Posted by Condom Depot on 05/20/2005
Think no-underwear zone, Sarah Beth Basinger urges the Hamilton Southeastern High School freshmen, as some shift uncomfortably in their seats. "It's not because I want to be mean. It's not because I want to be awful. It's not because I want to destroy your life," says Basinger, a teacher with Creating Positive Relationships, an abstinence-only sex-education curriculum used there, and by some other schools in Indiana and around the world.
May 20, 2005
As infection rates rise, abstinence-only course has advocates, detractors.
Local and national figures
Chlamydia, gonorrhea and syphilis cases among 15- to 19-year-olds in Indiana
- 1999: 6,932
- 2000: 7,027
- 2001: 7,490
- 2002: 8,046
- 2003: 7,727
Indiana pregnancy rates for 15- to 19-year-olds, per 1,000 females
- 1999: 62.1
- 2000: 59.1
- 2001: 54.6
- 2002: 52.9
- 2003: 51.5 (estimated)
Chlamydia, gonorrhea and syphilis cases among 15-to-19-year-olds nationally:
- 1999: 364,690
- 2000: 369,083
- 2001: 389,785
- 2002: 401,279
- 2003: 401,167
Source: Indiana State Department of Health
Think no-underwear zone, Sarah Beth Basinger urges the Hamilton Southeastern High School freshmen, as some shift uncomfortably in their seats.
"It's not because I want to be mean. It's not because I want to be awful. It's not because I want to destroy your life," says Basinger, a teacher with Creating Positive Relationships, an abstinence-only sex-education curriculum used there, and by some other schools in Indiana and around the world.
Basinger, a peppy twentysomething, wants the teens to avoid the potential negative consequences of sex -- pregnancy and a host of sexually transmitted diseases.
It's a message that's getting through to teens, but only in part. While teen pregnancy rates in recent years have plummeted in Indiana and across the country, the rate of sexually transmitted diseases in this age group has ticked upward.
The experts aren't quite sure how to explain this seeming discrepancy. But they agree the statistics signal a need for more research into what teens know and do when it comes to sex and how best to guide them to make wise choices.
"Like all teen behavior, sexual development and how teenagers make decisions is a complex issue," says Dr. Judith Ganser, medical director for maternal and child health services for the Indiana State Department of Health. "There does need to be more research into exactly what works. That's difficult research."
A recent Indiana Youth Institute alert on STDs speculated that the increase in infections may be linked to the fact that many teens have substituted oral sex for intercourse, considering it to be a safer option.
Some, including abstinence advocates, say that the best way to halt the spread of disease, therefore, is to promote avoidance of all sexual activities. Others, however, argue that teens need to know the importance of protection and regular screening for detectable and preventable STDs.
On a recent morning, Basinger focused on the risks associated with skin-to-skin contact of any sort, and told her young audience that condoms should not provide them peace of mind.
"Condoms are not as safe as you think they are. Do they offer some protection? Yes. Total? No," Basinger cautioned the Fishers students. "What you've got to be aware of is that by using a condom you're not erasing all chances of getting an STD."
Adolescents say they appreciate the candor of the CPR curriculum and take to heart the lessons it aims to impart.
"It brings up some important issues. They're uncomfortable issues, but they're important," says participant Patrick Meadows, 15. "It shows every side of it, good and bad, what can happen if you screw up and have sex in high school."
Amanda Miller said the class has taught things her parents would never tell her and things her friends just didn't know. "You learn the down and dirty truth about what STDs are, about what can happen," says the 15-year-old.
While the CPR curriculum emphasizes abstinence, others say educators also need to send a strong message about the importance of condom use. Although condoms will not completely eliminate the risk of an STD, they will lower it considerably.
"Our point is that there are some people who choose not to be sexually abstinent, and in that environment they need to know what the risks are, what the options are for protecting themselves," says Dr. James Allen, president of the American Social Health Association, a nonprofit organization that focuses on providing information about STDs.
Some studies have shown that teens who take virginity pledges are less likely to use condoms when they do begin having sex, and also less likely to be tested for STDs.
And a 2003 survey of youth behavior in Indiana suggests there's more work to be done in this state. The study found that only about 55 percent of youth surveyed who had had sex had used a condom in their last encounter.
Helps prevent diseases
Promoting condom use for teens who are having sex could make a difference in the rates of certain STDs, including chlamydia, one of the most common among teens, says Dr. J. Dennis Fortenberry, professor of pediatrics in the division of adolescent medicine at Indiana University School of Medicine.
"There's unequivocal evidence that consistent use and correct use of condoms substantially reduces the risk," he says.
More vigorous health screenings also might make a difference in teen STD rates, experts believe. A recent ASHA report on STDs in adolescents called for health professionals to screen more aggressively for diseases like chlamydia in young people. Chlamydia is a treatable bacterial infection that is often without symptoms, which increases the chance a person will pass it on unknowingly.
Untreated, chlamydia can lead to pelvic inflammatory disease and infertility.
In 2000, chlamydia accounted for 1.5 million of the more than 9 million cases of STDs among American youth, according to the Youth Institute report.
Health screenings needed
Current recommendations call for annual chlamydia screenings. Some experts, however, suggest that girls who are sexually active should be checked even more frequently.
Those who have been infected once should receive regular checks, as they are likely to contract chlamydia again, perhaps from the same partner who gave it to them the first time, Fortenberry says.
Teens also need to know that a lack of symptoms of chlamydia, which can include vaginal discharge and burning, does not mean an absence of disease. Adolescents who have not been screened, "could come into a relationship, use condoms for a few weeks, and decide that everything was OK and discontinue condom use," Fortenberry says.
Still, no device can protect against all harm.
At the close of her class on STDs, Basinger posed this hypothetical to the teens: Let's say someone invented a condom that's 110 percent effective. You have sex. Then your boyfriend or girlfriend breaks up with you.
"Did that condom protect your heart from getting broken? Did it protect your reputation? You really have got to start to think about it; it's not just STDs," she said.
By Shari Rudavsky
shari.rudavsky@indystar.com
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