Programs teaching teenagers to "just say no" to sex before marriage are threatening adolescent health by censoring basic information about how to prevent HIV/AIDS, Human Rights Watch charged in a new report released today.
The forty-seven page report focuses on federally funded "abstinence-only-until-marriage" programs in Texas, where advertising campaigns convey the message that teenagers should not use condoms because they don't work. Some school-based programs in Texas do not mention condoms at all.
Federal health agencies share the broad scientific consensus that condoms, when used correctly, are highly effective in preventing the transmission of HIV. Yet the U.S. government currently spends more than $100 million each year on "abstinence-only-until-marriage" programs, which cannot by law "promote or endorse" condoms or provide instruction regarding their use. The Bush administration is advocating a 33 percent increase in funding for these programs.
"The Bush administration wants to spend millions more dollars on abstinence-only programs that put teenagers at higher risk for HIV," said Rebecca Schleifer, HIV/AIDS researcher at Human Rights Watch. "In Texas, these programs don't just censor information, they actively promote misinformation about condoms. And they deprive adolescents of one of the most important tools that they need to protect themselves from HIV."
U.S. federal government organizations that set public health standards, including the Institute of Medicine, the National Institutes of Health, and the Centers for Disease Control, all agree that providing complete and accurate information to adolescents about the proper use of condoms to reduce the risk of HIV transmission is an essential part of the limited anti-HIV arsenal. The U.S. Department of Health and Human Services has included among its objectives increasing the proportion of adolescents who "use condoms if sexually active."
This policy clearly puts these federal government organizations at odds with the U.S. Department of Health and Human Services' divisions that run the abstinence-only programs, which cannot by law provide this advice.
Texas' programs provide no such information. In McLennan County, which has one of the state's highest rates of teen pregnancy, the federally funded "Truth for Youth" radio and television ad campaign suggests that parents who advise their children to use condoms may actually be putting their children's lives at risk. Adolescents and adults who have heard these ads report that they don't use or don't trust condoms because they heard on television or radio that they don't work.
Another federally funded program in Temple, Texas plans to include an exercise that compares pieces of latex condoms with plastic of different thicknesses that is designed to teach that condoms are not effective because they are thinner than many kinds of plastic, and easily broken by fingernails. Teachers in Laredo's abstinence program don't mention condoms at all.
Texas' commitment to abstinence-only programs has infected other sources of HIV/AIDS prevention information by restricting access to experts on HIV/AIDS prevention and by crowding out other sources of HIV prevention information. An HIV/AIDS educator in McLennan County was told that she could not speak to students in an abstinence-only classroom about prevention of HIV by using condoms. Many recipients of federal HIV prevention money likewise provide limited or no information about condoms in their HIV prevention trainings.
Abstinence-only-until-marriage programs are particularly harmful to gay and lesbian adolescents. The programs must teach that marriage is the only appropriate context for sexual activity and further that "sexual activity outside of the context of marriage is likely to have harmful psychological and physical effects." Federal law limits marriage to heterosexual couples. And, same-sex couples can't legally marry in any U.S. state.
"Teaching gay and lesbian youth that there is no safe way for them to have a sexual relationship-even when they become adults-only reinforces the hostile environment that many of them already experience at school," said Schleifer. "Denying them access to relevant and potentially life-saving information about how to have a safe sexual relationship only makes this situation worse."
Human Rights Watch's report focuses on Texas to illustrate problems posed by abstinence-only programs nationwide. Texas receives a substantial share of federal abstinence-only funding, and its programs command nationwide influence. Two of its programs are among the eleven chosen for an evaluation of federally funded abstinence-only programs.
Human Rights Watch found that federally funded abstinence-only-until-marriage programs in Texas 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. Because AIDS is a fatal disease that yet has no cure, the government's failure to provide complete and accurate information about HIV/AIDS prevention may also impede the right to life.
Human Rights Watch calls on the U.S. government to repeal abstinence-only-until-marriage legislation and to enact in its place legislation supporting comprehensive sex education that would include information and instruction about HIV/AIDS prevention, including the use of condoms for this purpose.