Showing posts with label birth control. Show all posts
Showing posts with label birth control. Show all posts

Monday, February 20, 2012

2/19/12

Last night, I was on FOX 11 news discussing a silly new program in CA. It's called Condom Access Project (as in "put a cap on it.") This project (funded by YOUR tax dollars) will send teenagers free condoms thru the mail in a discreetly wrapped package.

As with most govt solutions to problems THEY create, this one is based on 3 false premises.

False Premise #1:
Receiving condoms at home will be less embarrassing and awkward than going to a clinic or school health office.

If the child is sexually active with parental permission, chances are parents will provide them, there's no reason to send them in mail. If the child is sexually active without parental permission, receiving a box of condoms every month will surely let the cat out of the bag.

I asked several teens, "Which would be more awkward, going to the store/clinic to ask for them or getting a package at home your mom will probably see?" They all said, "It's going to come to my HOUSE???"

False Premise #2:
Teens fail to use condoms because they don’t have access to them.

NOT.

Teens fail to use condoms because the reasoning center of their brain is not fully developed until age 25. They aren't able of taking in information, filtering it thru time/nature/experience and predict the consequences of their behavior. Teens don't use condoms because they don't fully understand the risk!

The Youth Risk Behavior Surveillance Survey (taken every other year since the 1990s) has shown the highest condom use is among 9th graders (64-69% on avg). Condom use DECREASES
to 52-54% by 12th grade when ACCESS is greatly increased.


False Premise #3:
If teens have condoms they will use them and the rates of STDs will go down.

ASSUMED, but never proven!

1 out of 3 teen couples using condoms to avoid pregnancy GET PREGNANT in the first year.* It's not just because of breakage, it's because of inconsistent use! Even adults fail to use condoms with every single act of sexual contact. Inconsistent use (anything less than 100% consistent and correct) provides the same rate of infection as not using them AT ALL!

Then there's the question of "how much protection" condoms provide. The amount of risk reduction from correct/consistent condoms use varies by disease -- meaning which partner is infected and what type of sex they’re having. For instance, take Gonorrhea — if HE is infected: 85% risk reduction. If SHE is infected: condoms offer only 50% risk reduction.

Or take, HIV. For vaginal sex, 85% risk reduction. Anal sex: no evidence of ANY risk reduction.

But more than that, the Condom Access Project completely ignores the evidence! The CAP program was initiated because of high Chlamydia and Gonorrhea infection rates, but according to the NIH** condom effectiveness studies, condoms only reduced the risk of infection by 50%. (The website hosting this program says “Condoms give good protection against Chlamydia.” Does 50% sound like "Good protection"??)

Teens use condoms like they clean their rooms. Adults who believe giving kids more ACCESS to condoms will automatically result in lower rates of infection and pregnancy have obviously never met a teenager from Earth.

(I say this with no disrespect for teens, by the way. Teens get the fact that the reason stuff doesn't make sense sometimes is because they have no way to process the data adults throw at them. In this regard, teens are a LOT smarter than some adults!)

Sources:
*[See "Contraceptive Failure in the First Two Years of Use: Differences Across Socioeconomic Subgroups," Family Planning Perspectives, 2001, 33(1):19-27]

**National Institute of Allergy and Infectious Diseases, Scientific Evidence on Condom Effectiveness for Sexually Transmitted Disease (STD) Prevention, July 20, 2001.

Thursday, July 8, 2010

It Doesn't Work? Spend More Money!!

Here's something I bet you never heard...

Pregnancy rates in the US had been on the rise until 1993. From 1993 to 2006, pregnancy rates began to decline. In 2006, for the first time in 14 years pregnancy rates have begun going up.
  • 1993 (the year the decline began) was the first year public schools introduced abstinence programs.
  • In 2006 (the year the rates began to go up), the ACLU threatened lawsuits for discrimination against school districts whose sex education programs standard was "abstinence-until-marriage."
A cause-and-effect? Maybe, you say. OK, grab your high-blood pressure medicine, and follow the latest sex ed. developments.

Here's how your tax money for sex education was spent.
  • Title V began in 1994. It is currently funded at $50 million a year. This federal program gives a block of money for Abstinence Based Education to states who match every $4 with $3 from their own budget.
  • Since 2006, school districts in states who accepted this money have been the target of lawsuits by the ACLU, so only about 30 states currently accept the funds.
  • Community-Based Abstinence Education (CBAE) allowed individual abstinence programs to receive federal grants without requiring the state to match funds. CBAE was denfunded in 2009 by the Obama Administration.
  • When all the abstinence education (ASE) money was added up in 2008, it totaled $176 million.
  • When all the "comprehensive" sex education (CSE) money was added up it came to $609 million plus $27 Billion for HIV prevention programs.
In the 2010 budget, President Obama created two NEW funding streams for Teen Pregnancy Prevention. Tier I is $75 Million for existing evidence-based programs. And Tier 2 provides $15-$25 million for research and demonstration grants.

Here's the kicker: NONE of the new money can go toward Abstinence Education. Every penny of it has to go toward a "comprehensive" approach. (In government-speak that means you say abstinence is effective, but your main focus is getting teens to use condoms. Most comprehensive sex ed. programs discuss condoms over abstinence at a ratio of 7:1.)

Now, this is the REALLY funny part. TWO well-documented reports have been published showing comprehensive sex ed programs DON'T WORK!

The first was conducted by John Jemmott, PhD and published in the Archives of Pediatrics and Adolescent Medicine (here). It showed that in head-to-head measurements, only 33% of students who received abstinence based education were sexually active 2 years later compared to 50% of students who received comprehensive sex ed (abstinence plus condoms message), "safe sex" education (condoms only) and the control group (health information with no extra emphasis on sexuality).

This study marks the first time ASE and CSE programs were evaluated side-by-side, with the same at-risk population. It came as a surprise to some people who promoted handing out all that CSE money for the last 3 decades.

The other report came from the Institute for Research and Evaluation. Unlike every other evaluator of sex education, IRE doesn't have a dog in this hunt. They don't create or sell sex education programs. They just look at the evidence of what they produce.

Their evaluations (see pdfs here), over several years, in head-to-head comparisons found that:
  • The CSE programs touted as "effective in reducing teen pregnancy and STDs" didn't actually MEASURE pregnancy or infection rates at all.
  • NONE of them increased consistent condom use or had an effect on delaying sexual initiation over time.
  • But several studies have shown that ASE programs (the ones that just had their funding cut) are proven to be effective at delaying sexual initiation.
Oh, dear, how awkward that the new funding is only for existing "evidence based" programs.

Remember CSE gets $609 million dollars a year vs. ASE which got $176 million per year. The programs which cost taxpayers LESS money, and are MORE effective have been eliminated. The programs which HAVEN'T worked for the last 30 years, and cost taxpayers MORE are about to get an additional $100 million dollars.

Yep, reminds you of President Regan's old saying:
"The nine most terrifying words in the English language are: 'I'm from the government and I'm here to help.'"




Monday, April 13, 2009

Smuggling in the truth

Recently, a question was raised about a phrase I used on a previous blog: "I'm looking for ways to smuggle the truth in underground.” Was I referring to subverting the authority of public school administrators? Or perhaps getting specifically prohibited material into the hands of students?

Words have power, I always say... and then I assume everyone knows what I mean. (OK, so I have some blonde moments.)

The truth I want to "smuggle in" to those school districts where I am banned:
  1. That condoms/pills/shots do NOT provide the same level of protection as not having sex at all.
  2. That, despite how hard it is to do, there are benefits to controlling your sexual urges.
  3. Teen sex can produce long term relational consequences which adolescents can't grasp, foresee or predict.
  4. Sometimes people who say they want to keep teens "safe" from sexual consequences are motivated by financial gain.
That's it. I'm not trying to keep accurate information about birth control or condoms from teens. I do want them to have access to everything they need to make good decisions. Unfortunately, after talking to tens of thousands of teens, I know for a fact, that they are under the impression "using protection" is just as safe as not having sex. But their idea of "using protection" has a wide range of not very safe actions.

A few common myths teens (and some adults) believe about "safe sex":
  • Condoms aren't necessary if you're only having oral sex. Totally false. Most STDs can happily thrive in your mouth and throat.
  • You're "safe" if you both get tested before you have sex. The fact is, there are no tests for some STDs. (Not to mention, even if someone says "I go to the clinic every three months so I'm clean," that doesn't mean they didn't get infected last night!)
  • Teen pregnancy is the problem which requires the most attention. While it's true, almost a million teen girls become pregnant every year, its been estimated that 9 million 15-24 year olds become infected annually. (And don't forget, pregnancy only lasts a few months, but Herpes is forever.) The estimated direct cost of treating STDs in $14 billion per year --- that doesn't include indirect costs like lost wages and productivity, the cost of treating infants who have been infected, etc.
  • If you're on the Pill, you don't have to worry about using condoms. Its a well-documented pattern that older teens and teens with the greatest number of partners are less likely to use condoms than younger less experienced teens. College students are less likely to use condoms than 9th graders, even though the "pool" of potentially infected partners is much higher among college students.
  • You would be able to tell if you or your partner is infected. After being shown pictures of the "worst-case-scenario" diseased genitals, everyone thinks, "Well, I'd sure notice is someone's penis looked like a pickle." But the universally accepted data is 80% of the time STDs have no symptoms. No symptoms, very mild or hard to identify symptoms, sores in locations you can't see and (for some STDs) no test. [Just fyi, I've had both doctors and clinicians tell me they don't test for Herpes unless there is an active sore to culture. Their reasoning was, "Sure there's blood test to see if someone is a carrier, but you can't DO anything about it if they are, and it takes up too much chair time to deal with the emotional response to 'you have Herpes.']
  • You can trust the people who give you free birth control and condoms. Are you kidding!? Comprehensive Sex Ed. programs are developed and presented (most of the time) by people who's INCOME is tied to sexual treatment services. Your local sexual health clinics receive federal and state funding to provide pregnancy-related and STD screening services. But (unlike Positively Waiting) they also receive funding from the feds, states and school districts to develop and present their sex ed. program. (Am I the only one who sees this as a conflict of interest?)
Even after a 3-to-6 week Comprehensive Sex Ed. program these myths still persist. First, because the medical data is very complicated. Second, because adolescent brains simply aren't capable of taking in data, weighing it against time/nature/experience and being able to predict the outcome of their behavior. But third, because the information gets watered-down to "Be safe. Use a condom."

In a teen mind, the message sound just like: "Be safe, don't smoke." Teens know no one dies immediately from smoking a cigarette, or a joint. You have to do it a lot so the problem builds up over time. Do you know how that message translates to sex? "You shouldn't have sex with a lot of people when you're young." Teens rarely grasp that you can get pregnant or be infected for a lifetime after only one act of sex.

Even after hearing both Positively Waiting and clinical program, some teens still respond, "Thanks for telling me all this stuff. I'm definitely going to slow down." (Yikes!)

How much more will that misconception persist if no one is there acting as their "visual aids"?

Here's the "truth" we're trying to smuggle in a nutshell: See these two people? One practiced "safe sex" by the book and got infected anyway. The other one only worried about being pregnant when she didn't want to be and ended up throwing away the chance to get pregnant when she wanted to.

We just want to be sure teens process the WHOLE TRUTH about how sex can impact their lives. We want them to know they can eliminate risk by the choices they make, and we want them to know (despite what others might say) it is possible to control your sexual passion, because WE did it.

The truth is we were banned by people who have never seen our presentations. Not one single teen (even those who who were sexually active and blew us off) has ever said they think we shouldn't be allowed to tell our story. Everyone who seen it agrees: our story makes a difference. They don't understand why adults are preventing us from showing by our own lives how to be successful at sexual self-control.

And, in all truthfulness, neither do I.








Tuesday, May 20, 2008

Virgins & Oral Sex

A new study about oral sex is about to be published in the July issue of the Journal of Adolescent Health. The analysis of a federal survey released yesterday, found that more than half of 2,200 males and females aged 15 to 19, reported having had oral sex.

The revelation making the news is that virgins were much less likely to engage in oral sex than sexually experienced teens. Eighty-seven percent (87%) of teens who had "real sex" were also engaging in oral sex. Only 23% of virgins were engaging in this behavior.

This is good news... since there has been concern that teens were using oral sex to "preserve" their virginity. This study is the first to actually ask the question.

Here is my opinion. Based on my conversations with teens in every walk of life over 10 years, I can say, teens know that "protection" exists. They are not uninformed about the availability of condoms and/or birth control (although there is a great deal of MISinformation mixed in with what they know.)

BUT, they don't want to use it. The problem is NOT that they don't know they should. The problems isn't that they don't know how to get it or how to use it. They don't WANT to use it. It works like this...

Phase One: Two virgins are curious about sex. There has been some kissing and touching that produces really great feelings. They aren't thinking, "This could lead to sex, I better get protection." They're thinking, "We'll just keep doing this. There's no risk in this." Then, well... they don't call it foreplay for nothing. End result, they didn't use protection because they "weren't planning to have sex."

Phase Two: Nothing terrible happened, although SHE has just sweat bullets until her period came. She has The Talk where she tells him, "That was really risky. I don't want to do that anymore." He's thinking, "Are you crazy?! That was great! You better believe I want to do that again!" But he says, "Sure. Whatever you want. We don't have to do it. I can wait until you're ready."

In the meantime, he's looking at whatever will remove the obstacles to doing it again. Thus, he introduces the possibility of using protection... usually condoms. She receives this information as a form of his concern for her safety. BUT, if he actually brings condoms to their next rendezvous, the encounter will lose some of the spontaneity and she feels let down.

Phase Three: She becomes focused on not getting pregnant, but he has subtly ramped up the pressure to be sexually intimate. "Protection" seems so mundane and makes their "love" feel somehow lessened. So, one of them suggests oral sex. HE because he wants to remove any and all obstacles which might impede his next orgasm. SHE because she wants to preserve the relationship without "ruining her life."

Phase Four: Their relationship inevitably ends and they move on to other people. Oral sex for her in subsequent relationships seems like a way to eliminate the constant pressure for sex without being vulnerable to the risks. Oral sex for him is easily presented to the next girl as an option which "costs her nothing." It is extremely rare that girls are the recipient of oral sex... make of that what you will.

Phase Five: These teens hear a Positively Waiting presentation. First revelation: Any STD that can live between someone's legs will also live in another person's mouth. They are convinced (finally!) that protection is also necessary if they engage in oral sex. In future sexual encounters they can't help but think, "Umm, where has this body part been?"

Second revelation: The memories of those intimate experiences don't go away just because they have changed partners. Now they KNOW each experience and all the emotions tied to it will compile one upon another. The pain and fear and vivid memories will lurk in the shadows, ready to appear at inopportune moments.

If they choose to continue sexual activity (oral, anal or vaginal) now they KNOW they must use protection at all times, if they want to avoid risk. The decision to actively use protection and/or birth control makes it very hard to convince themselves that sex is a way of expressing "their love."

Phase Six: They pretend sex is just a sport. "It's fun. We're being responsible. No one's getting hurt. Sex helps us get to know each other." In other words, they become US.

We produce another generation that can't bond, that takes risks with other people's lives, that never develops relational skills and then walks away when it gets too hard.

Does anyone market "protection" against that?


Wednesday, April 16, 2008

Really BAD Abstinence Ed.

I was reminded today of the two contestants on American Idol who "promoted" abstinence education. One was a middle aged man who sang a song called "No Sex!" and the other was a high school student who wanted Simon Cowell to know it would "just be better" if he waited for sex until marriage. They, like the Church Lady from Saturday Night Live and the "coach" at the beginning of Mean Girls, give abstinence a bad name. We do look utterly foolish when we pretend sex is bad, dirty or evil.

The American Idol contestants represent just two of several forms of really bad abstinence education. Here are some others:
  1. Data Dumping: Scary statistics, graphic pictures of diseased genitals and study after depressing study on the negative consequences of non-marital sexual activity. It does produce a fairly impressive eeyewuuww! factor, but information doesn't change behavior.
  2. The Sleeping Beauty Method: extreme censorship of any and all material which might inspire a sexual thought. This is a favorite of churched families, generally based on the wrong belief that preventing ALL exposure to the sex-saturated culture as a young person will somehow keep them from wanting to have sex. It makes mom and dad feel good, but leaves the child totally unprepared from the onslaught of emotions and desire they have when they step outside the cocoon.
  3. Lowering the Bar: changing the standard to something other than wait for marriage, most often, "wait until you're ready/older/in a committed relationship." This are vague and unspecific targets which have broad interpretations. An adult's interpretation of the "commitment" stage is very different from a 14-year old's.
NONE of these strategies work.

I know this for a fact, because we tried them and failed. We found out the hard way that fear only works as long as the fear lasts. Its great when they're 5, but really ineffective at 15. When we finally set aside our pride, and really asked what works? what impacts your attitudes toward sex? Teens gave us the answers.

More next time...

Friday, April 4, 2008

LAUSD and Me

From 1998 until December of 2006, my husband and I talked to teens in LA Unified Schools (mostly in the San Fernando Valley). A frank talk about living with the consequences of sex really impacted their perspective about sex, about "safe sex" and about not "doing it."

BUT... in December of 2006, LAUSD made us stop. They were worried about "discrimination" and "medical accuracy." OK. We worked the system. Lots of legal hoop jumping, delays, written proposals and more delays... In the end, they have decided:

1) We are not qualified to tell our own story
2) While the whole point of our story is that "safe sex" failed us, in order to come back to LAUSD schools, we would have to include tell students there are "other FDA approved methods for preventing pregnancy and contracting STDS" [Note: That means we have to encourage them to use condoms.]

The absurdity is the FDA and the CDC will only say "Condoms are not 100% safe, but if used properly, will reduce the risk of sexually transmitted diseases."

REDUCE the risk???!! By how much? The rates vary depending on the disease, whose infected and what type of sexual activity they're engaging in...

(You didn't really believe a condom gave you 100% protection, did you?)

So, back to LAUSD... if we agree to tell students something we KNOW experientially didn't work for us, and we can PROVE scientifically won't work for THEM, the district will allow us to talk to the students... oh wait, I forgot. We aren't qualified to tell our own story.

Thursday, March 27, 2008

What are sex education studies REALLY measuring?

Any time you see a report saying "comprehensive sex ed. works" or "abstinence-only fails" its important to know what they're measuring. The GOAL of comprehensive sex ed (CSE) is to "reduce number of acts of unprotected sex." A CSE is successful even if teens who weren't having sex before, are now having sex using condoms.

Yep, according to the folks who study this stuff, if you can turn a whole school of kids who were AVOIDING the risk of STDs and pregnancy before you got there, into teens who are now having "protected" sex, you gotcherself a successful CSE.

But in the Real World, using a condom "sometimes" is a whole lot riskier than not having sex at all. And that's the argument you never hear. It's not like teens don't know condoms exist. They do. But they have funny ideas about how they're supposed to use them...

For instance, the consistency of use is about the same as brushing their teeth or doing their homework. In a teen's world, once you "really trust your partner" you stop using protection to prove it.

The truth is, according to the Youth Risk Behavior Survey, 9th graders who've just received their sex education on condoms, report using a condom about 75% of the time. But by their senior year of high school, condom use drops to 54%. By then, they're relying on other forms of birth control. But they have a much greater chance of getting infected with a sexually transmitted disease than they do of getting pregnant. (Think about it, only one way to get pregnant, only a few days a month v. every type of sexual contact can transmit disease, 24/7).

If teens weren't teens, a "safe sex" strategy might work. But they are teens ---and ALL teens think their invincible and NO teen can predict the consequences of their behavior. If we can teach them not to drink & drive, not to smoke, not to use drugs and not to pollute... what's the problem with applying those same behaviors to adolescent sexual activity?

The Truth about Sex Education

If I read one more article saying "abstinence doesn't work" my head will explode. Its such a ridiculous statement. Of course if you're not having sex, then you aren't going to have sexual consequences. DUH. But the argument isn't about whether or not "abstinence" works, or kids need more access to birth control. It really is about ADULT agendas.

If kids learn how to control their sexual passions, develop a broad range of interest to re-channel that energy, and learn good relationship skills... they will be more successful in life. That's a fact supported by a ton of research. It's also what every parent wants for their kids.

BUT, if a teenager, in the full flush of their peaking hormones, exercises some sexual self-control, the response from adults isn't "Good for you! Great job! I'm proud of you!"... it's "Uh-huh. Be sure you have a condom in your wallet, just in case."

The problem is that ADULTS want to believe there is such a thing as casual-sex-without-consequences. But there isn't. You can trust that latex condom all you want, but the FACT is the most common sexually transmitted diseases have the same transmission rates with or without condoms. Look it up on the CDC website.

And because teenagers are kind of famous for not following through, that whole business about 98% effective against pregnancy is a myth. Teens using condoms to avoid getting pregnant, have a failure rate of 30% in the first year (that means they GOT pregnant).

The desperate belief that pills, shots, creams, foams and condoms can somehow allow teens to be sexually active in serial relationships, but still arrive at adulthood unscathed is RIDICULOUS!

For me, its not just about avoiding STDs and making babies. Its about developing character. Being faithful to one person is hard. It takes a lot of practice and mental discipline. Learning to communicate on an intimate level requires a person to abandon the self-centeredness of childhood, and care about others. Real lasting success in relationships is hard work. If a teen is giving in to the desire to satisfy that drive for sex and only concerned with avoiding the social consequences, how and when will they learn these important skills??

Sexual self-control is hard, but so beneficial. I know, I did it myself. When I was giving in to my desires for sex, I didn't care about anyone but me. But when I stopped using people for sex, I learned how to love them.

I want that for the kids in my community.