By: Maryjo M. Oster
Holy Prophylaxis, Batman!
Last winter, my colleague and I facilitated a training on the Making Proud Choices! curriculum with one of our school district partners. Making Proud Choices! is a science-based safer sex focused teen pregnancy, HIV, and STI prevention program. The program heavily emphasizes condom use to reduce one’s risk of unintended pregnancy or HIV and STI transmission. One of the teachers at this training raised her hand and asked us, “Are there any places in our community where the students can go to get condoms for free?” As my colleague and I were deliberating about the existence of such locations in the area, the teacher followed up her question by adding, “I know our schools don’t make condoms available to the students and if this curriculum is, in fact, effective and the students want to use them, we want to be sure that they have access to them, or else what’s the point?!”
This teacher was absolutely right. What would be the point of advocating condom use if there are no condoms to use? Make no doubt about it, condoms do exist. Of this much I am sure. There is certainly not a shortage of latex in the world. This is not our problem. The issue is making them affordable and accessible to youth.
You probably see where I’m going with all of this…I’m going to say the one thing you’re not supposed to say in the discourse on adolescent sexuality. I suppose I could play nice and just keep my opinions to myself, but that really wouldn’t be my style. That’s just not how I roll…
So here goes:
Condoms should be available in every middle and high school in America.
Think I’m crazy? Think again. There is this all too prevalent fear that making condoms available to youth in schools will encourage sexual activity, but it is a fear that is not based on any real evidence. In fact, all of the evidence on this subject suggests that making condoms available in schools does not hasten the initiation of sex or increase its frequency. The only thing that increases when condoms are made available in schools is the frequency of protected sex.[1] Go figure, when kids are given access to affordable (i.e., free) contraception, they use it! It’s mind boggling, isn’t it?!
Okay, I’ll stop with the sarcasm now. Instead of being snarky, I’ll share an anecdote with you from my personal life. I was recently vacationing in Edinburgh, Scotland, where my husband and I met a couple from Sweden who were also there vacationing. Without fail, whenever and wherever I bring up my job, people immediately want to launch into a discussion about sex, sex education, teen pregnancy, their own experiences as kids, etc. I happened to find this particular conversation immensely more interesting than most, however, because when I mentioned that the name of my organization was the Pennsylvania Coalition to Prevent Teen Pregnancy, they both looked at me with such confusion on their faces. Finally, the woman asked, “Prevent teen pregnancy?” as if she had never heard of such a thing, which is not all too surprising considering that Sweden has among the lowest teen birth rates in the industrialized world.[2] “Isn’t contraception free for all teenagers?” she asked. I sighed and responded, “No, I wish…” She then asked me why this was not the case, and I unfortunately had no good response to offer her. The fact of the matter is that it is inexcusable in my opinion that such a blatantly beneficial public health practice is consistently rejected and written off, and that our only justifications for this rejection are based on unfounded fears as opposed to actual scientific evidence.
It is time we Americans wake up and smell the coffee. This conversation with my new Swedish friends made me realize just how behind the times we are as a nation with regard to our public health practices. I long for a day where the phrase “teen pregnancy” elicits looks of confusion among my fellow Americans as it did from my dinner companions in Edinburgh. Sometimes it seems too insurmountable a problem, but the Swedes reaffirmed my belief that it is only as complicated as we make it. We are capable of doing a better job of protecting our youth from unintended pregnancy and HIV and STI acquisition. We simply have to step up to the plate and do the thing that everyone is afraid of doing, to say that one thing that no one else will say.
Want to see our kids stop having kids? The answer really is this simple: Give them the knowledge and skills they need to make the right decisions and provide them with the resources they need to follow through on those decisions. Giving youth access to contraception in schools does not increase sex, but it does decrease pregnancies and HIV and STI transmission. Let’s conquer our fears with reason, because to be quite frank, I have pretty much had it with ideology getting in the way of the health and well-being of our young people.
[1] Blake, S.M., Ledsky, R., Goodenow, C., Sawyer, R., Lohrmann, D., & Windsor, R. (2003). Condom availability programs in Massachusetts high schools: Relationships with condom use and sexual behavior. American Journal of Public Health, 93(6), 955-962.
[2] Lawlor, D.A. & Shaw, M. (2004). Teenage pregnancy rates: High compared with where and when? Journal of the Royal Society of Medicine, 97, 121-123.
