FAQs on Sexuality, STIs, and Education

1)  What’s the difference between sexually transmitted diseases (STDs) and sexually transmitted infections (STIs)?

STIs: This is an inclusive term to use for potentially dangerous pathogens (germs) that can exist in a body with or without causing permanent harm.

Example: About 90% of women who are infected with human papillomavirus (HPV) clear the infection from their bodies within two years. This means that this particular infection did not cause permanent harm to the tissues in these women’s bodies.

STDs: This is a term used when permanent damage occurs to human tissue from an infection.

2) What’s the definition of sex?

The answer to this question may seem simple yet the definition can be complicated. When the word “sex” is mentioned in research it usually is used to mean sexual intercourse. But when we are talking about sexually transmitted diseases this word must be defined as all sexual activity. The meaning must be inclusive because infections can be transmitted in many ways not just through intercourse.

The Medical Institute defines sexual activity this way:

“Sexual activity means sex as well as other actions intended to result in sexual arousal or gratification.”

How ever the word is defined, it must be defined in each conversation. Otherwise, each person listening to a message regarding this topic may be hearing a different meaning.

3)  What’s the difference between abstinence-until-marriage education and contraceptive-focused education?

Abstinence Education

Central concept: Abstinence from sexual activity outside of marriage is the healthiest choice for single persons.

Prevention emphasis: Primary prevention i.e. prevention of high-risk behavior.

Commonly taught subjects:

• Anatomy & physiology.
• Physical, emotional, psychological, social consequences of sex.
• STIs/STDs
• Teen pregnancy: Realistic expectations
• Contraception: Emphasis on effectiveness and failure of methods.
• Future dreams and goals.
• Dangers of pornography.
• The benefits of marriage.
• Relationship skills.
• Boundary setting

Central themes: Abstinence-until-marriage and fidelity in marriage are the best decisions to ensure your sexual health and potential marriage. Your parents are the best source of information regarding sexuality.

Contraceptive-focused Education

Central concept: All persons, regardless of age or sexual identity, have the right to be sexually active.

Prevention emphasis: Secondary prevention i.e. prevention of consequences to high-risk behavior

Commonly taught subjects:

• Anatomy & physiology
• Physical consequences of sex.
• STIs/STDs
• Contraception: Emphasis on how methods work, how to use them and how to access them.
• How to pleasure self and partner(s).
• Pornography use as a way to be abstinent.
• Marriage is one of many options for life.
• You decide your gender and experimentation is necessary to determine what gender you are. We must embrace and accept whatever gender or combination of genders others want to be.
• We are born gay or lesbian.

Central themes: You (only) determine when to start sex. There are only physical consequences to sex.  Pregnancy and birth can be avoided. Sex is for pleasure. Pornography and other aids can be helpful to increase pleasure. Marriage is one choice in life.

4) All teens are having sex, aren’t they?

No. But it can seem that way if we listen to the media. Here’s some current statistics:

• Before the age of 19, 70 percent of females and 65 percent of males have had sex.¹
• By the age of 24, 89 percent of males and 92 percent of females have had intercourse with a sexual partner of the opposite sex.²
• More than fifty percent of youth (ages 15-19) have had oral sex.³
• Statistically, 31 percent of young women become pregnant at least once by age 20.⁴
• There are 19 million new cases of  STIs reported per year; half of which occur among 15-24 year olds.⁵

Sources:
¹E. Terry-Humen, J. Manlove, S. Cottingham, “Trends and Recent Estimates: Sexual Activity Among U.S. Teens,” Child Trends Research Brief, (2006).
²William Mosher, Anjani Chandra, Jo Jones, “Sexual Behavior and Selected Health Measures: Men and Women 15-44 Years of Age, United States, 2002,” http://www.cdc.gov/nchs/data/ad/ad362.pdf (12.  (May 2008).
³“Science says: Teens and oral sex,” The National Campaign to Prevent Teen Pregnancy September 2005, <http://www.thenationalcampaign.org/resources/pdf/SS/SS17>(2 May 2008).
⁴Saul D. Hoffman, National Campaign to Prevent Teen Pregnancy, October 2006,
 < http://www.thenationalcampaign.org/resources/pdf/pubs/BTN_Full.pdf > (2 May 2008).
⁵H. Weinstock, S. Cates, S. Berman “Sexually Transmitted Diseases among American Youth: Incidence and Prevalence Estimates, 2000,” Perspectives in Sexual Reproductive Health, 2004: 36: 6-10.

5) Why does it seem so difficult to motivate parents to talk to their children about sexuality?

• Some feel disqualified from their pre-marital sexual behaviors.
• Many parents are concerned that their teens know more than they do.
• Some parents are involved in behaviors that they don’t want to reveal.
• Many parents fear their teens’ refusal to talk about this subject.

6) If we teach every teen how to use a condom will they use them?

Probably not. One of the myths in education is that if we teach a skill to all of the students, all of the students will adopt the skill and use it every time they’re involved in an activity. When we apply this to condom use, many factors affect teens in using condoms besides understanding how to use them. No matter how many teens and adults are taught how to use condoms, many will choose not to use them for a variety of reasons. Here are some recent statistics on teen condom usage:

Males:

• Among 15–19-year-olds, condom use at first sex increased slightly from 69% to 71% between 1995 and 2002. This change represents a decline among young white men (from 76% to 68%) counterbalanced
  by substantial increases among young black and Hispanic men (61% to 85% and 55% to 67%, respectively).¹
• Condom use declines with age. In 2007, 76% of sexually active ninth grade males used condoms at last sexual intercourse, compared with 60% of 12th graders.²

Females:

• 45% of teenage women who practice contraception use condoms, either alone (19%) or with another method (25%).³

Both:

• In 2005, 34% of currently sexually active high school students did not use a condom during last sexual intercourse.⁴
• Among the 35.0% of currently sexually active students nation wide, 61.5% reported that either they or their partner had used a condom during last sexual intercourse.⁵

Sources:
¹Guttmacher Institute (2008). “In Brief: Facts on young men’s sexual and reproductive health. http://www.guttmacher.org/pubs/fb_YMSRH.pdf (August 14, 2008)
²Guttmacher Institute (2008). “In Brief: Facts on young men’s sexual and reproductive health. http://www.guttmacher.org/pubs/fb_YMSRH.pdf (August 14, 2008)
³Guttmacher Institute (2008). Facts in brief: Facts on contraceptive use. http://www.guttmacher.org/pubs/fb_contr_use.html (August 14, 2008)
⁴CDC. Youth Risk Behavior Surveillance—United States, 2005 [pdf 300K]. Morbidity & Mortality Weekly Report 2006;55(SS-5):1–108.
⁵CDC (2008). “Youth risk behavior surveillance- United States, 2007.” Morbidity and Mortality Weekly Report, vol. 57, SS-4. www.cdc.gov/mmwr (August 14, 2008)

7) How is Abstinence education defined in the federal legislation that’s used in government grants?

Abstinence education as defined by Section 510 of Title V of the  Social Security Act.

 It is “an educational or motivational program" which:

• Has as its exclusive purpose, teaching the social, psychological, and health gains to be realized by abstaining from  sexual activity; 
• Teaches abstinence from sexual activity outside marriage as the expected standard for all school age children; 
• Teaches that abstinence from sexual activity is the only  certain way to avoid out-of-wedlock pregnancy, sexually  transmitted diseases, and other associated health problems; 
• Teaches that a mutually faithful monogamous relationship in the context of marriage is the expected standard of human  sexual activity; 
• Teaches that sexual activity outside of the context of marriage is likely to have harmful psychological and physical  effects; 
• Teaches that bearing children out-of-wedlock is likely to have harmful consequences for the child, the child's parents, and  society; 
• Teaches young people how to reject sexual advances and how alcohol and drug use increases vulnerability to sexual  advances; and 
• Teaches the importance of attaining self-sufficiency before engaging in sexual activity.'

8) What is the history of sex education?

Here are a few articles that help illustrate the roots of this type of health education and organizations that have helped  supportive organizations to develop:

• A Look at the Sexual Revolution in the United States: And how it informs the work of abstinence educators
  /pdfs/fosi/abstinence/Sex_ed_history.pdf
• SIECUS history: http://www.siecus.org/index.cfm?fuseaction=Page.viewPage&pageId=493&parentID=472
• Planned Parenthood history – Wikipedia
  http://en.wikipedia.org/wiki/Planned_Parenthood