Pope's Emphasis on Monogamy is Smart Policy
I plan to address this question from the standpoint of Pope Benedict’s XVI’s recent comments that condom use isn’t helping and is, in fact, worsening the HIV crisis in Africa. It’s hard to jump into the middle of this issue, since there is a long tradition of Roman Catholic moral theology behind the pope’s statement. (John Paul II was especially good at explicating what he called the “theology of the body.”) However, I don’t think the question really means to engage Catholicism’s teachings about the dignity of human beings, the importance of family, or the proprieties of sexuality. The word “smart” in the question suggests a consideration of the effectiveness of condom distribution as a matter of public health. (I hope we’re not considering commending condoms as a mere political expedient.)
So why even bring up the pope? Well, it has partly to do with the media firestorm that blazed after Benedict said what he said, which he did en route to Africa onboard the papal jet, Shepherd One. His comments reverberated in the media echo chamber throughout the apostolic journey—and since—and angered many people, although the million people who attended the pope’s Mass in Angola seemed downright joyful. Africans weren’t angry at Benedict’s message of restraint, perhaps because they know firsthand that in “every African country in which HIV infections have declined, this decline has been associated with a decrease in the proportion of men and women reporting more than one sex partner over the course of a year -- which is exactly what fidelity programs promote.” This quote comes from an article (from the website of the Catholic magazine First Things) by Edward C. Green and Allison Herling Ruark. Green is director of Harvard’s AIDS Prevention Research Project and Ruark is a research fellow there. They also write that abstinence programs aimed at teens have also been shown to cut down the incidence of infection.
There are no studies that show an association between increased condom use and a decrease in the incidence of HIV in Africa, which is another reason to treat the pope’s point of view with a little more respect.
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The pope has no idea what he is talking about. Monogamy can still cause unwanted pregnancies and STDs...Wake up Pope.
...pants on fire.
"There are no studies that show an association between increased condom use and a decrease in the incidence of HIV in Africa, which is another reason to treat the pope ’s point of view with a little more respect."
This is a blatant lie. The use of condoms DOES reduce risks.
This kind of tatic costs us money and promotes irresponsiblity. If they want to engage in illicit sex then let them protect themselves. Tough love works. Enabling never works.
Condom distribution is not enabling, it is protecting against risks that would have otherwise occurred.
Condom distribution has been proven to reduce both the rate of STDs and the rate of pregnancy which is what we are trying to do here.
You know truehappiness try the intercity sometime.Work with the homeless,drunks,junkys and whores.THATS TOUGH LOVE!
As a Christian I do what I can to keep them alive that means clean needles, condoms and teaching the love of Christ
The Catholic Church is very powerful in Uganda, so it is not an accident that it is the only African nation which has overcome the AIDS problem. They have a policy of strenthening marriages by promoting fidelity. IT WORKS.
You see, my Church gives women their highest dignity, by being the object of faithful lifelong love from their husbands. Once we ask Our Lord's help to promote His moral teachings, the grace comes to overcome the deepest moral depravity.
Condoms reveal a deep mistrust in man's ability to find the truth. Jesus is the way, the truth and the light.
In an article published in Science Magazine. http://thesop.org/index.php?article=11165
Just the facts.
Re: Harvard Scientist agrees with the Holy Father.
In an article published in Science Magazine. http://thesop.org/index.php?article=11165
Just the facts.
First off, please do not promote thesop.com as a reliable source of info -- a quick look at their articles shows a right wing agenda as severe as any other on the web. Just the facts would include all the facts...
Second, the ' science ' promoted in Science seems more correlation than causation. I agree that it is weird how such a piece got in this usually esteemed journal but it would not be the first time the Ivy League or an esteemed publication prostituted themselves for dogma...
This really has nothing to do with faith. Abstinence prevents the spread of HIV . The reason is obvious, if one does not engage in sexual intercourse, than they cannot get the HIV virus. However, usage of condoms while engaging in sexual intercourse, also prevents the passage of HIV. The reason for this is also very obvious, the condom prevents bodily fluids that carry the virus, from exchanging between one individual to another. The pope is being irresponsible with his stance on condom usage by saying they shouldn't even be available to the public. How about this idea? Abstinence should be promoted, while at the same time, making condoms available. That way we got both things going against HIV.
Preaching monogamy *or* using condoms in the face of violent conflict will not be effective. While comprehensive programs such as Uganda's ABC campaigns are arguably more successful than abstinence-only's woeful track record, I believe we should consider the fact that unstable conflict-ravaged regions will have little ability to promote safe-sex programs. Monogamy's not going to save someone from a rapist. Condoms have unequivocal success in dealing with STDs and unwanted pregnancies, but useless prattle over their morality is condemning the Church when it could be acting to bring attention to stopping conflicts and thus allowing sex-ed programs a place to take root and have effectiveness.
In more stable regions, I see no reason not to use a condom.
"They also write that abstinence programs aimed at teens have also been shown to cut down the incidence of infection."
They can write anything they want, that doesn't mean it bears any resemblance to reality. The numbers are very clear on this--states and counties which insist on abstinence-only education as opposed to comprehensive education have the highest rates of teen pregnancy, abortion , and STDs in this country; rates higher than any other first-world nation. Their claim is a lie and your belief in it despite the statistics demonstrates a credulity that would be laughable if it weren't so dangerous for the women and children living in the places your policies affect.
Actually, according to the National Campaign to Prevent Teen and Unplanned Pregnancy, one of the predictors of reduced rates of both teen pregnancy and STDs is that a person attends a church that values abstinence before marriage.
I did not hear anyone say that churches do not have a role in the prevention of teen pregnancy or that teaching the values of abstinence and marital fidelity would not reduce the spread of HIV . For the people who choose to live that way, it can be a very good thing. There is definitely a role for religious teachings.
My objections are to the stigmatization by churches of the people who choose to live by other lights and to the implications that church rules make appropriate public policy. We don't live in a world dominated by religious institutions. We, many of us, live in democratic and pluralistic communities where we are free to live in ways that some religious leaders don't like. Public Health policy is not designed for a community of Sunday Schools and if you look at the teen pregnancy statistics, abstinence is not fool-proof there.
The great thing about the separation of church & state is that, in the end, it's better for both institutions, when each is free of the other. I would never think of telling you how to run your church; any more than I would willingly allow the values of your church to set policy in my public health program. It always seemed like a fair deal to me, although, from experience, I have learned that mutual respect must begin at both ends. Why is it so essential to the rubric of religions that they need to impose their values on the secular community? Why is is that religious folks are so rarely content to live by their faith ? Why do they need to make it contagious? Why is it that so few are content to preach by example?
America has gone through a very bad patch of public and political religion . After the faux-Christian era of George W. Bush, I think some humility is in order.
I think it is fair to assume that the Pope almost always assumes that his words will be attended to by the faithful within his faith community. That is his primary responsibility. And it remains true that the data can be interpreted by at least one other, who has not so far been identified as a practicing Catholic, in the way the Pope did. That makes it a difference of opinion, not a lie.
Those protective factors I listed are not publicized by the National Campaign to Prevent Teen and Unplanned Pregnancy, you have to dig into the report. Their stated reason for not focusing on these factors is that they are not amenable to change by public organizations.
The most effective AIDS intervention in Africa that I've heard of is the combination of promoting monogamy, male circumcision , and condom use. Again, the combination seems problematic for public organizations.
Promoting condom use alone has not been effective. The (true) statement that it is the most effective TECHNOLOGY misses the subtleties of human sexual behavior.
Churches tend to promote family connectedness by combating poverty and by teaching that a child's parents ought to remain married to one another, tend to be places where one finds peers who delay sexual activity, can obviously be the faith community that values abstinence before marriage.
When the Pope speaks, I don't take it personally. I am not a Catholic.
The statement you make on male circumcision with respects to being effective in AIDS prevention is totally groundless. In no way does the removal or non-removal of the foreskin play any effect in the transmission of the HIV virus whatsoever. I don't know where you came across this idea but let me assure you it's completely false. I'm not saying there are no advantages to circumcision. However, if you read recent or modern medical journals on the subject. The necessity of circumcision with regards to cleanliness isn't really significant. The Practice of circumcision in America is for the most part cultural. Religious practices and beliefs also play a role in in this practice. Keep in mind there are many European nations where this practice is not the norm, and they experience no health or cleanliness issues because of this.
The practice of circumcision in America is a disgrace because it is a surgical procedure performed on an individual who cannot consent! But it also does not help prevent AIDS and may even be harmful in leading to a false sense of security, because a surgical procedure cannot be considered to be a viable method of protection against STDs.
Intact America is a group formed to oppose the practice of infant circumcision in America, and sends open letter to the AAP (American Academy of Pediatrics) in which it states: "The baby , not the parent, is your patient." http://tinyurl.com/ygselx8
but the WHO (and I don't mean the rock band) disagree.
I googled AIDS circumcision and got this link
http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=43110
Do you have anything more recent than 2007? I would be interested to see your data.
I had never read this study before. I must admit that I was completely wrong on this one. After reading the article you posted, I searched for a second credible source to verify this claim. Here is the second article I found by "Scientific American" titled "Fact or Fiction: Does circumcision help prevent HIV infection?". They concur.
http://www.sciam.com/article.cfm?id=circumcision-and-aids
However, doctors still do not recommend routine circumcision in the United States. "the benefits have not been compelling enough to recommend it routinely. And the medical risks are not compelling enough to recommend against it." This is quote from an article published by "WebMD the Magazine" titled "New Studies Sharpen Circumcision Debate". This was published in 2008 by the way. Here is the link.
http://children.webmd.com/features/new-studies-sharpen-circumcision-debate
For the prevention of HIV in Africa, I would have to agree that the benefits of circumcision vastly outweigh the minimal medical risks of it. Thank you for the explanation. You got me.
...but that statistic says absolutely nothing about the state of the sex education those children are receiving, either at school or at home and how that correlates to the rates of teen pregnancy and STDs. The CDC's statistics, however, are crystal clear on the topic.
CDC's map of cases and rates of HIV by region: http://www.cdc.gov/hiv/topics/surveillance/resources/slides/aids_regional/slides/AIDS_Regional_1.pdf --rates in the "abstinent" bible belt approach double those on the heathen, liberal West Coast.
Figures from the CDC's STD surveillance report: http://www.cdc.gov/std/stats07/figures.htm it takes some browsing, but you can clearly see that with every single reportable STD charted, the rates in the south are highest in the country.
Rates for Syphilis are especially toothsome: http://www.statemaster.com/graph/hea_syp_rat-health-syphilis-rate
Mississippi has the highest teen birth rate: http://www.reuters.com/article/domesticNews/idUSTRE50679220090107 recently displacing New Mexico and Texas for the "honor".
The US rates for teen pregnancy, abortion , and STDs are the highest by far in the western world, and amongst developed countries ranks second only to Russia.
The truth is, teenagers have been getting it on in the back seats of their cars (metaphorically speaking) for roughly sixty five million years. A few lectures in church ain't gonna stop them. Hormones are powerful things, and your best hopes for responsible decision-making are nothing in the face of basic reproductive biology.
We educate and instruct our children on all manner of things... brushing their teeth, talking to strangers, how to protect themselves from physical harm, teach them how to manage their finances, their jobs, and their friendships. We teach them how to eat right and exercise , how to throw a baseball, balance a checkbook, and choose a credit card company. Sending them out in the world in a state of complete ignorance regarding one of the most basic aspects of human biology is both a woeful oversight and a grievous injustice.
According to Sexual Risk and Protective Factors, a publication on the National Campaign to Prevent Teen and Unplanned Pregnancy website, these are the factors that come up first in a statistical analysis of low rates of teenage pregnancy . I'm sorry it doesn't directly address STD transmission but it isn't a big leap of logic to believe that there is a correlation in that, too.
1. Attachment to and involvement with family--bio-parents married, family connectedness, supervision, education and income.
2. Peers who delay sexual activity.
3. Faith community that promotes delaying sex until after marriage.
4. Success at school -- clubs, athletics, or academics.
To address number three, last I saw, the Pope was the leader of a faith community. He has an obligation, if he is concerned about STD transmission or unplanned pregnancy, to say just exactly what he said.
Referencing number four, the quality of education generally, not of sex ed programs, makes a bigger difference than sex ed programs (or access to condoms).
As far as number three goes, passing out condoms is a powerful symbolic communication that gives the (false) impression that teenagers are a victim of their raging hormones, that "everybody is doing it," as opposed to having peers who delay sexual activity.
And in your reference to the abstinent Bible belt, it's not religion that is the issue, it is poverty .
http://www.census.gov/Press-Release/www/releases/archives/income_wealth/012528.html
Regions
* The number in poverty in the South increased to 15.5 million in 2007, up from 14.9 million in 2006, while the poverty rate remained statistically unchanged at 14.2 percent in 2007. In 2007, the poverty rates for the Northeast (11.4 percent), the Midwest (11.1 percent) and the West (12.0 percent) were all statistically unchanged from 2006. The poverty rate for the Northeast was not statistically different from that of the Midwest or West.
Mississippi has the highest poverty rate in the nation. Poverty impacts number one above, family connectedness.
We can agree, I believe, that educating children about reproductive health is important. It is vital that this information be disseminated in school settings. It is also vital that verifiable information about rates of sexual activity among teenagers be shared. In areas where the rate is high, emphasis could be placed on national statistics, rather than local statistics.
It is also important that the issue of poverty is addressed. This should be our focus. The uproar about the Pope's statement came in connection with Africa, not Mississippi. The international community needs to get serious about stabilizing Africa politically and economically.
--Referencing number four, the quality of education generally, not of sex ed programs, makes a bigger difference than sex ed programs (or access to condoms).---
I would like to see some proof of this. While I might agree in general terms that better educated teenagers with identifiable goals and ambitions are less likely to engage in risky behavior, there's really no doubt that a certain percentage of teenagers will choose to be sexually active, regardless of their income (Bristol Palin), faith community (Bristol Palin), or intact family status (Bristol Palin). There is also little doubt that given the knowledge and tools to protect themselves, they will choose to do so. When their parents and community treat these young adults as children , insist that ignorance is preferable to knowledge, and send them out in the world unarmed the result is pregnancy and chlamydia.
What you seem not to understand is that no matter what you think (and no matter what those church -going teens in loving and supportive homes tell you), everybody pretty much IS doing it. Delayed sexual activity still only means age 16-17 on average in nearly all first-world nations. Last I heard, sixteen and seventeen year-olds can still get pregnant and catch herpes. If you make it difficult and humiliating to get the tools they need to act responsibly, it doesn't mean they won't have sex, what it means is they'll be having sex without condoms. Western Europe has, almost without fail, rock-bottom rates of teen pregnancy, abortion , and STDs. The difference is the honest belief that teenagers are "adults in training" and are treated as such. They are armed with knowledge about sex and reproductive health , the subjects are not treated as taboo, and condoms are readily accessible and available. In this environment , with the mystery and intrigue removed, teenagers will (get this) make responsible decisions about delaying sexual activity until age 16-17 on average, and when they do choose to be sexually active they choose (get this) far fewer partners on average and routinely use condoms with those partners. It turns out that when you treat teenagers like the adults they will be next year, they tend to act like it.
Regardless, you're right the pope's statement came in connection with Africa, which makes the whole situation even more absurd and infuriating. These are adults who will make their own decisions (unless you're female, in which case you don't have much say in the matter) on whether or not to be sexually active, and invoking the name of god to purposely withhold an inexpensive tool that will greatly reduce the spread of this epidemic is absolutely unconscionable. Parents withholding condoms because they want to control their teenagers' behavior, though misguided, is somewhat understandable. One ungodly man using his position to support the spread of HIV is not so much "misguided" as "horrifying".
It's true that the issue of poverty needs to be addressed, and that political and economic stabilization will do much to reduce the spread of HIV--I think you might agree that this will be a long, slow, and painful process. In the meantime, we should be doing everything we can to stem the tide and that means promoting condom use and providing condoms. In any case, when greater than 30% of the population is infected, that means even within the bounds of marriage people will still be at risk for contracting HIV. Since we know telling people not to have sex does not work, the only ethical thing to do is provide the tools and knowledge that will allow people to protect themselves when they do choose to be sexually active.
Abstinence has the highest failure rate of all birth control methods.
But unfortunately, this study http://www.thenationalcampaign.org/resources/pdf/pubs/SexualRisk.pdf ( I don't know why this did not make a link. sorry) is a meta analysis. However, the country with the lowest teen birth rate in Europe is Greece, which has almost no sex education . They are also a homogenous population, which the US is not. European countries generally have less diverse populations and a lower percentage of immigrants than the US. Areas of the US with a larger population of immigrants actually decreases the teen pregnancy rate. Somehow, comparing the US to Europe on that particular factor leads to confusion.
Your assertion that delayed sexual activity means age 16-17 on average can be misinterpreted. It doesn't mean that most everybody is sexually active by age 16 (boys) and 17 (girls). It means that about half of each group has had sex once at that age.
To suggest that the fact that people do have sex means that the rate of promiscuous sexual activity is unchangeable is to also suggest that the fact that people don't always use condoms in non-monogamous sex means that the rate of condom use is also unchangeable
The problem, I think, is that because the churches were addressing promiscuous sexual activity before other agencies were that has somehow made it a "moral" issue that other agencies are reluctant to address.
Promiscuity is a behavioral issue, always has been. That churches addressed it before there were good scientific studies to show that it was dangerous does not mean they own the issue. It just means that they were ahead of the curve.
And if you are not Catholic, abstinence is a 100% effective birth control method. If you are Catholic, well, there were One or two "failures."
---Promiscuity is a behavioral issue, always has been.---
Well good, then you're surely agree that the two-odd millenia the church has been attempting to stem the tide of sexual activity through ignorance and fear has been a dismal failure in that regard.
----And if you are not Catholic, abstinence is a 100% effective birth control method. If you are Catholic, well, there were One or two "failures."---
This doesn't even make sense. I'm trying to decide whether or not you're making a joke, except it doesn't even make sense in a humorous vein. The efficacy of a contraceptive method has no ties to your personal religious dogma. I'll give you a hint: abstinence, as with any other method of contraception, is only effective so long as it's used every single time sexual activity is likely to occur. When we discuss contraceptive efficacy there's a difference between "theoretical perfect use" rates and "real-world typical use" rates. Though the theoretical efficacy for abstinence is 100%, in real-world actual practice the failure rate is astronomically high... in fact, the worst of any method of contraception. Telling people not to have sex simply does not work to prevent either pregnancy or STD transmission.
I hope you were able to dig through the paper at the link I provided. And I'm sorry you didn't think my joke was funny.
Although I agree with you that "solely telling people not to have sex simply does not work to prevent either pregnancy or STD transmission," it seems to me that telling people "God is dead, we've got antibiotics and birth control pills" preceded a big increase in unplanned pregnancy and in the incidence and variety of STDs, which of course may not be a causal link, but it is an interesting correlation. And I found the differentiation of male/female ages while I was clicking around, sorry I didn't keep track of the site. Also, I don't even recognize most of those people you mention, but there are my virgin until their marriage friends who did marry virgins, LouAnn and Kathy and Danielle, and Barbara, and Connie, and Becky, Justine, and Me, and Todd, and Greg, and Greg, and Jeff, and Jeff, and Jeff and Steve, and my four adult children , at least 12 of my cousins. That's my 60 to your 14. And I could name, more too. plural of anecdote . . .
I should have dug a little deeper on Greece. Got me there!
It's not that I didn't think it was funny so much as I didn't get it at all ;0)
--it seems to me that telling people "God is dead, we've got antibiotics and birth control pills" preceded a big increase in unplanned pregnancy and in the incidence and variety of STDs, which of course may not be a causal link, but it is an interesting correlation.---
Except that it's not a true correlation at all. First of all, " god is dead, we've got antibiotics and birth control pills" is something you just invented. Secondly, the "big increase in unplanned pregnancy" and "incidence and variety of STDs" is also something you just invented. As a matter of fact, the conjunction of antibiotics and a massive public education campaign preceded a drastic drop in STD rates nationwide in the 1950s. Major outbreaks of venereal disease have been recorded as early as the fifteen hundreds. Even if you examine rising rates in STDs over the last few decades, we can equally (or better) attribute this to better surveillance and diagnosis and a strong direct relationship to plummeting public education efforts than to belief in a supernatural omnipotent being. As far as pregnancy goes, there have always been unplanned pregnancies, it's just that in the 50's a girl was "sent to live with an aunt" for a year or had a quiet illegal abortion . The CDC reports that declines in teen pregnancy rates between 1990 and 2004 are also reflected in steady declines in both teen birthrates and abortion rates during that period. The Guttmacher Institute found in a recent analysis that 86% of the decline in teen pregnancy between 1995 and 2002 was due to more teens using contraception and using it more effectively. If you look at rates prior to the 20th century... well, there are none, because prior to the contemporary period, teen pregnancy and marriage as early as the onset of puberty was the norm.
The people I mentioned are all well-known "Christian" leaders who were involved in messy public sex scandals of various kinds (prostitution, affairs with married parishioners, affairs with underage parishioners of the same or opposite sex, homosexuality ). Anecdote of course not being the plural of data, but it's awfully charming to me when such folks who spew fire and brimstone, bigotry against gays, and pound the pulpit for monogamy spend their off-hours with hookers and glory holes. It seems that virginity and monogamy are fine for the masses but not so much for the priests and the preachers.
Here's another secret about your friends and cousins: plenty of people call themselves virgins. It doesn't mean much, especially when plenty of church -going kids I know are proud of preserving their virginity through the wonders of oral and anal sex. A few months back I had to tell a fourteen year old girl she was pregnant. She was insistent that it couldn't possibly be so--after all, she was still a virgin. An extensive and puzzling conversation ensued wherein it was revealed that she was certain she was a virgin because (and this is a direct quote) "it only lasted five minutes and wasn't even fun".
It usually doesn't make the papers when people act with integrity. A press release that says "I'm faithful to my spouse" invites ridicule and well, bad luck.
But my big problem on this thread was the "The Pope Lied" assertion. When I said "it seems to me" and then said something that was untrue, you provided information to the contrary. You didn't say I was a liar. The Pope said what he believes. I think that based on the aspect of science that the same set of data can lead to different conclusions, the Pope genuinely believes that distributing condoms does pose a risk of worsening the problem. (Yes, I know it wasn't locavore that said the Pope lied.)
I believe that health classes before ninth grade ought to teach reproductive health , including psychological and socio- economic sequela of transitory and precocious sexual activity. I believe that kids misinterpret that statistic that on average kids have had sex by 16 or 17 to mean that most kids are sexually active, and the belief that one's peers are sexually active does increase the rate of sexual activity in teenagers. I believe that DISTRIBUTING condoms to teenagers also reinforces the impression that most kids are sexually active, which could increase the rate of sexual activity. And yes, I believe that even absent STDs and pregnancy , that high rates of teenage sexual activity are detrimental.
Distributing condoms (even to teenagers) where AIDS is epidemic, I can support that. I can also support the Pope believing that the Catholic Church providing the service that it does provide will be more effective.
---But my big problem on this thread was the "The Pope Lied" assertion. When I said "it seems to me" and then said something that was untrue, you provided information to the contrary. You didn't say I was a liar. The Pope said what he believes.---
I think the concern comes in where, when ordinary citizens like us speculate or make false assertions, such statements don't have much effect beyond the development of local policy which can generally be course-corrected year by year as the effects of our beliefs and policies develop. Also, there's some allowance with "ordinary citizens" who may not have availed themselves on the data and can be excused for some degree of incorrect belief based on personal experience. The pope has none of these excuses and is subject to none of these allowances. He's (ostensibly) the leader of a global cross-cultural institution and his statements are viewed by many worldwide as the literal, infallible, word of god . When the pope says "condom distribution not only wouldn’t cure the AIDS crisis, it actually makes it worse" despite the vast amount of scientific truth at his fingertips, that statement most certainly -is- a lie. When the pope makes a proclamation, particularly one that has such sweeping consequences as this one, he carries much more responsibility than you or I arguing about giving condoms to teenagers.
In any case, what I called a lie is the assertion that "...abstinence programs aimed at teens have also been shown to cut down the incidence of infection" as the statistics are extremely clear on the dismal failure of such programs.
---I believe that health classes before ninth grade ought to teach reproductive health , including psychological and socio- economic sequela of transitory and precocious sexual activity.---
A solid curriculum, as long as the "reproductive health" section is scientifically accurate and comprehensive and includes all aspects of reproductive health. Contraception and STD prevention might not be information they need right at this second, but familiarity with the concepts and tools prepares them for the time when they actually will need them. If you wait any longer you'll be too late. Many, many kids as young as twelve and thirteen are sexually active. Your claim that the average age of onset of sexual activity doesn't reflect the behavior of "most" kids is somewhat specious--it's only 1% off of "most" and for those on the bell-curve that initiate sexual activity after the median there are just as many that become sexually active long before age sixteen.
--I believe that kids misinterpret that statistic that on average kids have had sex by 16 or 17 to mean that most kids are sexually active, and the belief that one's peers are sexually active does increase the rate of sexual activity in teenagers.---
So what? Do you propose we lie about the statistics, or just conceal them? Is it okay to discuss it amongst ourselves but not to let the teenagers know we know what's happening?
---I believe that DISTRIBUTING condoms to teenagers also reinforces the impression that most kids are sexually active, which could increase the rate of sexual activity. And yes, I believe that even absent STDs and pregnancy , that high rates of teenage sexual activity are detrimental.---
When you say "distributing" do you mean actively handing them out? Or simply making them available on request? Do you believe that withholding condoms and making it humiliating and difficult to access them has a beneficial effect? Does your belief extend to the idea that high rates of sexual activity with resulting STDs and pregnancy (but no "show of support" by adults distributing condoms) is a better outcome? I don't think we should start a nationwide campaign to hand out condoms to every teenager in every situation, but I do think it's appropriate in many communities. In my own small rural high school, with most families intact and wealthy and "Christianity" the norm, seven out of eleven girls in my graduating class were either pregnant at the time of, or had already given birth by graduation.
---Distributing condoms (even to teenagers) where AIDS is epidemic, I can support that.---
What about where unplanned pregnancy is epidemic? Or chlamydia? Or is it only for AIDS prevention where you believe condoms are useful?
---I can also support the Pope believing that the Catholic Church providing the service that it does provide will be more effective.---
I can support Dick Cheney believing the US invading the middle east will be more effective to line his pocketbook, and also that he believed he was acting in his own best interests and the best interests of his organization, but it won't stop me from calling him a liar and dismissing his policies as both self-serving and catastrophic for the communities they affect. The road to hell, I hear, is paved with good intentions.
Halperin DT, Steiner MJ, Cassell MM, Green EC, Hearst N, Kirby D, Gayle HD, Cates
W. The time has come for common ground on preventing sexual transmission of HIV .
Hearst N, Chen S. Condoms for AIDS Prevention in the Developing World: Is It
Working? Studies in Family Planning 2004;35:39-47.
AIDS Prevention in Generalized Epidemics: What Works?
Senate Testimony
December 11, 2007
I've put this info up here, this is the third time. When I push Submit, it disappears. Feeling a bit paranoid. If you approve my other posts, dismiss this one.
Norman Hearst, MD MPH
University of California, San Francisco
Many is the time I've lost extensive posts here. I've found it helps to write the thing in some other application, then log in (again) before posting. For some reason it can appear I'm logged in but still not allow me to post. Also have frequently saved myself by copying the text before hitting submit. I say this not to be condescending or anything, just that I think I had to rewrite half my posts before I figured that out.
I'll see if I can dig into PubMed and find these, thanks!
This fact sheet (or one that is similarly clear) should be discussed in every reproductive health class. It clarifies what is often interpreted as "everybody IS doing it."
http://www.kff.org/womenshealth/upload/3040_04.pdf
...involved in the discussion. Numbers that hover around 50% are high enough for me, keeping in mind that many students won't be truthful about their illicit activities. I'm not sure what your goals are here, but if half of all students were diagnosed with, say, polio, we'd call that an epidemic. If half of all students reported using crack cocaine, we'd call that an epidemic. If half of all students took up hula hooping or wearing slap-bracelets, we'd call that a phenomenon and a craze, and say "everybody is doing it!" If half of all teenagers are sexually active, that's plenty enough for me to ensure they have easy access to condoms and contraceptive products, to educate ALL of them on the risks and consequences of the behaviors they choose, and instill in them a comprehensive understanding of risk-management skills. As I said before, sixteen and seventeen is plenty close enough to adulthood for me to believe that we should treat them like adults, and give them the information they need to make adult choices regarding adult behaviors.
Adults lie to kids all the time, and kids know it. The consequence of the fire-and-brimstone "have sex and your parts will rot off" is that kids reject all subsequent information that comes from the abstinence-only crowd... because guess what? They had sex, and their parts didn't rot off. Also, it was fun! These "kids" will be 100% free to make these choices and engage in these behaviors without your guidance or consent in a year or two. There's nothing magic about the age of eighteen. The years leading up to to the age of consent are ones which we should spend providing them with the knowledge and tools they need to be successful. You can't spend their first seventeen and 11.99 months saying "here's some basic information on your reproductive system. Don't have sex. That's all you need to know" and then on their eighteenth birthday send them out into the world. Hopefully you learned to manage an allowance and balance a ledger long before you got your first credit card or car loan. These teenagers are young adults, treating them like it shows respect and means they'll listen to what you have to say. If you're frank and truthful about the risks, consequences, and risk-management, they'll be far more likely to listen to you when you say "even when managing the risks, sex is not risk-free, and you know, there are a LOT of reasons to choose not to have sex right now..."
...because half of them are doing it anyway.
but it is outdated.
http://www.kff.org/youthhivstds/upload/U-S-Teen-Sexual-Activity-Fact-Sheet.pdf
The reason I think a discussion about what the statistics actually mean is exactly because of your understanding of the statistics. That roughly half of teenagers have had at least one sexual encounter by those ages means that roughly half of teenagers have delayed the option to that point, and continue celibate behavior beyond that point for some period. (That statistic includes sex that was coerced, by the way, which means that the average age of first consensual sex is even higher.) There is a difference, especially for norm-seeking adolescents, in understanding (correctly) that 1/3 of their peers are sexually active, or understanding (incorrectly) that 1/2 of their peers are sexually active. I don't know how robust those statistics are, but neither do you.
The reason I insist on calling the subject reproductive health instead of sex education is because I want the students to have a thorough exposure to the biology, the psychology, the sociology, and the economic results of the choices they make, before ninth grade.
Our points of difference seem to me to be limited to
1. I think the Pope has an honest difference of opinion with Lancet and WHO, not that he lied.
2. I think that understanding norms of teenage sexual behavior will decrease the rate of AIDS transmission.
3. I think that distributing condoms to teenagers reinforces a flawed perception of the norms of teenage sexual behavior.
Upon further reflection, I withdraw my support for distribution of condoms except among populations where there is a high rate of risky behavior. This would limit it to prostitutes and homosexuals. Everybody else can buy a box at the grocery store.
I think our disagreement comes in where you define having had a single sexual encounter as "not sexually active". My experience with quite a few teenagers who "only had sex once" and were facing concerns about STDs and pregnancy tells me that there's every bit as much concern with one time encounters as with routine activity--more, in fact, since most of these "one off" encounters occur unplanned, unprepared, and sometimes unwanted and thus tend to be much riskier in terms of pregnancy and STDs. Also, since many teens don't define anything as "sex" if it doesn't involve penile-vaginal intercourse, it's my considered opinion that we should be providing condoms and education even when "only" oral, anal, or mutually masturbatory encounters are involved.
I think that knowing the complete and comprehensive truth about their reproductive health will decrease the rate of AIDS transmission far more effectively than a review of the statistics. This we already do, and it's not making much of a dent. It's sure not going to help in Africa.
Furthermore, if half the kids have chosen celibate behavior up to the age of sixteen or seventeen, and will continue celibate behavior beyond that point for some period, that means half the kids have chosen (or not chosen, as the case may be) to participate in a sexual encounter before the age of sixteen or seventeen, and prior to that point for some period. So... now we're right back in the same place. 50% is epidemic enough for me. Especially when that 50% only counts "sexual intercourse" and the individual teenager's definition thereof.
I guess it depends on what the definition of "is" is.
I guess I'm also at a loss to understand why your position that the glass is half-empty somehow negates my position that the glass is half-full. You seem to want to pat yourself on the back for the ~52% who have not had sex, while I want to provide tools and education to the 48% who have and the inclusive approximately 100% who will, eventually.
So I'll ask again for the second or third or fourth time: when you say "distributing" do you mean actively handing them to each teenager? Or simply making them available?
As for your last comment, that's a nice thought if you live in an area where stores exist, where they sell condoms, and where the clerk doesn't know your entire family. For many teenagers with limited or no transportation options, this means that effectively they will choose unprotected sex. I'd rather they be able to filch a handful from a jar in the nurse's office and be protected than insist on humiliation and fear to "protect" them. Hint: it won't.
But hey, let's leave that aside.
So what if we had a reproductive health class that provided all the information you described, spending weeks of class time exploring the statistics and ensuring a complete and thorough understanding that "not everybody is doing it". Knowing that the teenagers in question understand thoroughly that approximately half of them have had sex at least once and that some number under half are routinely sexually active, does that change the notion that teenagers have the right to complete and accurate information on reproductive health, STD prevention, and pregnancy prevention? Even if none of them were sexually active, I still firmly believe they have the right to that information, every bit as much as they have the right to education on mathematics, science , language, and so on. Mostly because I think teenagers are smart enough to understand that just like insistence on seat belts doesn't change the rate at which people drive cars, insistence on condoms as a factor in reproductive health doesn't change the rate at which teenagers have sex. If they're going to have sex they'll do it with or without provided condoms. If they're [motivated, smart, capable, self-confident, ambitious, moral, socially awkward] enough to choose to delay sexual activity, they'll make those choices internally, with or without provided condoms.
I think a one day discussion of norms of sexual activity would be sufficient, As I said, this is one of the three points we disagree on. You think that understanding the norms would be a waste of time.
"The reason I insist on calling the subject reproductive health instead of sex education is because I want the students to have a thorough exposure to the biology, the psychology, the sociology, and the economic results of the choices they make, before ninth grade." The biology would cover both pregnancy and disease, because those are both biological processes.
It is an interesting artifact that rates of HIV infection are higher among the wealthy in many African countries than among the poor. I've never been to a third world country. I would assume there are vendors of some sort serving many populations.
You say that as though you think no one is presenting and discussing the statistics. I never said it was a waste of time, I said it was insufficient, in and of itself. I notice you neglect to answer any of the questions.
"I would assume there are vendors of some sort serving many populations"
You would assume incorrectly. You would also assume people spend their money on condoms when they're occasionally starving to death.
“So I'll ask again for the second or third or fourth time: when you say "distributing" do you mean actively handing them to each teenager? Or simply making them available?”
“You would also assume people spend their money on condoms when they're occasionally starving to death.” I put this here because even thought it isn't a question, it begs for an answer.
US teenagers can buy them, they aren’t choosing between buying condoms and starving to death. Are you sure that there are no vendors of any kind that could add condoms to their product line in the places you have been?
More people are starving to death in many of those places than are dying of AIDS . As I said earlier, poverty is a big problem.
“Knowing that the teenagers in question understand thoroughly that approximately half of them have had sex at least once and that some number under half are routinely sexually active, does that change the notion that teenagers have the right to complete and accurate information on reproductive health , STD prevention, and pregnancy prevention?”
No, it doesn’t. This is a point we agree on.
As I said, we only have those three points of disagreement.
Now I’ll ask. You keep implying that education with distribution of condoms in Africa is more effective than education without distribution of condoms for decreasing the rate of AIDS. This is one of those things that is so obvious that it doesn’t even need to be proved, but the only info I have been able to find contradicts that, and I shared it with you. Could you share your info with me?
US teenagers can buy them, they aren’t choosing between buying condoms and starving to death.
-------
Sure they can, if they:
--live where there are stores that sell condoms or have the ability including transportation to get to such places
--can purchase them without fear or humiliation
However, you say "everyone (presumably everyone on the planet) else can go buy a box from the store" as though Zimbabwe has a Wal-Mart on every corner. In the US there are plenty of rural communities where condoms very simply aren't available or accessible. In Africa, aside from living in, you know, a third-world country without much in the way of "accommodations," many people clearly have other monetary obligations.
"Are you sure that there are no vendors of any kind that could add condoms to their product line in the places you have been?"
Yes, I am. Have you never been to an isolated rural town? In some places, the one (1) store in town sells a little bit of everything from groceries to hardware to video rentals and is owned and solely staffed by your best friend's grandma or your father's boss' wife. In small communities where everyone knows each other, even if the store carried them, the kids don't feel comfortable buying them, or aren't allowed. It's easy enough to say "well, just drive to the next town over" unless the closest town over five thousand people is an hour drive and none of your friends have access to a car. There are towns and areas like this in every state I've traveled through. These are areas that also have enormous teenage birthrates and often high rates of drug use .
________
"More people are starving to death in many of those places than are dying of AIDS . As I said earlier, poverty is a big problem."
Agreed.
It's just like they told me in Sunday School,
If you tell the truth you don't have to remember anything--Mark Twain
Precisely?
should lead to an apology. I am sorry. The two pieces of data were on the face of them inconsistent. I should have asked for clarification without implying dishonesty. As should all those who said the Pope lied.
I've found I experience quite a bit more in the way of truth and integrity outside Sunday School than in it. I believe Mr. Clemens would agree.
I hope the cites were useful.
I think we all can agree that encouraging less promiscuous behavior delayed sexual activity, sexual fidelity, and reduction in partners is the most effective tool in reducing the AIDS pandemic. Unfortunately, with such a large sector of the population being born HIV + or passively infected, sexual fidelity does not always mean protection against HIV. Condoms do. I am for the preservation of lives and not the preservation of face and faith . Fidelity is fantastic, but faith alone won't stop HIV/AIDS. Latex does.
Also, that Norman Hearst thing is the author of the article, not a signature. I haven't actually seen the data yet, myself, as I found the article references in the senate testimony. I may have to physically leave the mushroom farm and go to the University library tomorrow. Ahhh, Sunshine!
---To suggest that the fact that people do have sex means that the rate of promiscuous sexual activity is unchangeable is to also suggest that the fact that people don't always use condoms in non-monogamous sex means that the rate of condom use is also unchangeable---
You're wrong to draw a parallel between the two concepts. To address the first half of your statement, it is absolutely true that at some level, people will continue to have sex. We only need to look around us to know that this is true. Catholic priests can't even keep it in their pants, and they ostensibly have more incentive than the rest of us... not to mention a roster of such shining beacons of Christian monogamy as (Bristol Palin) Lonnie Frisbee, Marvin Gorman, Jim Bakker, Jimmy Swaggart, Mike Warnke, John Paulk, Paul Crouch, Ted Haggard, Lonnie Latham, Coy Privette, Joe Barron, Todd Bentley, and Tony Alamo, to name a few. Even in areas of the world where teen pregnancy, birth, and STD rates are extremely low they're still having sex. They're just better able to make responsible choices while doing so. In fact, it's funny that you cite Greece as an example of a country that has a very low teen birth rate despite a nearly complete lack of sex education. You are correct on this assertion regarding the state of Grecian sex-ed,but the reason for the low teen birth rate is not cultural homogeny, it's because they have an extremely high abortion rate, nearly the highest in Europe with more than 150,000 occurring annually. Abortions aren't even statistically counted for women under 16, and married women have them as a matter of course when family size begins to outstrip financial resources. Now, cultural homogeny may have a connection to the low rate of HIV --sexual activity within a closed population causes pregnancy but not necessarily disease.
Furthermore, to return to the subject of Africa, preventing the spread of HIV/ AIDS is not even necessarily about promiscuity. I, personally, have delivered more than one positive HIV test result to adult married African women who had never been sexually active with a partner other than their husbands. Do you want to sit these women down and tell them how believing the pope and eschewing condoms saved them?
To address the second half of your statement and the connection you've drawn, simply because A is true does not mean B must be as well, this is what we call a deductive fallacy. To illustrate, telling people not to drive their cars to anywhere but church and work will not do anything to reduce the number of cars on the road, the frequency of accidents, or the severity of accidents when they occur. However, educating people on safe, defensive driving practices, providing seat belts, and educating people on the necessity of using a seat belt every single time they get in a car -does- have a great demonstrable effect. The same is true of sex: telling people not to have sex outside the bounds of marriage simply does not work. Educating people on safer sex practices and providing them with the tools they need to accomplish these goals, does.
As an aside, you've injected the statistics regarding onset of sexual activity with interpretations of your own. "Age 16-17 on average" does not differentiate between males and females as you have and shouldn't be read any differently than exactly as written.
---The problem, I think, is that because the churches were addressing promiscuous sexual activity before other agencies were that has somehow made it a "moral" issue that other agencies are reluctant to address.---
No actually, the problem is that solely telling people not to have sex very simply does not work. No one is "reluctant" to tell people to be selective about their partners, to be mutually monogamous, or to delay sexual activity. The difference is that other agencies are aware that teaching and encouraging selective sexual behavior must be paired with comprehensive information on birth control and STD prevention. Otherwise, you end up with people that swear they won't have sex, until the next time they do, and when that happens they have no way to protect themselves.
Continued below
"I have spent my entire life since birth working in veterinary medicine , and at animal shelters, I have worked with hundreds and hundreds of dogs the large city shelter deemed "unadoptable" and sold for use in biomedical research ."
locavore on the PETA euthanizing animals discussion
"I, personally, have delivered more than one positive HIV test result to adult married African women who had never been sexually active with a partner other than their husbands. Do you want to sit these women down and tell them how believing the pope and eschewing condoms saved them?"
locavore on this thread.
The plural of anecdote is sometimes contradiction. You have presented a convincing debate. Many of the points you make are valid. I am still waiting for the information about AIDS rates and condom distribution in Africa, which the NGO you worked for would probably be happy to give you.
My father is a veterinarian, currently working as the dean of a vet tech program in California. I grew up in his practice and up until moving to my current location worked in a veterinary-related field, which eventually lead to spending a couple years handling the many hundreds of dogs that are sent into biomedical research by public shelters after being deemed "unadoptable". After relocating with my husband in 2003 I decided to take a job working in public health , in a publicly funded clinic (not an NGO) serving a largely high-risk and poor population mainly comprised of IV drug users, prostitutes, recent immigrants (thus the African women), and many, many teenagers.
Work in both fields, animal health and human, has a lot of connections. Currently, I do a little of both. I've found both to be challenging and rewarding. Both challenge your empathy and your strength, both involve working with some of the very most down-and-out beings you can possibly imagine, and doing your very best to help see them to a better life. Neither job pays well, but there are other reasons to do them.
Don't be so smug, pal. It doesn't become you.
I'm working on the cites. Unfortunately, most of the NGOs which championed condom distribution were more or less nuked from aiding Africa by the Bush Administration's Global Gag Rule, so data are mostly not recent.
UNAIDS. 2004 Report on the global AIDS epidemic, page.72
Holmes K, Levine R, Weaver M. Effectiveness of condoms in preventing sexually transmitted infections. Bulletin of the World Health Organization. Geneva. June 2004.
WHO/UNAIDS. Information note on Effectiveness of Condoms in Preventing Sexually Transmitted Infections including HIV . Geneva. August 2001.
UNFPA. 2007 report on donor support for contraceptives and condoms for STI/HIV prevention 2007.
Condoms have helped to reduce HIV infection rates where AIDS has already taken hold, curtailing the broader spread of HIV in settings where the epidemic is still concentrated in specific populations.
Condoms have also encouraged safer sexual behaviour more generally. Recent analysis of the AIDS epidemic in Uganda has confirmed that increased condom use, in conjunction with delay in age of first sexual intercourse and reduction of sexual partners was an important factor in the decline of HIV prevalence in the 1990s.
--Singh S, Darroch J.E, Bankole A. A,B, and C in Uganda: The Roles of Abstinence, Mongamy and Condom Use in HIV Decline. The Alan Guttmacher Institute. Washington DC. 2003.
Look, I agree with you that the first priority should be to promote mutual fidelity, but there's no doubt that when condoms are used correctly and consistently, HIV rates are cut drastically. There's also no doubt that to really stem the tide, we need to stabilize the continent both socially and economically. We can still work on risk-management in the meantime.
And any reasonable human being looking at the situation in Africa can see that preaching about monogamy is less than useless at stemming the tide of this epidemic--but for a group that devalues women perhaps it makes perfect sense. When your women are powerless and have no say in their use as a sex object or in their church , when your women are told their men are all-powerful and their word is law, when your women are told their god will protect them, it makes perfect sense. After all, keeping your women pregnant, weak, and ill is the way to keep them from realizing your church is a fraud and your god is a lie. People are dying in unfathomable numbers; in some countries the infection rate is 30%. Preaching about monogamy is not working and it's not smart policy--it's the reason one third of the population in Zimbabwe are infected with HIV . If this is god's "smart policy" then I fail to grasp why any reasonable person would voluntarily worship a god whose "smart policy" is the cause of so much innocent human suffering. We wouldn't re-elect a politician who failed even a fraction of the degree.