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HIV/AIDS: The role of abstinence only programs

Posted Aug 23 2008 3:20pm
Welcome to this installment of The AIDS Pandemic, a podcast hosted by Dr. David Wessner from the Department of Biology at Davidson College. I’m Amy Jendrek.



In fiscal year 2005, President Bush requested $270 million to fund abstinence-only education programs in the U.S. While Congress did not appropriate the full amount requested, they did allocate $167 million to support these programs. There are three principal programs that use federal funds to support abstinence-only education.



The first of these is SPRANS, Special Programs of Regional and National Significance, which has a sub-program devoted to Community-Based Abstinence Education. In 2001, its first year of funding, 33 SPRANS recipients received $20 million in grants. By 2004, the program had over 100 grantees and a budget of $75 million.



The second program is Section 510 of the 1996 Welfare Reform Act, which provided $250 million over five years for programs with “the exclusive purpose” of promoting abstinence. The law has since been extended in June 2004, providing $50 million per year.



The third program, the Adolescent Family Life Act (AFLA) was originally passed in 1981 to promote “prudent approaches” and self-discipline to adults. In 2004, it provided $13 million for abstinence-only education programs, and the same amount was again appropriated in 2005.



In 2004, California Representative Henry A. Waxman led an investigation of abstinence-only education programs funded by the federal government. The investigation, titled “The Content of Federally Funded Abstinence-Only Education Programs,” found that 80% of curricula used by two-thirds of SPRANS grantees contained false, misleading, or distorted information about reproductive health.



The report looked at 13 abstinence-only sexual education curricula, and found errors in scientific information presented by 11 of them. Many contained errors regarding HIV prevention and the effectiveness of condoms.



According to the CDC, “Latex condoms, when used consistently and correctly, are highly effective in preventing the transmission of HIV.” According to the Waxman report, multiple abstinence-only curricula use a 1993 study by Dr. Susan Weller which found that condoms reduce risk by 69%, using an analysis which both the FDA and the CDC found erroneous. One abstinence-only curriculum, “I’m in charge of the FACTS ” claims that “The actual ability of condoms to prevent the transmission of HIV/AIDS, even if the product is intact, is not definitively known.”



These curricula fail to mention the multiple studies showing the effectiveness of condoms against transmission of HIV, as well as the rigorous standards the FDA holds for testing contraceptives.



Another area in which the Waxman report found many errors was in curricula’s analysis of HIV risk behaviors. Data on exposure risks is presented in a confusing and exaggerated manner. Data from CDC chart titled “HIV infection cases in adolescents and adults under age 25, by sex and exposure category,” is presented by FACTS as “Percent HIV Infection.” This means that, where the CDC chart showed that nearly 50% of male teens living with HIV reportedly acquired it through homosexual contact, the curriculum’s chart shows that 50% of homosexual male teens are HIV+. In a similar fashion, it implies that 41% of heterosexual female teens are also HIV+. After the Waxman Report, a caption was added to include the original title of the chart.



Many curricula use a one in ten infection ratio for HIV-risk activities, ignoring the fact that even with a high estimate, one in 300 people in the US are infected with HIV.



WAIT (Why Am I Tempted?) Training , a program used by 19 SPRANS grantees, places sweat, tears, and saliva in the “At Risk” category for HIV transmission. Since the Waxman report came out, WAIT Training has changed its curriculum to put sweat in the “No Risk” category, but maintains that there is risk of contracting HIV through tears and saliva, as the disease can be isolated from them, despite the CDC’s assertion that there is no risk of transmission from these fluids.



In some cases, even discussion of HIV and AIDS are not allowed under abstinence-only guidelines. The Franklin County, NC, school board had three chapters cut out of a ninth grade textbook because they did not adhere to state laws mandating abstinence-only programs. The chapters covered marriage and partnering, contraception, and HIV. In Orlando, Florida, a high school teacher was suspended when he chose to show a student-made video about HIV prevention. In Illinois and New York, AIDS-prevention presentations by an AIDS task force and the CDC were cut from programming because they were not “consistent with an abstinence-only message.”



Other errors are more simple. In what is probably a typo, but one that should have been caught, Tree of Life Preventative Health Maintenance, Inc., a grantee in Arkansas , tells teens on its website that “AIDS is the result of HPV.” One student handbook, from the FACTS curriculum, defines AIDS as “Acquired Immune Disease.”



Currently, only 12 states have not accepted federal abstinence-only money. That does not necessarily mean that all these states provide a comprehensive sex education, or that those states that have accepted money teach a strictly abstinence-only curriculum. However, 35% of school districts with a sex education policy require abstinence to be covered and either do not allow discussion of contraceptives or allow discussion only of their failure rates.



According to Planned Parenthood, “most reputable sexuality education organizations in the U.S., as well as some prominent health organizations, including the American Medical Association, has denounced abstinence-only sexuality programs.” In 1997, the National Institutes of Health concluded that “Abstinence-only programs cannot be justified in the face of effective programs and given the fact that we face an international emergency in the AIDS epidemic.”



I’m Amy Jendrek. Thanks for listening.

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