Friday, November 13, 2009

CDC Report Finds Comprehensive Sex Education Programs Effective

There's been so much gnashing of teeth regarding health care reform and the coverage of abortion, that the following story was lost in the shuffle. It never ceases to amaze me how easy it is to get people's attention away from teen sexual health and sexuality education, and toward a more contrary issue. I'm not saying that abortion rights and health care reform are less important or that they don't play a role in teen sexual health; I am saying that these issues find their ways to the front burner, while the debate on sexuality education gets postponed again and again.

Nonetheless, read this report and pay close attention to the response of abstinence-only promoters. It's another example of the "my agenda is more important than scientific proof" thinking that has strong armed public policy for the past decade.

November 9, 2009

Sex education programs that advise students to delay sexual activity while also offering instruction on ways to avoid unintended pregnancies and sexually transmitted infections effectively reduce risky sexual behavior, increase condom use and decrease spread of STIs, according to a Centers for Disease Control and Prevention-commissioned report released on Friday, the Washington Post reports. The report said there is insufficient evidence to determine whether programs that focus on abstinence until marriage reduce the chance adolescents will engage in risky sexual behavior, become pregnant or contract an STI.

The report was authored by a 19-member expert panel assembled by CDC to examine the efficacy of various sex education programs. For the report, the panel reviewed an analysis of 83 studies on sex education programs from 1980 through 2007. The findings come as Congress considers whether to approve President Obama's request to redirect federal funding from abstinence-only sex education to programs that have been validated by scientific research.

CDC's Randy Elder -- who works with the Task Force on Community Preventive Services, an independent 15-member panel that issues public health recommendations -- said the study found "sufficient evidence that comprehensive risk reduction efforts are effective." However, "after a similar look, the task force determined that based on a number of problems with the studies presented to them there was insufficient evidence" to determine the efficacy of abstinence-only programs, Elder said.

Two members of the panel issued a dissenting report, arguing that the analysis indicates that comprehensive sex education programs in schools do not significantly increase condom use or reduce pregnancy and STI rates among teenagers, the Post reports. In their dissenting report, Irene Erickson of the Institute for Research and Evaluation and Danielle Ruedt of the Georgia Governor's Office of Children and Families said, "This is an important finding because the school classroom is where most teens receive sex education." Erickson added, "Furthermore, the data indicated that many types of (comprehensive) programs do not work, even in non-school settings, yet the recommendations do not identify what those are." The report's "conclusion that comprehensive sex education programs are broadly effective simply ignores these findings," they wrote, adding, "This is misleading to policymakers who are seeking evidence-based programs, especially for schools."

However, Elder disputed Erickson and Ruedt's arguments, saying, "All of those points were considered by the task force." He said that their arguments "reflect a fundamental misunderstanding of a systematic review process," adding, "The whole point of what we are doing is to aggregate data from as many studies that are critical to answering the question. What they were doing was chopping up the evidence into very fine subsets to poke holes."

Advocates of comprehensive sex education programs praised the findings, the Post reports. James Wagoner of Advocates for Youth said, "At long last, evidence and common sense have returned to public health policy," adding that the report "endorses the comprehensive approach to prevention that includes condoms and birth control." Wagoner said, "We should be spending taxpayer dollars only on evidence-based programs." Sarah Brown of the National Campaign To Prevent Teen and Unplanned Pregnancy said, "Most Americans would like their teens to stay away from sex," adding, "Strong research shows that the best way to do this, especially in schools, is to use a curriculum that encourages teens to delay sex and also -- this is the key -- talks to them about family planning and protection."

Abstinence-only supporters criticized the report. "If you compare the statistical significance of outcome measures related to sexual activity and sexual initiation, the data is better for the abstinence education program than the comprehensive program," according to Valerie Huber of the National Abstinence Education Association (Stein, Washington Post, 11/6).

Thursday, October 29, 2009

Newsweek Article on the Future of Abstinence-Only Programs

A while back, one of the leaders of Oklahoma's abstinence-only until marriage "vendors" publicly decried the possibility of losing federal funding. His major concern was not for the children of the state who have likely been harmed by these programs, but rather for the future of the fundamentalist religious organization that employed him. In his own words, he said that at least 70% of his agency's budget was from federal abstinence-only funds, and a loss of the federal funds would nearly destroy the group.

This caught my attention because he was basically saying that his "agency" existed on federal funding. (I won't name the group, but it is well known for its connections to the arch-conservative Family Research Council with its anti-choice, anti-contraception, anti-sex, anti-gay work.) In other words, he was admitting that MY TAX DOLLARS were being used, through federal and state abstinence-only funds, to support his organization -- an organization whose mission is diametrically opposed to honest education, public health, sexual self-determination, and the separation of church and state.

Forgive me if I don't shed any tears.

With this background in mind, I was especially interested to read about a recent article in Newsweek. A review from the National Partnership for Women and Families follows. The bolding of certain words and phrases are mine.

Future of Abstinence-Only Programs Unclear
Without Federal Funding, Newsweek Reports
October 29, 2009

Abstinence-only sex education programs that received substantial federal grants under the Bush administration are turning to private donors as an attempt to keep their programs running, Newsweek reports. Since 1997, the abstinence-only industry has received a total of $1.9 billion in government funding, including $1.5 billion from the federal government. However, the "next decade may well be its bust," as President Obama's 2010 budget cut federal funding for abstinence-only programs in favor of programs that have been proven effective, Newsweek reports. Although Congress could restore funding to the programs -- as the Senate Finance Committee voted 12-11 to do last month in its health care reform bill (S 1796) -- the "chances are slim" that the full Congress would approve such a measure, according to Newsweek.

Twenty-five states were already rejecting federal funding for the abstinence-only programs when Obama proposed the budget changes, with 16 of them citing ideological reasons or saying that they weren't seeing results in reducing teen pregnancies and STIs.

Alesha Doan, author of "The Politics of Virginity: Abstinence in Sex Education," said that now, the "open question" is whether abstinence-only advocates and their programs "will continue to thrive when federal funding is not longer available." She asked, "What is the underlying support in society for this?" The shift in funding comes as a growing body of research indicates that abstinence-only messages do not reduce rates of teen pregnancy and sexually transmitted infections.

"Everyone was willing to give new ideas a trial period" when the programs were first introduced, according to John Santelli of Columbia University's
Mailman School of Public Health. However, "[e]ach evaluation came along ... and each showed it didn't work," he said. In 2007, a federally funded study of four abstinence-only programs showed that students involved were no more likely to abstain from sex until marriage than students enrolled in a comprehensive sex education program. At the same time, a 2008 review of 48 studies found that two-thirds of comprehensive sex education programs reduced the frequency of sex or number of sexual partners.

Newsweek reports that there are several reasons why abstinence-only programs "proved largely ineffective," citing the incomplete and inaccurate information provided as major reasons. For example, one study, released earlier this year by the Texas Freedom Network Education Fund, found that one curriculum in Texas was teaching that condoms have "little to no benefit," despite recommendations from the Centers of Disease Control and Prevention that condoms are highly effective in preventing the sexual transmission of HIV infection and reducing the risk of other STIs.

Researcher Doug Kirby said, "The programs that have by far the strongest evidence that they have a positive impact ... are those that give the message that not having sex is safest, but if you have sex always use condom and contraception."

Religious influence also contributed to the criticism of some federally funded abstinence-only programs, with the American Civil Liberties Union filing "a number of lawsuits (some successful, some not)" against such programs in public schools and against state-sponsored events that encouraged a specific religious perspective, Newsweek reports.

Experts on both sides of the issues expect the abstinence-only program industry to continue to "shrink significantly," even if Congress restores Title V funding, Newsweek reports. Several states are turning to a comprehensive approach, combining abstinence-based programs with more comprehensive curricula that include basic information about contraception. For instance, the North Carolina Legislature this summer approved a program that teaches abstinence until marriage and offers information about contraceptives. Parents are allowed to opt out of portions of the program. The bill has attracted support from the Rev. Mark Creech, executive director of North Carolina's Christian Action League, as well as from Planned Parenthood.

Abstinence-only advocates argue that programs combining abstinence and comprehensive sex education programs send mixed messages to teens, teaching them to remain abstinent until marriage "while demonstrating how to use condoms," Newsweek reports. Leslee Unruh, director of the Abstinence Clearinghouse, called such programs "very harmful."

According to Newsweek, abstinence-only advocates say they "are not quitting," even though the federal funding is gone and a growing body of research indicates that the programs are not effective. Unruh said that the loss of federal funding, "will have a chilling effect on abstinence education across the country," adding, "We're in a race against time to keep these people in business."

Private fundraising has been successful for some abstinence programs, such as Oklahoma's KEEP -- Kids Eagerly Endorsing Purity -- which receives about $100,000 in federal funds annually.

The Newsweek article profiled the effect changes in abstinence-only funding have had on Texas' McLennan County Collaborative Abstinence Program. In 2006, it had a $1 million budget comprised entirely of government grants, which it used to educate 6,000 to 7,000 students. However, the group now "struggles to reach half that number" after its $800,000 grant from the Community-Based Abstinence Education program ran out in 2007 and was not renewed. The group also no longer receives Title V grants. MCCAP Executive Director Tracy Cousins said, "It was a definite shock to go from everything we had ... down to the bare minimums," noting that the group used to have seven staff members servicing 19 school districts. They now have two employees and are likely to operate in four or five school districts going forward (Kliff, Newsweek, 10/27).

Friday, October 2, 2009

Doing the Funding Shuffle

My day yesterday was spent working with staff and volunteers in preparation for a very important fundraiser, so I stayed away from TV, radio, and the Internet. That evening, as guests began arriving at the event, more and more people stopped me to ask what I thought about the committee vote in favor of reinstating federal funding for education that is abstinence-only until marriage. I was clueless. Could it be? Could it be that the majority of the Senate Finance Committee members had ignored multiple studies showing abstinence-only ed to be a failure? Could it be that they discounted the number of states who, finding abstinence-only to be downright dangerous, have refused to bring abstinence-only funds to their public schools? Could it be that the committee had snubbed the majority of parents who support a more comprehensive approach to sexuality education for young people.

Apparently so, to the tune of $50 million. Granted, there are many more committee meetings ahead on this subject, but wow. The vote was 12 to 11 in favor of abstinence-only funding.

I hope the committee's next step is to ensure universal health care coverage because at this rate, there are likely to be a lot more teen pregnancies and a lot more sexually transmitted infections in 2010.

Tuesday, September 29, 2009

Some Texas Schools Abandon Abstinence-Only as Teen Pregnancy Climbs, Funding Shifts

I thought this article from the National Partnership for Women and Families Daily Women's Health Policy Report was interesting and timely. Granted, it IS Austin, but Austin is still in Texas. Is it too much to hope that Oklahoma will follow suit?

Some Texas school districts are abandoning abstinence-only curricula in favor of abstinence-based programs that also teach about contraception and prevention of sexually transmitted infections, the Austin American-Statesman reports. Many of the school districts, including Austin's, made the change after it became clear that teen pregnancy rates were climbing under the abstinence-only approach, according to the American-Statesman. The change also comes as the Obama administration seeks to shift federal abstinence-only dollars to programs proven to reduce teen pregnancy rates.

More government money has been spent teaching abstinence in Texas than any other state, and it has the third-highest teen birth rate in the country, the American-Statesman reports. A Texas State University study released earlier this year found that less than 5% of Texas districts have comprehensive sex education. The school districts in Austin, Lufkin and some other areas have adopted "abstinence-plus" curricula, which teach that abstinence is the safest choice but also stress the importance of using contraception if teens become sexually active.

"Our data says that what we're doing isn't working, and our community is ready for us to do something different," Roy Knight, superintendent of the Lufkin Independent School District, said. Whitney Self, lead teacher for health and physical education in the Hays Consolidated Independent School District, which switched to abstinence-plus, said, "We mainly did it because of our pregnancy rate. We don't think abstinence-only is working."

One federal abstinence program -- known as Title V -- expired in June. Congress, with support from the Obama administration, is also considering replacing a second federal program, the Community-Based Abstinence Only Program, with one that funds initiatives "proven to delay sexual activity, increase contraceptive use (without increasing sexual activity), reduce the transmission of [STIs] or reduce teen pregnancy."

The American-Statesman reports that Texas could face challenges as it seeks to implement the types of federally funded programs envisioned by Congress. Sex education is not required in the state, but when it is offered, it must meet strict abstinence mandates under the Texas Education Code, which is "widely interpreted as barring detailed instruction about birth control and condoms," according to the American-Statesman.

Austin Tries New Approach

The revised sexual education program in the Austin school district was created by Janet Realini, a San Antonio physician and public health expert who testified before the state Board of Education in 2004 about faulty medical information in school health textbooks. Realini's program teaches students about STIs and the success rates of various forms of contraception.

"The key message is, if you're sexually active, you need to use a condom because it will reduce the risk of [STIs] and reduce the chance of pregnancy," Realini said. Her program, available online and free of charge, has been adopted by school districts in Hays County, San Antonio, Lufkin and the Rio Grande Valley. The Houston school district, Texas' largest, is considering the program for next year. Houston has more children born to teens under age 15 than any city in the country (Bell, Austin American-Statesman, 9/27).

Monday, September 21, 2009

Great Video!

Friday, September 18, 2009

Isn't It The Truth

The quote at the end is priceless...

Teen Birth Rates Highest in States With Greatest Levels of Religious Belief, Study Finds
September 18, 2009 — States whose residents have high levels of conservative religious beliefs also have higher teenage birth rates, a study published this week in the online edition of the journal Reproductive Health found, according to HealthDay/U.S. News & World Report.
Study author Joseph Strayhorn -- an adjunct faculty member at Drexel University and the University of Pittsburgh -- noted that the findings showed an association and not causation, adding, "But if we may speculate on the most probable explanation, we conjecture that religious communities in the U.S. are more successful in discouraging the use of contraception among their teenagers than they are in discouraging sexual intercourse itself."

Do The Math

Elizabeth Schroeder, Ed.D., M.S.W., is the executive director for Answer, a national sexuality education organization housed at Rutgers University. Dr. Schroeder is also the co-founding editor of the American Journal of Sexuality Education. This article first appeard on National Sexuality Resource Center website at http://nsrc.sfsu.edu.

Teen Pregnancy and Abortion Prevention ≠ Comprehensive Sexuality Education

I love Barack Obama. I love him for many reasons. But right now, I’m speaking as a sexuality educator. I love that he regularly mentioned lesbian and gay people during the campaign. I love that he pledged to end the military’s “Don’t Ask, Don’t Tell” policy (okay, so he hasn’t gotten to that one yet). And I’m over the moon that he has openly supported comprehensive sexuality education— in the Senate as an original co-sponsor of the REAL (Responsible Education about Life) Act, throughout the campaign, and now as President.

Well, sort of.

He has proposed a federal budget that eliminates much of the harmful Abstinence-Only-Until-Marriage funding. And, in that very same budget, he did propose funding to support pregnancy prevention and abortion reduction programs. But while reducing unintended pregnancy and abortions are important and desired outcomes of sexuality education, they are not, nor should they be, the only goals of sexuality education. More importantly, however, funding teen pregnancy and abortion reduction is not the same thing as funding comprehensive sexuality education.

By setting up such specific outcomes for potential funding, the Administration risks creating competition among organizations that should be – no, need to be – working together, especially in this challenging economic climate. This competition impedes our work toward accomplishing the goals of comprehensive sexuality education. Let me explain.

For many years now, I’ve come to see the sexuality education field – both comprehensive and abstinence-only-until-marriage proponents—as being very similar to an elementary school soccer game. If you’ve never seen one, the referee places the ball onto the field, blows the whistle, and moves quickly out of the way. As the crowd watches on the sidelines, both teams descend upon the ball en masse, kicking wildly, until the ball pops out and lands nearby. The entire gaggle of players moves together to surround the ball and begins kicking again.

Sometimes the ball will advance, and sometimes it will move backward. Sometimes it will stay exactly where it is. Points may even be scored. On both sides, there will often be frustration, name-calling and even tears. The game is a race against time – and if no one scores, the game still ends when time is up. The excitement and energy abates, the referee collects the ball, and everyone simply goes home.

Today, the myriad youth-serving professionals who have anything to do with providing sexual health information or services are the players in this elementary school soccer game. The federal government is the referee, and the soccer ball is funding. The teams are made up of a wide variety of approaches, goals, and ideologies. The fighting and limited progress speak for themselves.

With the prospect of the budget passing, and money being included for teen pregnancy prevention and abortion reduction programs and not comprehensive sexuality education programs, I have to admit, I’m worried.

I’m worried that the general public will continue to misunderstand the breadth of what is needed via comprehensive sexuality education to help young people grow into healthy sexual beings. I’m worried that focusing on teen pregnancy and abortion reduction will reinforce the mistaken perception that all kids are heterosexual, and that the bullying and homophobia running rampant in our schools nationwide is somehow less important than the possible outcomes of unprotected vaginal intercourse. I’m worried that in focusing on pregnancy prevention and abortion reduction, the public and policymakers will incorrectly assume that sexuality education can start in high school or late middle school – when the keystone of the understanding, skills and self-esteem needed to make healthy choices about sexuality must be firmly planted in early childhood. And I’m worried that a funding stream looking to reduce teen pregnancy and abortion will, in such a tight economy, tempt organizations to revise their strategic or work plans – or even their very missions – in pursuit of the elusive dollar.

Just like the elementary school soccer game, our field would benefit extremely well from calling a “time out” to talk about a unified strategy for using whatever funding is included at the federal level – and for pushing for more. We need to avoid being so grateful to have any kind of funding relating to the work we do and hold the Administration’s feet to the fire to fulfill its promise to support comprehensive sexuality education. Otherwise, we will all continue to kick wildly at the soccer ball, exhausting ourselves and our resources without much to show for it all, until the referee’s whistle blows to let us know that the game is over.