Brownwood: Bush, Religion, Abstience, Sex Education, & STD's

Abstinence programs: lessons in futility?

Classes aren't changing Texas teens' sexual habits, researchers say

09:39 PM CST on Saturday, January 29, 2005
By LAURA BEIL / The Dallas Morning News
Abstinence-only programs – the hallmark of the Bush administration's federal sex education policy – seem to have little impact on the behavior of Texas teenagers.
The first evaluation of programs used throughout the state has found that students in almost all high school grades were more sexually active after abstinence education. Researchers don't believe the programs encouraged teenagers to have sex, only that the abstinence messages did not interfere with the usual trends among adolescents growing up.
"We didn't find what many would like for us to find," said researcher Buzz Pruitt of Texas A&M University. He and his colleagues discussed their data this week with state health authorities in Austin, who sponsored the research.
The study has its flaws, and Dr. Pruitt and others cautioned against overarching conclusions. But scientists welcome the fact that Texas is contributing to a field lacking in solid data. The federal government will spend $131 million this year on a smorgasbord of abstinence-only education programs. Many public health experts are concerned that no one really knows what the government is buying.
Among the findings in the Texas study: About 23 percent of the ninth-grade girls in the study already had sexual intercourse before they received any abstinence education, a figure below the national average. After taking an abstinence course, the number among those same girls rose to 28 percent, a level closer to that of their peers across the state.
Among ninth-grade boys, the percentage who reported sexual intercourse before and after abstinence education remained relatively unchanged. In 10th grade, however, the percentage of boys who had ever had sexual intercourse jumped from 24 percent to 39 percent after participating in an abstinence program.
"We didn't find strong evidence of program effect," said Dr. Pruitt. The results are based on a 10-page questionnaire – that alone the product of two years of preliminary research – filled out anonymously by junior high and high school students. The A&M study, which is still ongoing, examined five programs in more than two dozen schools.
To be funded as abstinence education, programs cannot provide instruction in birth control, outside "factual information about contraceptive methods, such as the failure rates that are associated with the different methods," according to documents from the U.S. Department of Health and Human Services. Among other things, the law also dictates that an abstinence program must have "as its exclusive purpose, teaching the social, psychological, and health gains to be realized by abstaining from sexual activity."
Dr. Pruitt readily acknowledges that studies like his are inherently problematic. For example: the A&M study lacks a comparison group. Ideally, researchers would like to overlay two sets of data: one from students receiving abstinence education and another from a group similar in every other way but with no abstinence education.
Without such direct contrasts, researchers can't say whether the teenagers would have shown an even greater increase in sexual activity had they not had abstinence education. The Texas researchers began with a comparison group, but it fell apart before the study's end. (During the project, the scientists realized too many members of the supposed reference group were hearing the abstinence messages.)
Nonetheless, public health experts say these and other data may eventually help fashion abstinence-only approaches that can make a difference. No-sex-until-marriage has been a major emphasis in Washington, and funding has increased in kind: The $131 million the federal government set aside represents an increase of $30 million over 2004, according to the Senate Appropriations Committee.

Little data to be had


But is the money making a difference? "We're using a bunch of programs, and we don't know what their effectiveness is," said Mike Young of the University of Arkansas in Fayetteville. Abstinence instructors have sprouted up across the country, he said, all claiming, often with scant or no scientific support, that they can successfully influence teenagers facing temptation.
Dr. Young and his colleagues have developed a curriculum called Sex Can Wait, which is one of the most studied abstinence programs in the country, and one of the few that has documented at least a short-term influence on teenage behavior. His program emphasizes abstinence in youth as an integral component of a successful life, and not a goal by itself. Students who can envision the long-term, he believes, are less likely to gamble their futures by engaging in sex.
The program has been recognized five times for Outstanding Work in Community Health Promotion by the U.S. Department of Health and Human Services. But not even the blessing of the federal government has improved the chances of Sex Can Wait getting into Arkansas schools. The state's Department of Health has yet to fund any grants based on this approach, choosing other programs with less scientific merit.

Who gets funding?


"Funding should be contingent on a very solid evaluation program," Dr. Young said, "and future funding should be dependent on past results."
Federal officials say the concerns about funding untested programs are "a fair criticism," said Harry Wilson, associate commissioner of the Family and Youth Services Bureau. Each agency, he says, must balance the cost of funding programs against the cost of study. "How much do we evaluate, and how much public money should go to fix the issue?"
The government is paying for a large, multi-year study of several abstinence programs, which when published will be the most comprehensive evaluation yet. The price: $4.5 million per year. The interim data was supposed to have been released already, but it remains unpublished. Mr. Wilson said the final report will be out by 2006.
Lacking objective information about a program's effectiveness, Mr. Wilson said, the government looks at other barometers, such as community needs, the educators' experience and ties to the community. "You do the best you can with what you know," he said.
Dr. Young and other researchers say they don't want their criticism to be misinterpreted: "I think we need to encourage young people to wait, and I don't think there's anything wrong with the government putting money into those efforts."
What bothers him are self-styled educators who he believes mold their content to meet the official federal definition of "abstinence" and aren't held accountable for accuracy or measurable results. "This combination translates into abstinence education programming which often deliberately provides inaccurate information in a misguided attempt to scare young people into choosing abstinence," he wrote in the current issue of the American Journal of Health Studies, in an article titled "What's Wrong With Abstinence Education."

Charged topic


The field has become so mined with emotion and ideology, many researchers studying abstinence programs fear that science is losing to politics. One Arkansas state legislator upset by Dr. Young's work physically threatened him; an anti-abortion group once labeled the program "Godless" – about the same time Dr. Young was ordained as a deacon in the Southern Baptist Church.
"We need to get over our fear of research," said A&M's Dr. Pruitt. "It does bother me that we don't have the kind of respect for research and evaluation that this area deserves. There seems to be a political fear of the truth."
Scientists have an ally in Dr. Joe McIlhaney. Founder of the Medical Institute for Sexual Health in Austin, Dr. McIlhaney has long championed abstinence-only education for adolescents. Dr. McIlhaney, who retired from a successful practice as an obstetrician/gynecologist, founded the organization in 1992 to combat teen pregnancy and sexually transmitted diseases.
He said he realizes that some of his fellow supporters of abstinence education have spurned research. He disagrees with them. "I think it's mandatory to do these evaluations," said Dr. McIlhaney. He doesn't believe, however, that abstinence education efforts should stall while scientists hash out the best approach. "For almost any issue you don't wait until you have results to institute a program," he said. "I think it's very important to institute abstinence education programs" while research is under way.
And he warns against hasty conclusions. The Texas study didn't find an effect, he says, but "it'd be a mistake to conclude that this research shows that abstinence programs don't work." Like the researchers themselves, he pointed out the study's lack of comparison group.
Texas has now joined about a dozen other states that have evaluated their abstinence education programs. "By and large they got no changes in behavior," said Debra Hauser, vice president of the non-profit group Advocates for Youth, which has conducted studies that support more comprehensive sex education programs that include contraception.
Research has shown that knowledge and intention alone cannot dissuade teenagers from having sex, and that studies that simply ask teenagers' attitudes are not always meaningful. "If you tell them for five weeks you want them to abstain, and then you ask them if they intend to abstain, they are going to say yes," she said. "Intention is necessary, but it's not sufficient."
Bill Albert of the non-partisan Campaign to Prevent Teen Pregnancy agrees that early research of abstinence education has not been promising but says the value of abstinence education is still unclear. "What we have said now for several years is that the jury is still out on the effectiveness of abstinence only programs," he said. "Most of them won't work, but most programs of any stripe don't work."
Health education researchers are eager to see the federally funded report. Still, that analysis alone will not provide a definitive answer. Dr. Pruitt predicts it may further inflame both sides.
"We need to all get in the same room, and we need to share information and ideas," he said. "We need to engage each other in conversation. We need to talk about kids instead of talking about politics."
E-mail lbeil@dallasnews.com
source: http://www.dallasnews.com/sharedcontent/dws/dn/latestnews/stories/013005dnnatabstinence.a9173.html

A liberal Christian in conservative Lubbock

Sundance's 'Education' tracks student's fight for sex ed

02:08 PM CST on Saturday, January 29, 2005
By CHRIS VOGNAR / The Dallas Morning News
PARK CITY, Utah – Shelby Knox is tired. The 18-year-old Lubbock native just got into Park City for the world premiere of the documentary The Education of Shelby Knox at the Sundance Film Festival. Her hotel room was a bit chilly on her first night, the interviews are starting to pile up, and the sleep deprivation has her seeking a catnap in her publicist's suite.


ERICH SCHLEGEL/DMN
The Education of Shelby Knox, screened at the Sundance festival, chronicles changes in the Lubbock native's beliefs.
But she should be able to handle the grind ahead. Her personal journey of the last few years, chronicled in Education, has steeled her for almost anything.
Just three years ago she was a sophomore and conservative Southern Baptist at Lubbock's Coronado High School, in a district with a strict abstinence-only sex education policy. Now she's a self-described liberal Christian who underwent a baptism of fire by becoming an advocate for comprehensive sex ed in her hometown.
"I was 15, and in my high school I could see it was an issue that was affecting my contemporaries," says Ms. Knox, now a first-year sophomore political science major at the University of Texas in Austin. She has her eyes set on Georgetown law school, is interested in getting into politics and says she'd love to live in New York.
"The people around me were getting sexually transmitted diseases," she says. "Young girls were getting pregnant. I heard all the myths about the different ways you can get pregnant, and I realized that was no education."
She was also called a baby killer when she volunteered for Planned Parenthood. "These protesters thought I was going to abort my child or something," she recalls. "I've never had sex, but they thought I was going to abort my child."
Many people told her she was going to hell. She went through the difficult, soul-searching process of questioning her beliefs. But she's not merely still standing. She's thriving.

A path to adulthood


The Education of Shelby Knox chronicles a teenager's path to adulthood, consciousness and political awakening. It's the story of a family that remains very close and mutually supportive despite vast political and ideological differences. Most of all, it's a story about becoming your own person, even when that means going against everything you've been taught. Or, in this case, everything you weren't taught.
Education, which will kick off the new season of the PBS doc series POV on June 21, begins with a series of bracing facts. Lubbock has one of the highest teen-pregnancy and sexually transmitted disease rates in the nation. Teenage gonorrhea rates are twice the national average.
"Lubbock is known for three things," says Ms. Knox. "Buddy Holly, the Dixie Chicks and STDs." (There's also Texas Tech, but you get her drift.)
This reputation is what got Ms. Knox interested in the sex education issue, first as a member of the Lubbock Youth Council, which works with city government, and then on her own. It's also what drew the attention of New York-based filmmakers Marion Lipschutz and Rose Rosenblatt, who were looking for a sex education story for their next film. They didn't go to Lubbock looking for Shelby, but once they found her, they knew they had an ideal protagonist.
"She's outspoken, and she's a terrific public speaker," says Ms. Lipschutz. "She's really dedicated to the issue that we were working on. She was a conservative Southern Baptist who had pledged abstinence until marriage, and she was involved in a fight for comprehensive sex ed, which is generally perceived as a liberal cause."

Choosing sides


So how did a nice Southern Baptist girl turn into a sex-ed crusader?
"As I came to see the world outside of Lubbock, I realized that my beliefs were more liberal than my parents'," she says. "I didn't make these decisions because I wanted to be the opposite of my parents. I made them because I read about the issues and figured out which side I wanted to be on."
Ms. Knox is still onboard with abstinence. "Kids must be taught that to be completely safe from STDs and teen pregnancy, the only way to do that is to abstain," she says. "However, kids know they can make that decision, and they need to make informed decisions. If they are going to have sex, they need to know the consequences. And they need to know how to protect themselves."
That's not how the Lubbock Independent School District sees it. The district receives federal funding for it's abstinence-only program, which has been in effect since 1995, and school officials would like to see the money continue to flow.
But the abstinence-only policy is not about cash. As depicted in the film, Lubbock is a proudly conservative and Christian city, with many residents and public officials who equate sex education with sexual provocation. The party line is that sex should be saved for marriage. Judging by the STD and pregnancy figures, that doesn't seem to be happening. The abstinence-only policy remains in place.
Among the abstinence-only advocates is Lubbock youth pastor Ed Ainsworth, who conducts "true love waits" abstinence pledge ceremonies with local teens. Ms. Knox took the pledge as a sophomore, but she now says Mr. Ainsworth uses "scare tactics." In the film, we see Mr. Ainsworth warning a room full of teens that STDs can be contracted through shaking hands.
"I talk to teenagers about sexual purity, specifically about abstinence," says Mr. Ainsworth in the film. "The reason I do it is that I'm sick and tired of seeing kids mess up their lives physically, mentally, spiritually, emotionally and financially."
Mr. Ainsworth, who estimates that he spreads the abstinence message at 200 schools and speaks to 250,000 students every year, has no ax to grind with Ms. Knox.
"She's a good kid," he says by phone. "I disagree with her philosophically and with where she's coming from. But it's America, and that's why we all live here."
However, Mr. Ainsworth, who has yet to see the film, adds that he's disappointed with the filmmakers' decision to make Ms. Knox the protagonist. He recalls that they came to Lubbock to make a film about the issue of comprehensive sex education vs. abstinence, before deciding to focus on Ms. Knox.
"I'm not angry, and I'm not upset with Shelby," he says. "I'm just disappointed."
On a personal level, the sex-ed issue is just one sign of Ms. Knox's political transformation. She's straight, and she strongly supports gay rights, a stance that hastened her resignation from the Youth Council when she felt the organization wasn't reaching out to gay students. Her favorite course at UT is called Women, Gender and Politics. She writes for a collegiate feminist magazine called The F Word. Her parents say she has always rooted for the underdog, and she can't deny it.
And she remains a proud Christian.
"Christians in general are not like what the religious right portrays," she says. "That is just a very vocal side of it. I believe most Christians are loving, caring and tolerant. They believe in civil liberties and civil rights. It's very sad and detrimental to the Christian faith that some people have decided to use it for political advantage.
"I accept everyone. I don't think there's one right answer."
This approach extends to the film's treatment of the city and its people. Festival director Geoffrey Gilmore likes the film, which is in the American documentary competition, largely because it doesn't buy into clichés or caricatures.
"The filmmakers really understand what this story is, and who this person is and the conflicts that are arising. That's one of the things that you don't see in a lot of films about religious or ideological conflicts, where everything is so black and white, with the forces of repression and the forces of tolerance and understanding. It's not played that way."

A family affair


Ms. Knox is firmly aware that her political beliefs have taken a sharp left turn from her family. And she admits to pangs of guilt.
"I think they might feel like they did something wrong," she says. "I feel bad, because in all ways it points to, I should have been a Republican. But my parents are so proud of me, and I love them for that. Everyone they meet in Lubbock, they tell about the film."
Ms. Knox's father, Danny, agrees with his daughter that comprehensive sex education would be beneficial for Lubbock. A conservative Republican, he's not quite as comfortable with some of Shelby's other causes. In the film, he bristles a bit when Shelby teams up with student activists to support gay rights. (In March of last year, a federal judge ruled that the LISD could disallow a Gay/Straight Alliance at Lubbock High School.)
To Mr. Knox's credit, he offers his daughter nothing but love and support.
"We feel like we raised her the right way, even if we see things a little different politically," Mr. Knox says by phone. A car sales rep in Lubbock, he was making plans early last week to bring the whole family, including Shelby's 14-year-old brother Devin, to Park City so they can celebrate with Shelby before the close of the festival today. "We're really proud of her," he says. "She's a great little lady."
Ms. Knox says the festival "has been one of the best experiences of my life. The screenings have been so energetic and wonderful." The film has received two standing ovations, and it received a rave review in the trade magazine The Hollywood Reporter, which says Education has strong possibilities for a theatrical release.
Now, she's ready to get back to school, hit the books and blend back in with the crowd.
"It's been fun being recognized, but I'm looking forward to my classes," she says. "And I'm looking forward to being just one of 50,000 students, instead of the girl from the film."
But "the girl from the film" will always be part of Shelby. When school is out and she comes home for the holidays, she goes into one room and watches CNN, which her dad calls "the Criminal News Network." Her parents sit in the living room, where they watch Fox News – or, as Shelby calls it, "Faux News."
In an age of frequently hostile red state-blue state divisions, the Knoxes could teach us all a thing or two about family values. In their case, blood is much thicker than politics.
E-mail cvognar@dallasnews.com
source: http://www.dallasnews.com/sharedcontent/dws/fea/entertainment/stories/013005dnartshelby.d7db8.html
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OP-ED COLUMNIST

Bush's Sex Scandal
By NICHOLAS D. KRISTOF

Published: February 16, 2005

I'm sorry to report a sex scandal in the heart of the Bush administration. Worse, it doesn't involve private behavior, but public conduct.

You see, for all the carnage in President Bush's budget, one program is being showered with additional cash - almost three times as much as it got in 2001. It's "abstinence only" sex education, and the best research suggests that it will cost far more lives than the Clinton administration's much more notorious sex scandal.
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Mr. Bush means well. But "abstinence only" is a misnomer that in practice is an assault on sex education itself. There's a good deal of evidence that the result will not be more young rosy-cheeked virgins - it will be more pregnancies, abortions, gonorrhea and deaths from AIDS.

Look, I'm all for abstinence education. I support the booming abstinence industry as it peddles panties and boxers decorated with stop signs (at www.abstinence.net), and "Pet Your Dog, Not Your Date" T-shirts.

Abstinence education is great because it helps counteract the peer pressure that often leaves teenagers with broken hearts - and broken health.

For that reason, almost all sex-ed classes in America already encourage abstinence. But abstinence-only education isn't primarily about promoting abstinence - it's about blindly refusing to teach contraception.

To get federal funds, for example, abstinence-only programs are typically barred by law from discussing condoms or other forms of contraception - except to describe how they can fail. So kids in these programs go all through high school without learning anything but abstinence, even though more than 60 percent of American teenagers have sex before age 18.

In the old days, social conservatives simply fought any mention of sex. In 1906, The Ladies' Home Journal published articles about venereal disease - and 75,000 readers canceled their subscriptions. Congress banned the mailing of family planning information, and Margaret Sanger was jailed in 1916 for selling a birth control pamphlet to an undercover policewoman.

But silence about sex only nurtured venereal diseases (one New York doctor, probably exaggerating, claimed in 1904 that 60 percent of American men had syphilis or gonorrhea), so sex education gradually gained ground. Then social conservatives had a brilliant idea: instead of fighting sex ed directly, they campaigned for abstinence-only programs that eviscerated any discussion of contraception.

That shrewd approach succeeded. In 1988, a survey by the Alan Guttmacher Institute found that only 2 percent of sex-ed teachers used an abstinence-only approach. Now, the institute says, a quarter of them do.

Other developed countries focus much more on contraception. The upshot is that while teenagers in the U.S. have about as much sexual activity as teenagers in Canada or Europe, Americans girls are four times as likely as German girls to become pregnant, almost five times as likely as French girls to have a baby, and more than seven times as likely as Dutch girls to have an abortion. Young Americans are five times as likely to have H.I.V. as young Germans, and teenagers' gonorrhea rate is 70 times higher in the U.S. than in the Netherlands or France.

Some studies have claimed that abstinence-only programs work, but researchers criticize the studies for being riddled with flaws. A National Campaign to Prevent Teen Pregnancy task force examined the issue and concluded: "There do not currently exist any abstinence-only programs with strong evidence that they either delay sex or reduce teen pregnancy."

Worse, there's some evidence that abstinence-only programs lead to increases in unprotected sex.

Perhaps the most careful study of the issue involved 12,000 young people. It found that those taking virginity pledges had sex 18 months later, on average, than those who had not taken the pledge. But even 88 percent of the pledgers had sex before marriage.

More troubling, the pledgers were much less likely to use contraception when they did have sex - only 40 percent of the males used condoms, compared with 59 percent of those who did not take the pledge.

In contrast, there's plenty of evidence that abstinence-plus programs - which encourage abstinence but also teach contraception - delay sex and increase the use of contraception. So, at a time when we're cutting school and health programs, why should we pour additional tax money into abstinence-only initiatives, which are likely to lead to more pregnancies, more abortions and more kids with AIDS? Now, that's a scandal.

E-mail: nicholas@nytimes.com

source: http://www.nytimes.com/2005/02/16/opinion/16kristof.html?hp