoolers, for instance, “seems to be
unique in that the program did appear to have an effect on sexual
behavior of the sexually experienced,” according to study author Elaine
Borawski of Case Western Reserve University.4
Waiting for Data: It’s easy enough to
give a multiple-choice test after an abstinence program to find out if
students have changed their attitudes toward premarital sex and the
risks of pregnancy and STDs. But most studies are not long enough to
find out whether the new information and attitudes translate into new
behaviors. 2, 12, 17, 18 “I do think that part of the problem is asking
teens about behavior before they have had time to change it,” Bennett
Sylvana Bennett, M.D., University of
California, San Diego Medical Center or 619.543.6922 or
Patricia Goodson, Ph.D., Texas A&M
University or 979.845.1756 or
Douglas Kirby, Ph.D., ETR Associates or
831.438.4060 x 144 or
Marilyn Maxwell, M.D., Saint Louis
University School of Medicine or 314.577.6143 or
1.U.S. Social Security Act 510 (b)(1)
Last accessed 9-22-05 at http://www.socialsecurity.gov/OP_Home/ssact/title05/0510.htm.
2. M.H. Thomas (2000) Abstinence-based
programs for prevention of adolescent pregnancies. Journal of Adolescent
Health, 26, 5-17.
3. Centers for Disease Control and
Prevention (2004). Surveillance Summaries. Morbidity and Mortality
Weekly Report, 53 (No.SS-2).
4. E.A. Borawski et al. (2005)
Effectiveness of abstinence-only intervention in middle school teens.
American Journal of Health Behavior, 29, 423-434.
5. National Public Radio/Kaiser Family
Foundation/ John F. Kennedy School of Government Poll. “Sex Education in
America.” Poll results last accessed 9-8-05 at http://www.kff.org/newsmedia/upload/Sex-Education-in-America-Summary.pdf.
6. D.J. Landry et al. (1999) Abstinence
promotion and the provision of information about contraception in public
school district sexuality education policies. Family Planning
Perspectives, 31, 280-286.
7. Committee on Psychosocial Aspects of
Child and Family Health and Committee on Adolescence (2001) American
Academy of Pediatrics: Sexuality education for children and adolescents.
Pediatrics, 108, 498-502.
8 .K.L. Wilson et al. (2005) A review
of 21 curricula for abstinence-only-until-marriage programs. Journal of
School Health, 75, 90-98.
9. R.A. Maynard et al. (2005)
First-Year Impacts of Four Title V, Section 510 Abstinence Education
Programs. Evaluation contracted by U.S. Department of Health and Human
Services, Office of the Assistant Secretary for Planning and Evaluation.
Last accessed 9-8-05 at
10. C.H. Tremblay and D.C. Ling (2005)
AIDS education, condom demand, and the sexual activity of American
youth. Health Economics, 14, 851-867.
11. P.S. Bearman and H. Brückner
(2001). Promising the future: Virginity pledges and the transition to
first intercourse. American Journal of Sociology, 106, 859-912.
12. H. Brückner and P. Bearman (2005)
After the promise: the STD consequences of adolescent virginity pledges.
Journal of Adolescent Health, 36, 271-278.
13. L.D. Lindberg et al. (2000)
Adolescents' reports of reproductive health education, 1988 and 1995.
Family Planning Perspectives, 32, 220-226.
14. J. Jemmott et al. (1998).
"Abstinence and safer sex HIV risk-reduction interventions for
African-American adolescents, a randomized trial." Journal of the
American Medical Association, 279, 1529-1536.
15. P. Goodson et al. (2003) Defining
abstinence: views of directors, instructors and participants in
abstinence-only-until-marriage programs in Texas. Journal of School
Health, 73, 91-96.
16. S.E. Bennett and N.P. Assefi (2005)
School-based teenage pregnancy prevention programs: a systematic review
of randomized controlled trials. Journal of Adolescent Health, 36,
17. S.D. Pinkerton (2001) A relative
risk-based, disease-specific definition of sexual abstinence failure
rates. Health Education and Behavior, 28, 10-20.
18. T.E. Smith et al. (2003)
Measurement in abstinence education: critique and recommendations.
Evaluation and the Health Professions, 26, 180-205.
The Center for the Advancement of
Health is an independent nonprofit organization that promotes greater
recognition of how psychological, social, behavioral, economic and
environmental factors influence health and illness. The Center advocates
the highest quality research and communicates it to the medical
community and the public. The fundamental aim of the Center is to
translate into policy and practice the growing body of evidence that can
lead to the improvement and maintenance of the health of individuals and
the public. The Center was founded by the John D. and Catherine T.
MacArthur Foundation and the Nathan Cummings Foundation, which continue
to provide core funding. Funding for this series was provided by the
Robert Wood Johnson Foundation.
For Information Contact:
Lisa Esposito, Editor, Health Behavior
News Service, Center for the Advancement of Health, 2000 Florida Ave.,
NW, Suite 210, Washington, DC 20009 or 202.387.2829 or fax 202.387.2857
Teenagers special: Going all the way
of females aged 15-19 who gave birth in 2002.
Teenage mothersLYNSEY TULLIN was 15
when she became pregnant. The only contraception she and her boyfriend
had used was wishful thinking: "I didn't think it would happen to me,"
she says. Tullin, who lives in Oldham in northern England, decided to
keep the baby, now aged 3, although as a consequence her father has
Tullin is not alone. In the UK nearly 3
per cent of females aged 15 to 19 became mothers in 2002, many of them
unintentionally. And unplanned pregnancies are not the only consequence
of teenage sex - rates of sexually transmitted diseases (STDs) are also
rocketing in British adolescents, both male and female.
The numerous and complex societal
trends behind these statistics have been endlessly debated without any
easy solutions emerging. Policy makers tend to focus on the direct
approach, targeting young adolescents in the classroom. In many western
schools teenagers get sex education classes giving explicit information
about sex and contraception. But recently there has been a resurgence of
some old-fashioned advice: just say no. The so-called abstinence
movement urges teens to take virginity pledges and cites condoms only to
stress their failure rate. It is sweeping the US, and is now being
exported to countries such as the UK and Australia.
Confusingly, both sides claim their
strategy is the one that leads to fewest pregnancies and STD cases. But
a close look at the research evidence should give both sides pause for
thought. It is a morally charged debate in which each camp holds
entrenched views, and opinions seem to be based less on facts than on
ideology. "It's a field fraught with subjective views," says Douglas
Kirby, a sex education researcher for the public-health consultancy ETR
Associates in Scotts Valley, California.
For most of history, pregnancy in
adolescence has been regarded not as a problem but as something that is
normal, so long as it happens within marriage. Today some may still feel
there is nothing unnatural about older adolescents in particular
becoming parents. But in industrialised countries where extended
education and careers for women are becoming the norm, parenthood can be
a distinct disadvantage. Teenage mums are more likely to drop out of
education, to be unemployed and to have depression. Their children run a
bigger risk of being neglected or abused, growing up without a father,
failing at school and abusing drugs.
The US has by far the highest number of
teenage pregnancies and births in the west; 4.3 per cent of females aged
between 15 and 19 gave birth there in 2002. This is significantly higher
than the rate in the UK (2.8 per cent), which itself has the highest
rate in western Europe (see Chart).
Another alarming statistic is the
number of teenagers catching STDs. In the UK the incidences of
chlamydia, syphilis and gonorrhoea in under-20s have all more than
doubled since 1995. The biggest rise has been in chlamydia infections in
females under 20; cases have more than tripled, up to 18,674 in 2003.
Chlamydia often causes no symptoms for many years but it can lead to
infertility in women and painful inflammation of the testicles in men.
No surprise, then, that teenage sex and
pregnancy has become a political issue. The UK government has set a
target to halve the country's teen pregnancy rate by 2010, and the US
government has set similar goals. But achieving these targets will not
be easy. In an age when adolescence has never been so sexualised, in
most western countries people often begin to have sex in their mid to
late teens; by the age of 17, between 50 and 60 per cent are no longer
Since the 1960s, UK schools have
increasingly accepted that many teenagers will end up having sex and
have focused efforts on trying to minimise any ensuing harm. Sex
education typically involves describing the mechanics of sex and
explaining how various contraceptives work, with particular emphasis on
condoms because of the protection they provide from many STDs.
The sex education strategy gained
further support in the early 1990s when policy makers looked to the
Netherlands. There, teenage birth rates have plummeted since the 1970s
and are now among the lowest in Europe, with about 0.8 per cent of
females aged between 15 and 19 giving birth in 2002. No one knows why
for sure, as Dutch culture differs from that of the UK and America in
several ways. But it is generally attributed to frank sex education in
schools and open attitudes to sex. Dutch teenagers, says Roger Ingham,
director of the Centre for Sexual Health Research at the University of
Southampton,"have less casual sex and are older when they first have sex
compared with the UK".
“Why do virginity pledgers catch STDs?
It's difficult to imagine intending not to have sex while also being
contraceptively prepared”But a new sexual revolution is under way.
Spearheaded by the religious right, the so-called abstinence movement is
based on the premise that sex outside marriage is morally wrong. "We're
trying to say there's another approach to your sexuality," says Jimmy
Hester, co-founder of one of the oldest pro-abstinence campaigns, True
Love Waits, based in Nashville, Tennessee.
Abstinence-based education got US
government backing in 1981, when Congress passed a law to fund sex
education that promoted self-restraint. More money was allocated through
welfare laws passed in 1996, which provided $50 million a year.
A key plank of the abstinence approach
is to avoid giving advice on contraception. The logic is that such
information would give the message that it's OK to have sex. "The moment
we do that, we water down the commitment," says Hester.
If contraception is mentioned at all,
it is to highlight its failings - often using inaccurate or distorted
data. A report for the US House of Representatives published last
December found that 11 out of the 13 federally funded abstinence
programmes studied contained false or misleading information. Examples
of inaccurate statements included: "Pregnancy occurs one out of every
seven times that couples use condoms," and: "Condoms fail to prevent HIV
31 per cent of the time." They also use some questionable logic
regarding the success rate of abstinence (see "Heads I win, tails you
While some states advocate
"abstinence-plus" programmes, providing a level of advice on
contraception alongside heavy promotion of chastity, the hard-line
"abstinence only" approach is in the ascendant in the US. Around a third
of US secondary schools have abstinence-only programmes, and nearly 3
million young people have publicly pledged to remain virgins until they
And it is spreading. Last June an
American group came to the UK to promote the Silver Ring Thing, a
Christian movement that encourages teens to publicly pledge to remain
virgins until marriage and to keep their promise with the aid of a $12
ring. And True Love Waits has held virginity rallies in Australia.
This trend comes amid claims that the
UK's more liberal approach not only does not work, but has the opposite
effect. "Free pills and condoms boost promiscuity" screamed the headline
on the front page of UK newspaper The Times last year (5 April 2004). It
was prompted by research by David Paton, an economist at the University
of Nottingham, UK, which found that in some areas that had increased
access to family planning services, teen pregnancy rates had remained
the same and STD rates had actually risen.
“Despite many people's assumption that
sex education is the best way to reduce pregnancies, there is little
evidence backing this view”There are now increasing calls from
conservative and religious groups for schools in the UK to consider the
abstinence option. A programme called Love for Life is now operating in
60 per cent of schools in Northern Ireland. It could be described as
abstinence-plus that is heavy on the abstinence. Its founder, Richard
Barr, a GP from Craigavon, County Armagh, says that focusing on
contraception ignores the bigger picture of human sexuality. "There's a
massive need for a more holistic approach, not just a damage-limitation
And the UK mainland is home to a small
but growing number of groups, most of them with Christian roots,
promoting abstinence-centred education. The word abstinence is less in
vogue than across the Atlantic, however, and such groups are more likely
to talk in terms of delaying sex until young people are in a committed
But does the abstinence approach work?
Do teenagers - a group not renowned for their propensity to do what they
are told - take any notice when adults tell them not to have sex?
Proponents of abstinence claim research
supports their strategy. But the vast majority of studies that have been
done in this area have been small, short-term evaluations without
control groups. "There have only been three well-designed trials where
an 'intervention' group is compared with a control group and
participants are tracked over time," says Kirby.
One of these, published in 1997, looked
at a five-session abstinence-only initiative in California. The trial
tracked 10,600 teenagers for 17 months (Family Planning Perspectives,
vol 29, p 100). The researchers found it had no impact on the sexual
behaviour or pregnancy rates of teenagers. The other two studies had
similar results. "None of them show that any abstinence-only programmes
had any impact on behaviour," says Kirby.
Although not a controlled trial, one of
the largest studies of the effect of abstinence pledges tracked the sex
lives of 12,000 US teenagers aged between 12 and 18 (American Journal of
Sociology, vol 106, p 859). A group led by Peter Bearman, a sociologist
at Columbia University in New York, investigated whether taking a
virginity pledge affected the age when people first had sex. It did,
with an average delay of 18 months. The pledgers also got married
earlier and had fewer partners overall.
But when Bearman went back six years
later and looked at the STD rates in the same people, now aged between
18 and 24, he was in for a surprise. In research presented at the
National STD conference in Philadelphia last year, he found that though
pledgers had had fewer sexual partners than non-pledgers, they were just
as likely to have had an STD. And the reason? "Pledgers use condoms
less," says Bearman. "It's difficult to simultaneously imagine not
intending to have sex and being contraceptively prepared."
Here lies the problem that many have
with the idea of abstinence-only education. While it may work for those
kids who live up to the ideal, those who don't are left without the
knowledge to protect themselves when they do have sex. "It's not rocket
science," says Bearman.
But here's where proponents of the
liberal approach can stop feeling smug. Because despite many people's
unquestioning assumption that comprehensive sex education is the best
way to reduce teenage pregnancy, there is actually little good-quality
evidence backing this view.
One of the problems in carrying out
randomised controlled trials in this area is the question of who should
be used as the control group. Most schools now have some form of sex
education in place, however rudimentary, and it would be unethical to
take this away from some children to create the control group. Instead
researchers have tended to compare standard sex education with new
initiatives specially designed to reduce pregnancy rates. But the
results have been unimpressive. A systematic review in 2002 of 26 such
studies showed that not one of them improved the use of birth control or
reduced the teenage pregnancy rate (British Medical Journal, vol 324, p
But in the past few years, a handful of
randomised controlled trials have been published showing that some
carefully designed sex education programmes do appear to work. One of
the most effective is the Carrera Adolescent Pregnancy Prevention
Program, aimed at 13 to 15-year-olds in a poor area of New York
(Perspectives on Sexual and Reproductive Health, vol 34, p 244).
Abstinence is mentioned during the programme, but most of the emphasis
is on contraception. A three-year study showed that the pregnancy rate
of teenage girls who took the programme was less than half the rate of
those who didn't. Analysis showed this was due to both greater condom
use and delayed onset of sex.
Why should these programmes be any
different? As well as lasting longer, they were, says Kirby,
"interactive and personalised, not just abstract facts". The Carrera
programme, for example, not only covered sexual behaviour, it tackled
the social disadvantages that lead to teenage pregnancy. Along with
information on and free access to contraceptives, it involved intensive
youth work such as sports, job clubs and homework help.
Most UK sex education programmes seem
half-hearted in comparison, providing the bare biological facts, perhaps
alongside a demonstration of how to put a condom on a cucumber. "It's
something I feel quite angry about," says Michael Adler, a former STD
physician at University College London Hospital. In his job he saw many
casualties of unsafe sex. "We're failing young people right at the
beginning," he says.
Unfortunately policy makers have
recently lost a good source of information about what works and what
doesn't. The US Centers for Disease Control and Prevention (CDC) in
Atlanta, Georgia, commissioned a panel of external experts to carry out
a rigorous review of various sex education programmes. The panel
identified five strategies that were successful in reducing the rate of
teenage pregnancy, all based on comprehensive sex education, and the
details were posted on the organisation's website. But in 2002 that
information disappeared and the CDC will no longer release it.
According to the CDC press office, the
review programme is being "re-evaluated". But sceptics fear it has been
dumped because its conclusions don't fit with the Bush's
administration's views. "They were inconsistent with the ideology to
which this administration adheres," says Bill Smith of the Sexuality
Information and Education Council of the United States, a liberal sex
education advocacy group based in New York.
“Sceptics fear the information on
successful sex education programmes has been dumped because it doesn't
fit with the Bush administration's views”What of the study that made the
newspaper headlines in the UK last year, showing that contraception
provision is linked with higher STD rates? Perhaps it should not really
be taken as a damning indictment of the liberal approach. The study
looked at National Health Service family planning clinics, not
school-based comprehensive sex education. Simply doling out condoms
without tackling the wider issues is unlikely to have much impact.
Anyway, should the correlation between sex clinics and STD levels really
be so surprising? "Has it occurred to [David Paton] that they put more
services in areas with high rates?" asks Roger Ingham.
In fact, amid all the scare stories,
the average age when a person first has sex now appears to be levelling
out at around 17 in the US and 16 in the UK. And although rates of STDs
are on the increase in the UK, teenage pregnancy and birth rates are on
a downward trend, as they have been in most developed countries for
several years. A report from the Alan Guttmacher Institute, a
reproductive health research group in New York, concludes this is due to
factors such as the rise of careers for women, and the increasing
importance of education and training (Family Planning Perspectives, vol
32, p 14). Perhaps it is unsurprising, then, that it is among society's
lowest income groups that teen pregnancy rates are highest.
In the face of such complex societal
forces, those who try to influence teenagers' behaviour on a day-to-day
basis undoubtedly have a tough job on their hands. There may be no
single solution. More research is needed to produce detailed information
on which kind of sex education programmes work best, and in which
One approach is to involve older
teenagers, on the premise that 14-year-olds may be more likely to listen
to 18-year-olds than people of their parents' generation. Since having
her son, Lynsey Tullin has started working for Brook, a young people's
sexual health charity, to ensure that today's teenagers are more savvy
about sex. "We talk the same language," she says.
A tactic that she finds hits home is to
describe new parenthood in all its gory details - the nappies, the lack
of sleep, a social life in tatters. "We run workshops about being
parents, telling them what we went through," she says. "It's a shock."
issue 2489 of New Scientist magazine, 05 March 2005, page 44
Different approaches to teenage
Provides explicit information about
contraception, sexuality and sexual health
Teaches that the only place for sex is
within marriage, and the only certain way to avoid pregnancy and STDs is
abstinence. Does not teach about contraception
Promotes abstinence as the best choice,
but provides varying degrees of information on contraception in case
teens do become sexually active
Heads I win, tails you lose
LOOK at any abstinence-only literature,
and you'll read that this is the only certain way to prevent pregnancy
and avoid catching a sexually transmitted disease (STD). "Abstinence.
Failure rate 0 per cent," is the claim on one pro-abstinence website.
But does this make sense? The most
important measure of any method of preventing pregnancy and STDs is not
its ideal effectiveness, but its "use effectiveness" - how successful it
is in the real, sometimes messy, world of sex. Condoms, for instance,
have a 97 per cent success rate at preventing pregnancy if used
correctly, but have an estimated use-effectiveness of 86 per cent, due
to problems such as tearing or slipping. If people who intend to use
condoms but never get as far as opening the pack are included, some
studies suggest the use-effectiveness of condoms could be as low as 30
per cent - the sort of figure abstinence fans shout from the rooftops.
What about applying the same real-world
rules to abstinence? Unfortunately there are no studies detailing the
use-effectiveness of abstinence in preventing pregnancy, but it is
highly unlikely to be 100 per cent, as commonly claimed by its
proponents. Their reasoning goes like this: individuals who set out to
remain abstinent but succumb to temptation and have sex are no longer
seen as abstinence "users". And those who become pregnant may even be
marked up as a failure for the contraception strategy if, say, they
attempted to use a condom but bungled it.
Abstinence campaigners are very vocal
about the failings of contraception. But is it perhaps time to own up
about the failure rate of abstinence?
Sex and the single artist
two is the number of names British artist Tracey Emin sewed into her
tent, Everyone I Have Ever Slept With 1963-1995. Artists and poets have
a reputation for having a high sex drive. Now Daniel Nettle of the
University of Newcastle upon Tyne and Helen Keenoo of the Open
University, both in the UK, have added support to the idea.
They asked 425 British people,
including artists and poets, on many sexual partners they'd had
(Proceedings of the Royal Society B, DOI: 10.1098/rspb.2005.3349)
Professional artists and poets averaged 4 to 10 sexual partners, other
people averaged only 3. "What we seem to have established is that
artists and poets are, amongst other things, horny old toads," Nettle
Volunteers were also assessed for
character traits associated with schizophrenia which has previously been
linked to creativity. Some professional artists and poets scored as
highly on these measures as people with schizophrenia did.
Combined with a high sex drive this may
explain the persistence of schizophrenia in the population, says Nettle.
New Scientist asked Tracey Emin to
comment on the results and she denied that she has more sex than the
general population. “In fact, I do everything to avoid it,” she says.
“That’s because I don’t want to have sex with most people. I want
angels, giants, tigers, and I would love to love myself.”
Source: From issue
2529 of New Scientist magazine, 10 December 2005, page 23,
- An estimated
850,000–950,000 persons in the United States are living with HIV. Of
these, 180,000–280,000 do not know they are infected.
- Of new cases,
a disproportionate number are in persons who do not know they are
- Each year at
publicly funded testing sites, 27,000–30,000 HIV test results are
- Of those who
test positive at CDC-funded public testing sites, 31% do not return
for their results.
More women die of AIDS
AIDS is destroying
more women than men. This is confirmed by recent mortality records of
the Family Health and Population Action Committee (FAHPAC) Home Based
Care program. The most pathetic thing is that more women die because of
two main reasons. The culture of silence by women, even in the face of
injustice. Experience shows that even when it is clear that the problem
of HIV infection could be traced to the husband, he cannot be queried by
the wife. Most men will treat their sexually transmitted disease and
even AIDS without discussing it with their spouses. Poor women! She
struggles with diseases for which she is innocent and suffers in
silence. A good number of men resist HIV screening when their wives are
HIV positive. The woman only bemoans the situation and takes no actions
to safeguard her own interest and prevent further infection. The
“master” is a sacred cow. Again, the woes that befall a woman whose
husband dies of AIDS is intolerable and degrading. She faces a barrage
of sanctions and punishments for her sin. She may be beaten up, isolated
and ridiculed publicly. Of course, she may automatically lose all her
family property to the in-laws. Coupled with all these inhumane
treatments, is the possibility of having any of the children test HIV
positive. The woman is thus even disadvantaged because she may be
completely left to “her own fate.” The clarion call from FAHPAC is for
all concerned government, nongovernmental organization and communities
to wake up to the support of women who are HIV positive. These women
suffer unimaginable deprivation. If they are looking well and not yet
showing any signs of AIDS, men still approach them for sex. Even when
informed about her HIV positive status, the woman is pressurized to
accept unprotected sexual intercourse. It is evident that women who are
HIV positive but receive care and support live positively and learn to
be selfish with the virus. These reduce the spread and scourge of AIDS.
It is a divine obligation to take positive action. We cannot afford to
fail. We must protect women's rights. (full text)
Reaching Out. 2000 May-Jun;3(3):2.
Godfrey, Rhett with Neale S. Godfrey.
The Teen Code. How to talk to us about sex, drugs, and everything
else - Teenagers Reveal What Works Best. Believe it or not, there
are ways to talk to teenagers so they’ll listen. But first you have to
“crack the code” of how teenagers think and talk. To find out how,
18-year-old Redtt Godfrey asked the experts themselves: teenagers from
across the country. Now he takes parents inside the very secretive world
of today’s teenager. The frank and surprising conversations Rhett shares
give parents a clear path about what kids say works best-and what can
backfire- when talking to them about sex, drugs, privacy, alcohol,
cigarettes, school problems , family problems and self expression.
Rodale Inc, 2004, ISBN 1-57954-852-0
Harvey, Eric, Walk Awhile in My
Shoes, Too: Straight talk from parents and teachers to children and
students, The Walk the Talk Co. This handbook, written for adults
and children, is a powerful vehicle to open lines of communication and
establish relationships based on empathy, values, trust and mutual
respect. The Walk the Talk Co,
Buy this booklet!
* * *
Many people are offended by the truth.