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I. SUMMARY
Each year, hundreds of teenagers in the United States contract HIV (human immunodeficiency virus), the virus that causes acquired immune deficiency syndrome or AIDS. Experts report that in recent years, there has been a lowering of the median age of HIV onset in the United States. And, while the overall incidence of AIDS among all U.S. populations declined during the 1990s, there has been no comparable decline in the number of newly diagnosed cases among young people.Before [the abstinence only program], I could say, "If you're not having sex, that's great. If you are, you need to be careful and use condoms." Boy, that went out the window. There is no vaccine to prevent HIV/AIDS, and the best treatment does not constitute a cure. U.S. government institutions responsible for setting public health standards have therefore repeatedly and strongly urged that providing complete and accurate information to adolescents about HIV/AIDS prevention, including the proper use of condoms as a means to reduce the risk of HIV transmission, be an important part of the government's prevention efforts. The Bush Administration is nonetheless advocating for a substantial increase in funding for "abstinence-only-until-marriage" programs, which portray abstaining from sexual activity until marriage as the only acceptable behavior for youth, where marriage is defined exclusively as heterosexual marriage in a traditional nuclear family. These programs cannot by law "promote or endorse" condoms or provide instruction regarding their use and cannot provide HIV/AIDS education sensitive to the rights and needs of gay, lesbian and bisexual youth. Consequently, they deny adolescents basic information that could prevent the spread of HIV/AIDS. Federally funded abstinence-only programs interfere with fundamental rights guaranteed by international law, including the right to "seek, receive and impart information and ideas of all kinds" and the right to the highest attainable standard of health, and, indeed, may have dire consequences on the right to life. The failure to provide accurate information about prevention of HIV transmission needlessly puts children at risk of contracting this devastating and fatal disease. HIV/AIDS educators from public health departments in Texas told Human Rights Watch that they have been limited in their capacity to provide complete HIV/AIDS prevention education in schools with federally funded abstinence-only education programs. Teachers whose school districts have adopted abstinence-only curricula provided by federally funded programs reported that they were restricted in providing information about condoms that they had been able to provide prior to the adoption of the abstinence-only curriculum. Teachers in Laredo, Texas' abstinence-only program reported that they do not discuss condom use at all. Other Texas abstinence-only programs provide information that asserts that condoms are ineffective in preventing HIV transmission, thereby running the risk of encouraging people to forgo condom use who may not forgo having sex. Teachers and administrators in one Texas school district with an abstinence-only program told Human Rights Watch that they "don't discuss condom use, except to say that condoms don't work," and described an activity to teach students about condoms' ineffectiveness. One abstinence-only media campaign for youth includes radio and television advertisements that suggest that it is a lie to teach children that condoms protect against many sexually transmitted diseases. A counselor from Planned Parenthood told Human Rights Watch that teenage patients had told her that they had learned on television that "condoms aren't as safe as everybody seems to think," and that their boyfriends had told them that they had heard on the radio that "condoms don't work." A county government HIV/AIDS counselor told Human Rights Watch that an adult injecting drug user told her that he did not use condoms because he heard on television that they did not work. Federal law requires that federally funded abstinence-only education programs (1) teach that a "mutually faithful monogamous relationship in context of marriage is the expected standard of human sexual activity," that "sexual activity outside of the context of marriage is likely to have harmful psychological and physical effects," and that "bearing children out-of-wedlock is likely to have harmful consequences for the child, the child's parents, and society," and (2) may not provide any information inconsistent with this instruction. Teachers and administrators in Texas' abstinence-only programs told Human Rights Watch that they either omit discussion of homosexuality altogether, or mention it only as a risk factor for HIV/AIDS. As one teacher told Human Rights Watch, "We don't talk about homosexuality in a love relationship. We bring it up in certain STDs [sexually transmitted diseases] that are more common among homosexuals. People in a homosexual relationship are more apt to catch AIDS because anal sex is risky." Federally funded abstinence-only programs potentially harm all youth by suppressing important HIV prevention information. By their terms, they discriminate against gay and lesbian youth in additional ways. Given that same-sex couples may not legally marry in any U.S. state, abstinence-only programs implicitly teach that there are no safe ways for gay and lesbian youth to have a sexual relationship-now or as adults-thereby reinforcing the hostile environment that gay and lesbian youth experience at school. In so doing, abstinence-only programs deny access to relevant and potentially life-saving health information to gay and lesbian youth and impede their right to an education free from discrimination. Schools can play an important role in providing information to young people about the nature of the HIV epidemic and specific actions they can take to protect themselves from contracting the disease. Fifty-three million young people, including 95 percent of five- to seventeen-year-olds, are enrolled in nearly 117,000 primary or secondary schools throughout the country.1 Most states mandate that education about HIV/AIDS and sexually transmitted diseases (STDs) be provided to students.2 Depriving children of life-saving information about preventing HIV/AIDS distorts this mandate and places American children at needless risk of HIV infection. 1 National Center for Education Statistics, U.S. Department of Education, Digest of Education Statistics, 2000, http://nces.ed.gov/pubs2001/digest/dt006.html (retrieved on July 25, 2002); Centers for Disease Control and Prevention, Healthy Youth: An Investment in Our Nation's Future (Atlanta, Georgia: Centers for Disease Control and Prevention, 1999); see also Douglas Kirby and Karin Coyle, "School-based Programs to Reduce Sexual Risk-Taking Behavior," Children and Youth Services Review, vol. 19, no. 5/6 (1997), pp. 415-436. 2 Thirty-eight states mandate that schools provide HIV/AIDS and STD education, while twenty-two states require broader sexuality education. Alan Guttmacher Institute, State Policies in Brief, February 1, 2002.
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