On May 5, 2015 several news media outlets reported on the story of a Chlamydia outbreak in a Texas high school. In response to the report, several opponents of abstinence based education programs have voiced their opinions that abstinence education does not work.
The Crane high school “abstinence” curriculum was taught only over a 3 day period and attendance was optional. What percentage of students attended the three day session? Did any of the 20 students infected attend the class? Certainly, behavior change takes more than a 3 day program. Looking at education as a source of prevention, consideration should be given to the options of Abstinence (sexual risk avoidance) and comprehensive (sexual risk reduction) Risk avoidance means avoiding exposure to an STI. The only true risk avoidance is to either not engage in sexual activity (including oral, vaginal, and anal sex), or to only engage in sexual activity in a mutually monogamous relationship in which both partners are infection-free.
Risk reduction, when it comes to STIs mostly comes down to latex condom use. Recent studies have shown that only correct and consistent condom use is of any benefit in protecting against STIs. Inconsistent or incorrect condom use does not seem to protect any better than no condom use. Even with 100% correct condom usage, transmission of Chlamydia is decreased by about 50 – 60% at best. It makes common sense to prioritize avoiding the risk altogether.
Educating our young people on the risks of sex outside of a long-term committed relationship with a disease-free partner is important. Educating our young people on how to form healthy relationships is also important. Teaching the truth about the limitations of condoms and the risks of alternate sexual behaviors is also important. All of these elements are included in our medically accurate abstinence-based education programs. But, education has its limits. The sexualized culture also impacts their views and their behavior. Our efforts to mitigate this cultural impact need to be clear in order for them to eliminate risk.
The Centers for Disease Control and Prevention attributes half of all cases of new STIs to young Americans under the age of 25, even though this age group makes up only about one-fourth of the sexually active population. The numbers of STIs has risen to about 20 million cases per year in the U.S. alone, which means about 10 million of those cases are occurring in our youth. Chlamydia is the most commonly reported bacterial infection and it can be successfully treated with antibiotic therapy. Unfortunately, it often goes undetected and undiagnosed until it has caused irreversible damage to the body. Our students need more than a school program. They need an engaged adult community who clearly empowers them to make optimal health choices that help them avoid all sexual risk.