Challenging Dogma - Fall 2007

...Using the social and behavioral sciences to improve the practice of public health.

Wednesday, December 12, 2007

The Forbidden Fruit Is Always Sweeter: The Problems With Abstinence-Only Education—Jessica Assiamah-Ansong

Ignorance may be bliss in some circumstances but in the situation of unprotected sex, ignorance can be deadly. Not knowing how to use condoms or other forms of contraception during sexual activity may place an individual at risk for various diseases including sexually transmitted infections (STI’s) and HIV/AIDS. HIV is one of the leading causes of death between people ages 18 to [25]. Policy makers understand that sexuality is a topic that must be addressed; therefore, policy makers are encouraging sex education in schools. The Bush administration is of the opinion that students’ curriculum should include sex education that is strictly focuses on abstinence and neglects information on contraception or condom use. Moreover the federal government will only fund programs that strictly emphasize abstinence from sexual activity. They believe that sharing contraceptive information with teenagers will put them at a higher risk of becoming sexually active [1]. The Bush administration also suggests that abstaining from sexual activity is 100% effective against STI’s, HIV and pregnancy. Finally, in the government’s opinion, sex is only appropriate in the confines of a marriage. Sex outside of marriage is the cause of many illegitimate births, the AIDS epidemic, poverty and the destruction of the nuclear family.

Many of these points are valid; however, they completely ignore the fact that adolescents are having sex. In fact, by senior year, there are more high school students who are sexually active or have been sexually active than seniors who are virgins [2]. Furthermore, lecturing rebellious teenagers about abstaining from sex may encourage them to engage in sexual behavior. Lastly, the media fails to educate or value abstinence as it is flooded with thousands of sex images, scripts and innuendos. In the following paragraphs, I will use the arguments stated above to support my belief that abstinence-only education is not effective.

Overview of Sex Education in the U. S.
It is important that adolescents learn about sex in schools. Engaging in risky sexual behavior places individuals at risk for teen pregnancy, STI’s, HIV and other emotional distress. The US has one of the highest teen pregnancy rates in the developed world [5]. Teen unintended pregnancy rates are twice as high as those in England, Wales or Canada and nine times as high as the rates in the Netherlands and Japan [5]. There is plenty of evidence that suggests that sex education is necessary.

Sex education refers to the education of human sexuality contraception with the intention to reduce teens’ risk of contracting STI’s, HIV and getting pregnant [5]. There are two types of sex education—abstinence-only-until-marriage or abstinence-only and comprehensive sex education or abstinence-plus. Each program’s main objective is to reduce STIs, HIV and unintended pregnancies, but they use different strategies to reach their goal. An abstinence-only curriculum refers to a curriculum that promotes abstinence from sex [1]. By emphasizing that abstinence is the only 100% effective way to avoid STI’s, HIV and unintended pregnancies, school teachers fail to discuss contraception or condom use [1]. A comprehensive sex education, on the other hand, acknowledges students who are sexually active and the students that will eventually become sexually active by providing them with contraception and condom use information [1]

As of 1996, the federal government has funded only programs that provide abstinence-only education [6]. They allocated $50 million each year for abstinence-only education [6]. The federal government forbids “abstinence-only” education to discuss contraceptive methods unless they are discussing failure rates, but emphasize that sex outside of wed-lock is wrong [5]. Recently, the Sexuality Information and Education Council of the United States (SIECUS) released report indicating that that policymakers decided to raise funds by $28 million for abstinence programs that have failed to make an impact on adolescents’ behavior [7]. This increase in funding for abstinence-only education will not reduce the spread of HIV/AIDS or STI transmission. Abstinence-only education is simply ineffective and the government should adapt another method for educating students about sexual education.

Abstinence-only education does not account for adolescent’s need for independence; therefore, it may lead them to engage in sex as an act of rebellion against authority figures.
Adolescents, who value independence, want to exercise the freedom of making their own decisions without authority figures enforcing rules or beliefs upon them. For example, teenagers can be described as rebellious, moody and restless. A teenager is anxious to drive and get his own car; persuades his parents to extend his curfew and wants a job to pay for his clothes. Typically, teenagers strive for independence. They want to be free to have their own beliefs and make their own decisions.

During adolescence, Erikson, a psychologist who is known for his theory of psychosocial development, argues that teenagers strive for autonomy and to find an identity [10]. It is important that parents and other authority figures allow their teenager to explore their identity. Health professionals recommend that parents do not judge or enforce beliefs among a teenager [8]. They recommend that parents refrain from enforcing their opinion on the teen’s identity, such as clothes and the type of music the teen enjoys [8]. Teenagers want to feel that they are in control.

An adolescent’s autonomy is challenged by abstinence-only education’s attempt to persuade them to refrain from all sexual activity. A teacher that strictly enforces abstinence-only messages may produce an alternate result—it may encourage a teen to experiment with sex. Santrock, an author of an adolescence textbook, suggests that developing a sexual identity is another task that an adolescent must complete [10]. Sexual identity refers to ideas about sexuality and the decision to engage in sex. These decisions are influenced by social, physical and culture factors, as well as peers and the media [10]. Therefore, there are a multitude of variables that influence the behavior of adolescents. It is not guaranteed that an abstinence-only education would convince adolescents to postpone sex until marriage. Forbidding a teenager from doing something only strengthens teenagers’ desire to engage in sexual activities.

The majority of adolescents have already become sexually active and abstinence-only education fails to give them the proper instructions on how to protect themselves.
Abstinence-only education does not apply to the population of students who have already made the decision to engage in sex. Research suggests that American teens are engaging in sexual behavior at earlier ages and are having multiple sex partners [21]. Social scientists suggest that the majority of the adolescent population will not wait until marriage to engage in sexual activities [5]. Most teenagers will initiate sexual activities during their adolescent period [10]. There is plenty of scientific evidence indicating that adolescents are not waiting until marriage to initiate sexual activity. A nation-wide survey entitled the Youth Behavioral Risk Surveillance-2005 estimated that 46.8% of students have been sexually active [2]. This rate only increases as the students matriculate through high school. The Alan Guttmacher Institute suggests that 6 out of 10 teenage women and 7 out of 10 teenage men have had sexual intercourse by their 18th birthday [5]. For a teenager who has already made a decision to have sex, abstinence-only education may not be relevant.

Abstinence-only education does not reach sexually active adolescents. Studies have shown that sexually active teenagers are not influenced by abstinence-only messages [9]. In fact, these teens were more likely to drop out of these programs [9]. One study found that abstinence-only education was only effective upon boys who were already sexually abstinent [23]. Other studies suggest that abstinence delays sexual activity; however, it does not completely eliminate it until marriage [9]. Previous scientific studies indicate that sexually active teens do not adhere to abstinence-only messages.

An abstinence-only curriculum fails to provide adolescents with information that could protect them while engaging in sexual activity. A curriculum that is not comprehensive may actually be more detrimental than beneficial. When adolescents decide to become sexually active, they do not know how to protect themselves. Previous research has indicated that abstinence-only education deters contraceptive use among sexually active adolescents. This may increase the amount of STI’s among the adolescent population [5]. Other researchers argue that some research supporting abstinence-only education programs have many flaws; therefore, it is hard to make an accurate conclusion out of the data [26]. A recent report suggested that students desired to learn more about contraception information if they were forced into sexual situations [14].

Media has become the sex educator for today’s teens and is providing them with erroneous information.
All forms of the media abide by the notion that “sex sells.” Sex is used to sell anything from toothpaste to cars. Although sexual content is ubiquitous in the media, the media fails to acknowledge the negative consequences and risks of sexual behaviors. Unfortunately, the media, full of faulty information, is one of the major sources of sex information for adolescents. Furthermore, the average American youth spends a significant amount of time exposed to the media.

The average American youth is exposed to media one third of each day. The majority of the youth’s time spent watching television occurs in the absence of parents [16]. Research suggests that teenagers watch more than three hours per day of television. Moreover, when adolescents finish high school, they will have watched 16,000 to 20,000 hours watching TV and only 14,000 hours learning in a school classroom [16]. The data indicate that the media may have a potentially greater impact on teens’ behavior than schoolteachers.

After spending eight hours in school, they come home to environment inundated with various forms of media—Internet, television and radio—which all provide messages that contradict the lessons in an abstinence-only curriculum. Contrary to the messages adolescents hear in school, media messages glamorize recreational sex outside of marriage [20]. In fact the majority sexual interactions between individuals in the media occur between two unmarried individuals [17, 24]. The attractive individuals engage in sexual activities frequently and seldom discuss contraceptives or the risk of participating in unprotected sex. The media makes sex appealing to teenagers. Unfortunately, teens have a lack of experience and cannot discern the messages presented in the media from reality [20, 22]. The media tends to overemphasize the positive aspects of sex while leaving out the negative consequences of sex [20, 22]. A teen with very few experiences, is very vulnerable and can be heavily influenced from these media messages. Research suggests among all television programs with sexual content, only one out of eleven of them mention the possible risks of engaging sex [22].

Given the inaccurate information in media, it remains a major influence on the decisions of adolescents [22, 24]. Studies have revealed that viewing sexual content on television was significantly related to early initiation of sex among adolescents [19]. The amount of exposure to sexual content in media was related to sexual behavior [24, 25] Many models, theories and researchers support the notion that the media makes a large impact on adolescents’ behavior [15]. Strasburger [13] suggests that teens perceive their peers to be influenced by media messages. The messages of abstinence-only education taught within a classroom from a mediocre teacher cannot compete with the glamorous music videos featuring artists who discus their sexual escapades and glamorous life. The media is a greater influence on the decisions of adolescents than schoolteachers.

It an ideal world, teachers could follow an abstinence-only curriculum that would significantly change teenager’s behavior. Unfortunately, there are so many contradictory messages on sexuality that compete for adolescents’ attention. Regrettably, some adolescents may succumb to the pressure. The unfortunate truth is that research has shown that the majority of adolescents will not wait until marriage to engage in sexual activity. Therefore, sex educators should aim to present information for the teenagers who are sexually active and for those they may eventually become sexually active. A more comprehensive education will not only provide sexually active teens information on how to protect themselves during sexual activity, but also complement the adolescent mentality. Adolescents desire to be treated as adults and value independence. A more comprehensive sex education would teach teenagers how to protect themselves from teenage pregnancy, STI’s and HIV.

References
1. Collins, C., Alagiri, P. & Summers, T. (2002). “Abstinence Only vs Comprehensive Sex Education What are the arguments? What is the evidence?” (Policy Monograph Series – March 2002). AIDS Policy Research, Center for AIDS Prevention Studies, AIDS Research Institute: University of California, San Francisco.
2. Centers for Disease Control and Prevention. Youth Risk Behavior Surveillance—United States, 2005. Surveillance Summaries, June 9, 2006. MMWR 2006: 55(No. SS-5).
5. The Alan Guttmacher Institute (2002). Facts in Brief Sexuality Education.
6. Advocates for Youth. (2007, July). History of Federal Abstinence-Only Funding. Washington, DC: Marcela Howell.
7. Sexuality Information and Education Council of the United States (2007). Congress Loses Its Bearings and Supports Bush’s Request for Abstinence-Only Until Marriage Programs. Retrieved from www.siecus.org/media/press/press0155html.
8. Yale-New Haven Children’s Hospital. Adolescent rebellion: A Survival Guide for living with a teenager. Retrieved from http://www.ynhh.org/pediatrics/behavior/adolescent_rebellion.html November 12, 2007
9. Haignere, C. S., Gold, R., McDaniel, H. J. (1999). Adolescent Abstinence and Condom Use: Are We Sure We Are Really Teaching What is Safe? Health Education & Behavior, 26, 43.
10. Santrock, J. W. (2007). Adolescence (11th ed.) New York: McGraw-Hill.
11. Ott, M. A., Pfeiffer, E. J., Fortenberry, J. D. and Fortenberry,, M. A. (2006). Perceptions of Sexual Abstinence among High-Risk Early and Middle Adolescents. Journal of Adolescent Health, 39, 192-198.
12. Kunkel, D., Eyal, K., Finnerty, K., Biefly, E., Donnerstein, E. (2005). “Sex on TV A Kaiser Family Foundation Report.”
13. Strasburger, V. C. (2005). “Adolescents, Sex, and the Media: Ooooo, Baby Baby—a Q & A. Adolescent Medicine Clinics, 16, 269-288.
14. The Henry J. Kaiser Family Foundation. (2000). Sex Education in America A Series of National Surveys of Students, Parents and Principals. California: Henry J. Kaiser Family Foundation.
15. Chaves-Escobar, S. L., Tortolero, S. R., Markham, C. M., Low, B. J., Eitel, P., and Thickston, P. (2005). “Impact of the Media on Adolescent Sexual Attitudes and Behavior.” Pediatrics. 116, 303-326
16. Roberts, D. F. (2000). “Media and Youth: Access, Exposure, And Privatatization.” Society for Adolescent Medicine, 275, 8-14.
17. Ward, L. M. Talking About Sex: Common Themes About Sexuality in the Prime-Time Television Programs Children and Adolescents View Most Journal of Youth and Adolescence, 24 (5), 1995
18. Social Implicatons of music videos on youth. Greeson, le.
19. Collins,, R. L., Elliott, M. N., Berry, S. H., Kanouse, D. E., Kunkel, D., Hunter, S. B., and Miu, A. (2004). “Watching Sex on Television Predicts Adolescent Initiation of Sexual Behavior.” Pediatrics, 3, 280-389.
20. Ward, L. M. (2003). “Understanding the role of entertainment media in the sexual socialization of American youth: A review of empirical research.” Developmental Review, 23, 347-388.
21. Escobar-Chaves, S. L., Tortolero, S. R., Markham, C. M., Low, B. J., Eitel, P. And Thickstun, P. (2005). “Impact of the Media on Adolescent Sexual Attitudes and Behaviors.” Pediatrics, 116, 303-326.
22. Brown, J. D. and Keller, S. N. (2000). “Can the Mass Media Be Healthy Sex Educatiors?” Family Planning Perspectives, 32, 255-256.
23. Aten, M. J., Siegel, D. M., Enaharo, M., and Auinger, P. (2002). “Keeping Middle School Students Abstinent: Outcomes of a Primary Prevention Intervention.” Society for Adolescent Medicine, 31, 70-78.
24. Pardun, C. J., L’Engle, K. L., Brown, J. D. (2005). “Linking Exposure to Outcomes: Early Adolescents’ Consumption of Sexual Content in Sex Media.” Mass Communication & Society, 8, 75-91.
25. L’Engle, K. L., Brown, J. D., Kenneavy, M. A. (2006). “The Mass Media are an important context for adolescents’ sexual behavior.” Journal of Adolescent Health, 38, 186-192.
26. Kirby, D. (2002). “Do Abstinence-Only Programs Delay the Initiation of Sex Among Young People and Reduce Teen Pregnancy.” Washington DC: National Campaign to Prevent Pregnancy.

Labels: ,

1 Comments:

  • At December 13, 2007 at 7:39 AM , Anonymous Meg Gavaghan said...

    Jessica -- Great title! We need the federal government that decide to fund abstinence-only education to read your paper :) Your argument regarding the influence of media on the sex education of teens is very strong.

     

Post a Comment

Subscribe to Post Comments [Atom]

<< Home