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August 19, 2008

Sex (education) and the city

Kentucky sticks with abstinence-only education despite a teen birth rate that far exceeds the national average

A handful of local health departments across Kentucky share the following grim words of caution with teenagers: “WARNING! Going on this ride could change your life forever; result in poverty, heartache, disease, and even DEATH.”

The foreboding message — delivered via overhead projector in a font fit for a horror movie — then warns that those who ignore this advice will likely “come out losers.”

The potentially deadly “ride” is premarital sex, and the message is part of a federally funded abstinence-only-until-marriage education program, which teaches adolescents that abstaining from sex is the only safe option, omitting information about contraceptives.

In June, Congress voted to continue funding the federal Title V grants for abstinence-only education, freeing up $50 million to be distributed among participating states next fiscal year.

And although many states are abandoning abstinence-only programs in favor of a more comprehensive approach, Gov. Steve Beshear has no intention (at least for now) of joining the ranks of governors who have rejected the controversial Title V money.

“It’s not something that I’m aware of that he’s considered,” says Cathy Lindsey, spokeswoman for Beshear, when asked whether the governor has contemplated turning down the grant. “I talked to our folks at (the Cabinet for) Health and Family Services and they expect that we will continue to accept the funding.”

States that accept the money are required to contribute $3 for every $4 received, and that money must be used strictly in accordance with abstinence-only education guidelines, meaning talk of birth control cannot be part of the curriculum. Kentucky received more than $817,000 in Title V money last year (about one-third of the total amount of funding the state received for abstinence education through various grants).

Critics of abstinence-only education are disappointed by Kentucky’s continued participation, pointing out that the state’s teen pregnancy rate far exceeds the national average — proof that this approach to sex education clearly is not working.

Between 2005 and 2006, the Centers for Disease Control reports that the teen birth rate in Kentucky jumped 6.6 percent, more than twice the national average that same year. Overall, the number of 15- to 19-year-olds giving birth in Kentucky is 19 percent higher than the national average.

“Numbers don’t lie,” says William Smith, vice president for public policy with the Sexuality Information and Education Council of the United States. “It is time for Kentucky to join many other states in refusing this failed experiment of abstinence-only-until-marriage programs.”

In recent months, Smith points out that conservative states including Colorado and Idaho have turned down the funds, citing a lack of evidence that abstinence-only education works. Since the Title V program was established as part of welfare reform in 1996, state participation has steadily declined, with only 25 states now accepting funding.

“The fundamental reason these programs continue to be perpetuated in places like Kentucky is a lack of political will to stand up and say no,” Smith says. “In the state of Kentucky it is absolutely unconscionable that entities engaged in protecting the public health are involved in this type of programming.”

The Sexuality Information and Education Council recently issued a report focusing on Kentucky because of its high teen-pregnancy rate, and what the advocacy group describes as an abundance of abstinence-only programs based on fear, religion and false information.

The report suggests that such fear-based abstinence programs are particularly prevalent at crisis pregnancy centers, which receive a share of Kentucky’s Title V funding. These centers — including the Pregnancy Resource Center in Louisville — function as health clinics, yet most have religious affiliations, and according to Smith, they relay a strong anti-abortion message. Using federal money to further an anti-choice platform, some even relay incorrect information, Smith says, like referring to the morning-after pill as a form of abortion.

“Scare tactics didn’t work for the D.A.R.E. campaign and they aren’t working here,” Smith says, adding that sex education should teach that abstinence is the best choice while also providing information about contraceptives.

The majority of the Title V money pouring into Kentucky is allotted to 16 local health departments, including Louisville. The Metro Health Department uses the grant for its Teen and Youth Program of Encouragement, a mentoring group that meets at Jefferson County public schools to encourage abstinence. 

“It’s great to teach abstinence, but abstinence-only (education) is not an effective method of teaching,” says Dr. Paige Hertweck, associate professor of pediatric and adolescent gynecology at the University of Louisville.

Particularly troubling is the fact that many abstinence-only programs encourage participants to sign virginity pledges, says Hertweck, who suggests that those who sign the pledges are less likely to ultimately practice safe sex. The doctor believes that’s because they either don’t know how to use condoms, or believe using a condom means sex is pre-meditated, enhancing feelings of guilt.

Instead of teaching abstinence as the only choice, Hertweck says educators should teach teens that abstinence is the safest choice, but that contraception is necessary if they choose to have sex. That’s the message Hertweck relays at the Center for Adolescent Pregnancy Prevention, a nonprofit clinic that provides health and sex-education services for those ages 11-24.

“The reality is, people are not going to abstain forever,” she says. “When they do become sexually active, they need to know what to do.”