Risky business

Teens are having more sex–and getting more diseases. But is telling them to wait the answer?

Kate, Lara, and Lynn place their orders at a Princeton, N.J., pizza parlor (plain slices, Diet Cokes all around), share a tiny pot of strawberry lip balm, and settle in for an afternoon chat.

“Now that we’ve had sex, my boyfriend says I’m being a tease if I’m too tired and just want to kiss,” says Kate, a pert blond in a hooded Abercrombie sweatshirt.

“Yessss!” they all chime in. “I was just having that exact conversation with my boyfriend. Once you have sex, every time you hook up, you have sex,” adds Lara, who also wonders whether “it’s normal, the way he talks to me. He does have a temper and stuff.”

These are high school sophomores, 15 years old.

Oral sex? “When I was younger”–a fifth grader, Kate clarifies–”it was kind of a slutty thing to do. But now, it’s like everyone’s at least having oral sex,” she says. Having taken the morning-after pill twice, Kate is the expert among her girlfriends. “Freshmen might wait up to a year, sophomores wait, at most, a couple of months.”

“It’s like an added base,” explains Lara. (All three girls asked that their names be changed.

“Like shortstop or something,” says Lynn, who is a virgin. She seeks out her housekeeper to talk about sex because “I asked both of my parents, and they wouldn’t answer my questions.”

And yet, these are questions that are becoming ever more urgent. Kids from all walks of life are having sex at younger and younger ages–nearly 1 in 10 reports losing his or her virginity before the age of 13, a 15 percent increase since 1997, according to the Centers for Disease Control and Prevention. Some 16 percent of high school sophomores have had four or more sexual partners. One in four sexually active teens will contract a sexually transmitted disease, or STD, according to the Alan Guttmacher Institute. And despite a solid 20 percent decrease in the teen birthrate between 1991 and 1999, 20 percent of sexually active girls 15 to 19 get pregnant each year, according to the Henry J. Kaiser Family Foundation.

So what can be done to stem the tide? The Bush administration is putting its hopes in an initiative that provides for hefty increases in funds for community-based sex ed programs that teach only abstinence. The proposal would bolster past abstinence-only allocations by 33 percent while nearly doubling funds for the most restrictive of the programs. Among the requirements: that teens be told “sexual activity outside of the context of marriage is likely to have harmful psychological and physical effects” and that contraceptives not be discussed at all, except to highlight their failure rates.

The debate is likely to be intense, not only because of the money involved ($135 million next year alone) but also because the White House is driving home a controversial message: Don’t teach kids how to have sex. Teach them how not to have sex until they’re married. Health organizations such as the American Academy of Pediatrics and the American Medical Association, as well as some moderate Republicans and Democrats, counter that there’s no proof that these abstinence-only programs work. Instead, they back sex education that teaches both abstinence and the use of contraceptives.

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What nearly everyone agrees on is that STDs and risky “anything but intercourse” behaviors are rampant among teens–and that what to do about it is a very complicated question. Across the country, clinicians report rising diagnoses of herpes and human papillomavirus, or HPV (which can cause genital warts), which are now thought to affect 15 percent of the teen population. Girls 15 to 19 have higher rates of gonorrhea than any other age group. One quarter of all new HIV cases occur in those under the age of 21. “It’s a serious epidemic,” says Lloyd Kolbe, director of the CDC’s Adolescent and School Health program. “We’re worried.”

What is sex?

Elizabeth Walters, a nurse midwife and counselor at HiTOPS, recalls the recent visit of a mother and her 12-year-old son. “He was this sweaty soccer-jock type,” she says. The mother had noticed that her son was withdrawn and irritable after sleep-away camp. “The mom kept asking questions,” says Walters. Finally, as she was ferrying him from practice in the family minivan, he told her what was wrong: He had engaged in anal sex with a girl at camp. “It was all she could do to keep the car on the road,” says Walters.

Increasingly, kids are turning to sexual behaviors that were once considered taboo in order to maintain their “technical virginity,” says Kushner. They’re getting the message that abstinence is the goal–indeed, they’re placing a premium on it. More kids are reporting having less sexual intercourse. In 1999, the most recent year for which statistics are available, two thirds of graduating seniors, and 50 percent of all high schoolers, reported having engaged in intercourse, down overall from 54 percent of all high schoolers in 1991. But what’s becoming clear is that their efforts often amount to a letter rather than spirit-of-the-law approach. Health workers say that kids don’t seem to view many sexual behaviors as real sex. For example, some 24 percent of teens consider anal sex abstinent behavior, according to a recent North Carolina State University study. And half of all teens don’t consider oral sex sex. “There has been a shift in this idea of what constitutes sex,” says Claude Allen, who, as deputy secretary of health and human services, is in charge of the Bush administration’s abstinence initiative. “When we ask young people, ‘Have you engaged in sexual activity?’ we often hear, ‘Well, what do you mean by that?’

The pledge

At Promiseland church in Austin, youth pastor Ricky Poe is regularly consulted by his kids in the manner of, say, a revered referee: Is holding hands out of bounds? How about kissing? Nearly 120 of Promiseland’s teens took a pledge of abstinence in February, but Poe thought it might be a good idea to have a recommitment ceremony last month. Some of the teens, he felt, were not quite getting the point of the earlier abstinence pledge. “They were beginning to ask if oral sex is sex, things like that.” So, like leaders of many pledge groups across the country, Poe has shifted his focus from “abstinence” to “purity.” “It’s not just about not having intercourse,” he told the teens who gathered at the front of the altar on recommitment day. “It’s about saying that you’re not going to play around.”

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Today, as many as 1 in 6 teens nationwide is estimated to have taken a virginity pledge through rapidly growing programs like True Love Waits. One widely publicized joint study from Columbia and Yale universities had good and bad news for pledgers. The teens in the study who made pledges were found to delay the age of “sexual debut” by an average of 18 months–no small feat. When the kids did have sex, however, they were less likely to use contraception.

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And that is the disagreement at the heart of sex education today. It’s a debate that began in earnest in 1996, with a companion bill tacked on to the Welfare Reform Act that budgeted $440 million over five years to support abstinence-only sex education. The cash came with some requirements. Specifically, any programs using the funding could not be inconsistent with the federal eight-point definition of abstinence-only education. Among those points: “that sexual activity outside the context of marriage is likely to have harmful psychological and physical effects” and that “a mutually faithful monogamous relationship in the context of marriage is the expected standard of human sexual activity.” Today, every state except California accepts this funding, which was reauthorized by Congress last week. (A proposed amendment to the Welfare Reform legislation, calling for “medically and scientifically accurate” sex education programs, was rejected.

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“Youth are exposed to a tremendous amount of sexuality all the time,” says Kirby. “Programs just don’t do enough to rise above frank discussions of sex.” A federally funded evaluation of abstinence-only programs is now in progress. The evaluators’ interim report, released last month, found scant evidence that abstinence-only programs work. “Most studies of abstinence education programs have methodological flaws,” the report said, “that prevent them from generating reliable estimates of program impacts.” A final report is due in early 2003. Autor: Anna Mulrine
Fuente: usn