Friday, June 30, 2006

Effectiveness of Sex Education

I found an interesting commentary in Life Site News on the effectiveness of sex education. It analyzes a study which was recently published in the New England Journal of Medicine. The article points out how the headlines reported in most mainstream media down plays the studies actual findings.

I've added bolding for emphasis.

HPV Condom Study Shows The Failure of Condom Education

June 30, 2006 (LifeSiteNews.com) - "Study demonstrates failure of condom education." That is a headline you didn't read in your local paper although it accurately describes the results of a study published in the prestigious New England Journal of Medicine (Winer, June 22, 2006). Instead the headline in at least one paper reads "Condoms protect against cervical cancer." The subhead is a little more restrained: "When condoms are used effectively, a study shows they can help prevent the spread of human papilloma virus" (HPV).


Most people would assume for example, that "prevent" means zero infections, but what the study actually found was that if 100 women used condoms 100% of the time for one year, 37 would be infected with HPV. Admittedly that is better than the results for the 100 women who used condoms 5% or less of the time; 89 of these would be infected.

What the news story failed to mention, however, is that if 100 women used condoms 5% to 49% of the time, there would be 159 infections. In other words some women would have multiple infections.

How, you may ask, are women who at least use condoms some of the time twice as likely to be infected as those who use condoms rarely or never? The answer probably lies in the psychology of condom use. Those who have reason to believe that their partners are not infected are more likely to discontinue condom use altogether, whereas those who perceive some risk are more likely to insist on condom use, at least some of the time.

The study actually supports this strategy. Among the women who believed that their male partner had no previous sexual partners, there were no HPV infections. This is understandable since, if the male was not infected, he could not infect the woman.

On the other hand, the infection rate for the 100 women who had more than one new partner was 224, more than 2 infections per woman. The more sexual partners a woman has the greater the chance one of them will infect her.
The really bad news for the condom advocates is the percentage of women in the study who used a condom 100% of time. The 82 women included in the report were smart enough to get into college, prudent enough to arrive as virgins, concerned enough to enter a study, willing to record their sexual behavior every two weeks in an electronic diary, and health conscious enough to submit to regular exams. They undoubtedly were instructed in condom use and its importance, and the dangers of sexually transmitted infections, particularly cancer-causing HPV. This is the very best case scenario for condom education.

Therefore, the fact that in only 25% of the 164 eight month periods included in the study did the women report using condoms 100% of the time proves that condom education doesn't work.

The article does not report on the behavior and infections for the 82 women for the entire follow-up period which averaged 33.9 months, but rather reported on behavior and infections in eight month segments. Therefore, we don't know the percentage of women infected at least once at the end of the study.

Neither do we know from the article the percentage of the 82 women who used condoms 100% of the time for the entire study. It could be that 21 women used a condom every time. It is more likely that a larger number (but less than 50%) started out using a condom every time and then used condoms less frequently during subsequent eight month periods. What we do know is that using condoms less that 100% of the time is high risk behavior particularly if one has multiple sexual partners.

The study does not discuss the relationship between abstinence and HPV infection, because its authors know that abstinence offers 100% protection. The authors do report that 60 women initially recruited for the study were not included in the report because they did not engage in sexual activity.

In addition, the article includes only the data from the 164 eight month periods in which the women were sexually active. It does not report the number of eight month periods in which the women were abstinent, because of course during those periods there was no risk of a new HPV infection. While it is difficult it extrapolate that information from the other data, it is possible that the women in the study were abstinent during at least half of the eight month reporting periods. It would be nice to have the data on this.

The authors warn those who think the problem will be solved by the new HPV vaccine that the vaccine protects against only 4 of the scores of HPV strains.

We can assume that those pushing condom education and trying to de-fund abstinence education will use this study to prove condoms education works, when in fact what it really demonstrates is that abstinence works and even under optimum conditions encouraging women to use condoms puts them at risk.


This article made some very interesting points. I too would not consider an infection rate of 1 out of 3 as being "safe" or "protected." Considering these were college age women, I imagine the infection rates for younger women are much higher.

This acticle reminds me of the arguments made by Thomas Sowell in his book, Inside American Education. He proposed that sexual education in schools actually created the teen-sex epidemic.

p. 63
Teenage pregnancy was declining, over a period of more than a dozen years, before so-called "sex education" programs spread rapidly through American schools in the 1970s. Teenage pregnancies then rose sharply, along with federal expenditures on "sex education" programs and "family-planning" clinics, many located in schools. The pregnacy rate among 15 to 19 year old females was approximately 68 per thousand in 1970 and 96 per thousand in 1980.

.....Fertility rates among teenage girls had been declining since 1957, long before the massive, federally funded programs of the 197os and before Roe v. Wade made abortion legal in 1973.


Sex education is one of the many reasons (though not the main reason) my daughters do not go to public school. I want my children to know the truth about the risks and responsibilities that go along with sexual activity, not to mention the moral and spiritual elements.

Sex education, what an oxymoron.


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16 comments:

Ivory said...

Hmmmm.... So what I get out of this is that women who use condoms more are less likely to get diseases. Women who use them sporadically are more likely to get diseases. Sounds like a win to me. Better than nothing – right?

Considering these were college age women, I imagine the infection rates for younger women are much higher.

Not necessarily - younger women might be having sex with younger men who are less likely to be infected. Or not - really you can't draw any conclusions about younger women without data.

Another thing - the vaccine protects against four strains of the virus - two of them, 16 and 18 cause 70% of all cervical cancers. The other two strains, 8 and 11 cause 90% of all venereal warts. I won't bore you with the molecular details but these viruses causes cancer and warts because of specific "early genes" in their genomes. Not all HPVs are created equal and a vanishingly small fraction of the total number of strains cause warts or cancer. More than 90% of all cancers are caused by just three strains. Also, only 25% of people infected with HPV will ever have symptoms. This isn't a death sentence like AIDS. For more info, go to the CDC website at http://www.cdc.gov/std/hpv/ You'll love their recommendations as to how HPV infection can be avoided.

Given, this vaccine is not a panacea, but it will save the lives of thousands of women - 2,700 per year - and it will prevent thousands of others from getting disfiguring warts. It will also prevent these women from becoming vectors of these diseases to others - this is a very good thing! The reality is that today, 80% of women are infected with HPV by age 50. This vaccine will help prevent this from being true of our daughters.

I respect your desire to manage the flow of information about this topic to your children, I would invite you to consider that not every child has a well educated parent like you who invests the time and energy to inform them about birth control and that the public schools attempt to do this, however flawed, may be the only sex ed some kids get. High school students need to know about all of their options and they need to know where they can get more information (I love the CDC web site but Planned Parenthood and Kaiser Permanente have good ones as well.) I would also challenge the assertion that sex ed has lead to an increase in teen pregnancy or that it leads kids to decide to have sex and would invite you to consider that the irresponsible way sex is used in media to sell everything from cars to blue jeans probably does a lot more damage than all the talk of condoms and responsibility ever could.

I've never seen a scientific article that argues that abstinence does not work to prevent pregnancy or disease transmission. I have seen a lot of statements like “avoiding sexual contact is the only way to avoid acquiring a sexually transmitted disease. However, if you choose to have sex, barrier methods of birth control provide the most protection from infection and pregnancy.” Most people who are upset about abstinence only education dislike it because it is presented as the only effective method of birth control – while it’s probably the best, it is not the only method that works and presenting it that way is a lie.

Anonymous said...

Ivory definitely brought up good points, but I think that most people who dislike abstinance only education dislike it because it doesn't work. High schoolers will always experiment, but the difference between teenagers educated thoroughly regarding STD's and proper use of condoms, etc, and not through the watered down abstinance only programs of the public school system is substantial. Informed teenagers don't have sex more often, they have safe (or as you argue, only safer) sex more often.

Anonymous said...

Let's see: you are capable of doing a thorough critique of the news media's reporting of the study's findings--but then you accept Thomas Sowell, a source of known and extreme bias (and bigotry) without question? It gives me reason to doubt your own fairness in reporting.

Anonymous said...

Ivory says:

Hmmmm.... So what I get out of this is that women who use condoms more are less likely to get diseases. Women who use them sporadically are more likely to get diseases. Sounds like a win to me. Better than nothing – right?

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What I got out of this report is that young girls who were told it was OK to have sex with lots of partners got STD, even with "protection."

bernadette said...

We educate our 11 children at home. The rigorous studies of Biology and Bible History render your aforementioned oxymoron useless for our dear scholars.

I shall enjoy reading further down your blog.

WorldCup said...

To Anonymous two, do you know that Thomas Sowell is a Black American?

Janine Cate said...

The last statistic I've heard reports that about 50% of teens are sexually active at some point. This also means that 50% are not sexually active. When the sex education programs started a minority of students (20%) were sexually active. Promoting anything goes as long as you use a condom put the 80% of children at risk who would have otherwise been 100% safe.

At best only 25% of sexually active adults will use a condom consistently enough to protect themselves 67% of the time. I have another post which documents the surprising failure rate for condoms.

This "anything goes" attitude turns both our young men and women into pigs, and puts their very lives and futures at risk. We have students who can't pass an easy exit exam, but they can put a condom on a banana and explain the particulars of a deviant lifestyle. Wouldn't the resources be far better spent teaching students how to read and do basic math?

Janine Cate said...

One of the reasons I like Thomas Sowell is that he carefully documents all the data he uses in his books.

People may not like what he has to say, but they can't argue that he is not telling the truth.

Anonymous said...

p. 63
Teenage pregnancy was declining, over a period of more than a dozen years, before so-called "sex education" programs spread rapidly through American schools in the 1970s. ... The pregnacy rate among 15 to 19 year old females was approximately 68 per thousand in 1970 and 96 per thousand in 1980.


This quote leaves the reader with the false impression that teen pregnancy rates are still increasing, but those numbers are a quarter century old! Let's look at what happened since then.

Teen pregnancy rates peaked in 1990 and have been declining ever since, falling below the 1980 rate in 1996, and continuing to decline thereafter to 83.6 per 1000 in 2000.

Anonymous said...

One of the reasons I like Thomas Sowell is that he carefully documents all the data he uses in his books.

Documenting the data is important, but data may just show correlation, not causation. How does Sowell demonstrate causation rather than correlation in this case? To begin with, he would need to show that states that adopted sex education programs early should historically show increases in teen pregnancy earlier than states who adopted such programs later. He also needs to explain the decline in teen pregnancy in the 1990s and the much lower teen pregnancy rates in northeastern states compared to southern states. There's also the issue of how Western Europe has such lower teen pregnancy rates than the US, despite their broad sex education programs.

Janine Cate said...

I'm curious. Do declining birth rates reflect a declining conception rate or an increased abortion rate? According to the Alan Guttmacher Institute, there were almost 1.3 million legal abortions performed in the United States in 2002.

According to the Center for Disease Control, teens account for a significant proportion of the 15 million STD infections in the United States each year. Forty percent of chlamydia cases are reported among young people age 15 to 19, and young women in that age group also have the highest rates of gonorrhea.

If a private organization such as Planned Parenthood wants to offer condoms to teens and other bad advice for a meaningful life, they shouldn't do it through the school and without the parents' consent.

I just don't understand why so many "educrats" think they are being virtuous by encouraging destructive and dangerous behavior in other people's children.

A system that encourages a "do what ever you feel like" attitude is going to get "Lord of the Flies" behavior.

We can see the long list of negative side effects, such as this and this.

I by no means think the school is entirely responsible for the moral decline in teens. However, schools and amoral sex education are part of the problem.

Anonymous said...

I'm curious. Do declining birth rates reflect a declining conception rate or an increased abortion rate?

The teenage abortion rate dropped 43% from 1986 to 2000, so the declining teenage birth rate results from a very strong declining pregnancy rate despite a corresponding declining abortion rate.

Ivory said...

What I got out of this report is that young girls who were told it was OK to have sex with lots of partners got STD, even with "protection."

I dont' think that anyone in the study encouraged or discouraged a certain type of behavior. This was merely studying the participants behavior and how that resulted in disease transmission.

Promoting anything goes as long as you use a condom put the 80% of children at risk who would have otherwise been 100% safe.

I never had a sex ed class where anything goes was promoted as a good way to live. My sex ed class had a lot of information about disease transmission, birth control failure rates and the dangers of promiscuity. And since my mother was a doctor, she was invited to come speak and brought in a placenta, a pelvic cross section and some fairly detailed and accurate pictures of healthy and diseased male and female genitalia. Not exactly the sort of thing that makes most kids head for the back seat of the nearest chevy. In fact one girl asked in horror if all babies have to come with a placenta (yes they do - but after the baby comes out you'll hardly notice it.)

If a private organization such as Planned Parenthood wants to offer condoms to teens and other bad advice for a meaningful life, they shouldn't do it through the school and without the parents' consent.

I just don't understand why so many "educrats" think they are being virtuous by encouraging destructive and dangerous behavior in other people's children.


What does Planned Parenthood really say about birthcontrol on their website?

A direct quote:
Eighty-five percent of women who use no contraceptives during vaginal intercourse become pregnant each year. The only guarantee against pregnancy is not having vaginal intercourse. Other contraceptive methods can greatly reduce the risk of pregnancy during vaginal intercourse.

They go on to talk about which birth control methods prevent disease transmission and which do not - whatever you might think about their stance on abortion, they really do try to encourage people to make responsible choices about birth control and understand the consequences of their actions. Their website has a wealth of factual and accurate information.

You and your children have not participated in sex ed recently - I'm guessing that your ideas about this come from anecdotes from friends and family? It may be that in your community there are weird people running around teaching bizarre things in sex ed. But I wonder - that wouldn't be very responsible, would it? Perhaps this is all a big misunderstanding based on things that happened in the past (the free flying 70's?) that no longer happen now?

schools and amoral sex education are part of the problem. Perhaps - but I would say that media messages about sex and its consequences are pervasive, distorted, and in many cases perverse. We rarely see good examples of responsible sexual behavior on TV or in movies. Avon romance novels just started requiring that their writers include references to birth control and its use in their books but they are one of the few publishing companies that require this. If I had to choose between the media and schools as a degrading influence on the moral health of teens, I would choose the media - hands down - as most destructive. Why not be outraged about that?

Janine Cate said...

>I would choose the media - hands down - as most destructive. Why not be outraged about that?

I'm not paying for the media with my tax dollars. If a company has ads for their product on an inapproriate program. We write and let them know we aren't buying their product anymore. We let the network no we aren't watching their station anymore. It is the beauty of free enterprise. I get my financial vote. Tax dollars don't work that way. You want to support sex education, do it with your own money, not mine.

Basic health and reproduction information could be explained in about 15 minutes, and doesn't need a government program. Basic biology. This is how the human body works. It's not complicated.

Well, I came across the data the explains the declining pregnancy rate. I loath to even type it. The reason that pregnancy rates are falling is that oral sex is now the most common form of sexual contact among teens.

It has been noted that girls like to get drunk before "hooking up" because it numbs the experience and makes it less embarssing and emotionally painful.

This whole topic just makes me sad. I resent that we are turning anyone's daughter into unpaid prostitute. At least in the old days, she would get paid.


My perception of sex education is based on my on experience in high school and college (late 80's) and comments made by friends whose children are in now school. I remember sitting in "health class in 10th grade and being disgusted by the demeaning and crude way they talked about sexual relations. Just another biological urge and we are only animals anyway.

In college the student handbook listed 4 abortion clinics and how to get birth control in bulk. They had a "guess the number of jellybeans in the condom" contest. In contrast, there was no mention of adoption services in the handbook. The message was go ahead be a pig. If there's a problem, remember you can always dismember that annoying baby and have it sucked out of your body so that you can get on with your life.

If you wish to post a comment, go right ahead. But I am done with this topic.

Janine Cate said...

Wow. there's a whole bunch of typographical errors (punctuation and spelling) in my last comment. Ooops. I should know better than to post comments when I'm running late for a meeting.

Anonymous said...

You seem well informed, and probably waste too much time looking up obscure resources to back your points. Being a Dr. I think I've had some experience in this matter. Try turning your blame towards the media and the magazines or movies you and your kids probably indulge in, not our public schools who are only doing a public service to keep little ingrates from steadily multiplying and being vectors for diseases