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AIDS awareness and abstinence-only (ABSTINENCE-ONLY SEX EDUCATION)

Jun 1, 2007

Dear Dr. Bob,

First of all, thank you for this amazing service that you provide. I have already made a donation to your wonderful cause. I would like to ask for your advice.

I am part of an HIV/AIDS awareness group that goes to local high schools and teaches kids about HIV and AIDS.

The problem is that I live in the Bible-belt and often times the schools that we present at do not allow mention of condoms or safer sex practices. This is a huge problem because teaching these kids about condoms and how to use them is what I feel is the #1 most important point of our presentation! I often really do not see the point of even presenting if all we are teaching is abstinence-only. After all, this type of education has NOT shown to be effective!

Obviously, we have to respect the rules of the school. I was wondering though if you could give me advice on what would be the most effective way to provide education without mentioning condoms? Surely we can still provide some information that will be worthwhile, right?

Thank you for your help!

Response from Dr. Frascino


Isn't it almost beyond comprehension and certainly beyond common sense that we are trying to teach kids how to protect themselves from STDs, including HIV, and prevent unwanted pregnancies, but we are not allowed to even mention condoms or safer sex practices!!!!!! As it turns out this is really not what most schools or parents want. The "rules of the school" are really commandments laid down by Dubya and his sex-phobic, anti-science, right-wing, religious-zealot wingnuts! It's not only shameful; it's also a very dangerous policy. Excellent scientific studies have now demonstrated that abstinence-only sex education programs are a colossal failure. (See below.) I do have one piece of encouraging news to report. Just this week the Democrats who now control Congress said they plan to let the federally funded abstinence-only sex education funds expire on June 30! WOO-HOO!!! (See below.) Schools are quickly lining up to dump abstinence-only programs now that they won't be financially penalized by Bush and his extra-chromosome right-wing wingnuts. Just chalk it up to yet another poorly conceived Bush policy that has now failed miserably. So keep those latex condoms and bananas handy. I suspect even in the Bible belt you'll soon be using them for science-based, age-appropriate sex-education.

Dr. Bob

Abstinence-Only Sed Education Jul 29, 2006

Hey Dr. Bob,

Apparently Dubya is still pouring money into Abstinence-only sex education. Does this work or is "The Decider" wrong about this just as he's been so wrong about everything else?

Thanks for keeping it real Dr. Bob

Response from Dr. Frascino


Well, if there is one thing we all know all too well about Dubya's simplistic view of life it's that he values consistency. The man has never changed his mind about anything, much to the detriment of world peace, the economy, the environment and HIV-prevention efforts. Yes, Dubya is consistent. Too bad it's consistently wrong. The abstinence-only sex education policy is just one more shining example of his ineptitude and its unfortunate consequences. Here's the scoop:

The U.S. has supported abstinence-only programs to prevent unwanted teen pregnancies since 1981. Under Dubya's rule such programs have expanded dramatically to encompass HIV/AIDS and STD prevention. Dubya then forced this policy on the international community in 2003 with the implementation of his "President's Emergency Plan for AIDS Relief (PEPFAR)", which categorically mandates that one third of all prevention dollars allocated to 15 focus countries be earmarked for "abstinence-only" programs! Shocking, eh?

In the U.S., funding for abstinence-only programs has increased from $80 million in 2001 to $167 million in 2005. It is the cornerstone of the government's HIV-prevention strategy (or, as Dubya calls it, "strategery"). So is it successful? Does it stack up favorably to other prevention methods for which there are no targeted federal programs or funding? Let's take a look!

First I should remind everyone what abstinence-only programs really are. These programs teach "no sexual intercourse until marriage". (As an aside please note that since Dubya doesn't want gays like me to ever marry, I guess that means I should never have sex.) These federally funded programs must, by definition, have as their "exclusive purpose, teaching the social, psychological and health gains to be realized by abstaining from sexual activity until marriage" and must teach "that a mutually faithful monogamous relationship in the context of marriage is the expected standard of human sexual activity" and that "sexual activity outside of the context of marriage is likely to have harmful psychological and physical effects!!!" (No shit. I'm not making this stuff up, even though it sounds like a Jon Stewart Daily Show parody!) These programs are also prohibited from discussing contraception or STD prevention technologies, such as condoms, except in reference to their failure rates!!!!

There are also "abstinence-plus" programs. These programs strongly encourage abstinence among young people, but also provide information about contraception and STD-risk reduction. In addition to endorsing delay of sexual debut, abstinence-plus programs aim to increase knowledge about the use of contraception and disease-prevention methods among those who do become sexually active.

A scientifically rigorous evaluation of the efficacy of these programs has not been formally carried out. Some studies have tried to objectively assess these programs, but most have measured only attitudinal, rather than behavioral, outcomes. At best, the key behavioral outcome would suggest these programs might delay sexual debut by 12 to 18 months tops.

The results from a systemic review, in which data and outcomes from several studies are combined and analyzed together, have yielded the following results:

1. The most rigorous published review to date (28 sex education programs in the U.S. and Canada) found that none of the three "abstinence-only" programs demonstrated evidence of efficacy for delaying initial sexual activity.

2. Furthermore these three programs did not reduce the frequency of sex or the number of sex partners among those students who had sex.

3. The same review found the nine "abstinence-plus" programs showed efficacy in delaying initial sexual activity as well as reducing the frequency of intercourse and increasing condom use once sex began.

4. A different systemic review of the efficacy of AIDS-risk-reduction interventions for adolescents found that only two out of six studies showed any efficacy in delaying initial sexual activity among virgins and an increase in "secondary" abstinence (return to abstinence) among those who had been sexually active.

5. A review of 11 school-based HIV-prevention programs for youth in Africa fond only one program was effective in delaying initial sexual activity.

6. There was no significant difference in STD rates between "virginity pledgers" and non-pledgers.

Taken in total, the scientific data we have to date does not support Dubya's current policy of making "abstinence-only-until-marriage" programs the cornerstone of the U.S. government's HIV-prevention strategy for young people. Nor does it support the rapid and dramatic increase in funding to promote these programs in the U.S. or globally. Rather, the scientific evidence suggests that investing in comprehensive sex education that includes support for abstinence, but also provides risk-reduction information would be a more effective HIV-prevention strategy for youth.

So, once again, our immutable president, "The Decider," has decided wrongly!

Dr. Bob

You wrong wrong wrong!!!!!! Apr 29, 2007

You wrong wrong wrong about abstinence-only sexual education. There is solid proof that these programs are extremely effective! The teenage pregnancy rate is decreasing. Bet you weren't aware of that Mr. smarty-pants liberal know-it-all. Virginity pledges are the way to go! No sex before marriage ever!

Miss Waiting for my Prince Charming

Response from Dr. Frascino

Hello Miss Waiting for Prince Charming,

Actually I am aware of the sharp decline in teenage pregnancy rates in recent years. However, this is certainly not proof that abstinence-only sex education programs are "extremely effective!" In fact, if we look at scientific fact instead of faith-based fantasy, you would come to very different conclusions! For instance look at the article published in The American Journal of Public Health (Jan 2007) from researchers at Columbia University and the Guttmacher Institute. This study attributed 86 percent of the pregnancy decline to greater and more effective use of contraceptives and only 14 percent of the decline to teenager's deciding to wait longer to start having sex! Science once again clearly indicates that the current policy of emphasizing abstinence and minimizing contraceptive use should be turned around completely! Dubya's got the whole thing backwards once again!!! His policy of relying on abstinence-only sex education as the primary tool to reduce teen pregnancies and sexually transmitted diseases is foolish, unscientific, and increasingly indefensible! By the way Miss Waiting, you do realize Prince Charming is only a fairy tale, don't you???? And as for "Mr. Smarty-Pants Liberal Know-It-All", that's Dr. Smarty-Pants Liberal Know-It-All to you!

Dr. Bob

Big Risk? I don't think so sweetie Apr 25, 2007

Hi Doctor Bob,

I recently read in the paper, a story about HIV and high risk behaviors. This article was picked up by the general press and is now out there. This so called educator who counsels students said "Oral sex is a big thing with this young generation, and it's a big HIV risk." I find this statement dangerous and misleading to the young people out there. One could read it as, well, if oral is a big risk without a condom and vaginal/anal sex is a big risk without a condom, I am going to take the big risk of vaginal or anal sex. Don't these people have obligation to state the facts that oral is a very low risk and a "safe" alternative to vaginal and anal sex. I just thought I would share that with you. I bet she is a big bush supporter. This is exactly why we need to push the funds from abstinence only education to real sex education in this country.

Would love your comments. I will jump off my soap box!

Response from Dr. Frascino


I agree false statements and incomplete or misleading information can be very dangerous. Isn't that how we wound up in Iraq??? As for people having an "obligation to state the facts," well, unfortunately not. For example, the Vatican continues to "inform" people that condoms have holes big enough for HIV to swim right through and Dubya meanwhile tells us all that Alberto ("Torture Boy") Gonzales is doing a heck of a job! See what I mean? As for abstinence-only sex education programs, for which the federal government has been spending $176 million per year, it's recently been shown once again they have zero effect. That's right, zero! A study carried out by the nonpartisan firm Mathematica Policy Research, Inc. tracked 2,000 young people over several years and found that abstinence-only sex education classes had absolutely no effect on when kids took the plunge, so to speak. (It turned out to be 14.9 years, whether or not they had abstinence-only sex education classes). And so our $176 million per year has been wasted on another "faith-based" rather than science-based program. You're doing a heck of a job, Dubya!

As for jumping off your soapbox, don't! Stay up there and tell it like it is loud and clear! Science and common sense will eventually vanquish myth and fantasy.

Dr. Bob

Committee Chairman Says Funding Grant for Abstinence Program to Stop

May 17, 2007

On Wednesday, Democratic lawmakers said they intend to let money for the second-largest federally funded abstinence program expire on June 30. The $50 million Title V program has not proven effective, said Michigan Rep. John Dingell, chair of the House Energy and Commerce Committee, which oversees Title V funding.

Dingell cited a recent Congressional report on four abstinence-only programs in which researchers found teens who took part in the lessons were just as likely to have sex as those who did not. The study by Mathematica Policy Research Inc. also determined that students in the abstinence program had sex at about the same age as teens who did not take part in the program -- 14.9 years. "Abstinence-only seems to be a colossal failure," he noted.

Dingell said Rep. Diana DeGette of Colorado was instrumental in helping him decide to let the funding lapse. Both lawmakers, he said, prefer that the money be used for comprehensive sex education that includes an abstinence component.

"With all we know about how to prevent teen pregnancy and reduce sexually transmitted diseases, it is high time to redirect the millions of federal dollars that we squander every year on abstinence-only education to programs that actually work," said DeGette.

The federal government funds abstinence education though three separate programs. Abstinence-only programs under Title V were approved by Congress as part of welfare reform. Participating states match the grants with $3 for every $4 in federal money.

Valerie Huber, executive director of the National Abstinence Education Association, said abstinence is "a public health message that offers risk-elimination for youth. It's also consistent with what parents across America want for their youth."

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