Education sexual and abstinence
Jokin de Irala.
Senior Associate Professor D. in Public Health.
Epidemiology and Public Health Unit. University of Navarra.
Published in Diario de Navarra, Opinion section, January 20, 2002.
A law has just been passed in the US state of New Jersey that gives special priority to the promotion of abstinence from sexual intercourse in sexual education programmes in public schools Education (ACI digital Agency, 19-12-01). The law insists that teaching materials should be rethought so that the message that abstinence from sexual relations is the most effective and reasonable measure against unplanned pregnancies and sexually transmitted diseases, true epidemics of our time, is always clear and forceful.
In Spain, the messages we have been hearing in the media, as well as those defended by various social pressure groups and government bodies, have mainly been along the lines of "put it on, put it on", "against AIDS, prevent yourself" or advertisements showing a mother who is a "friend" of her daughter putting a condom in her pocket before she goes out. These messages have nothing to do with abstinence; on the contrary, they give the public a false sense of security against AIDS and unplanned pregnancies.
The prevailing argument on the street to justify the exclusivity of the condom message is essentially that "it is not possible, realistically, to ask young people to abstain". On the other hand, many will say, in line with the superficial anti-Americanism that seems to be the current political correctness, that such a law is the result of how exaggerated and puritanical Americans are about everything.
The problem is serious, we are facing unprecedented epidemics of unplanned pregnancies and sexually transmitted diseases, millions of young people are becoming infertile or acquiring the human papilloma virus which is the main cause of genital cancer manager . These are sexually transmitted diseases against which condoms do little and let us not forget that in different countries on the African continent life expectancy is currently around 45 years due to AIDS. We have to consider different solutions, but we must avoid populist discussions such as those sometimes heard on some radio talk shows with pseudo-experts. We may or may not address the problem from the interesting moral point of view. However, we should never ignore the existing scientific evidence.
There is no doubt that the message that abounds in this country has nothing to do with the official message of other health authorities such as the World Health Organisation, where three recommendations are stated in this order: 1) The only effective means of AIDS prevention is abstinence from sexual relations. 2) If this is not possible, to have mutually monogamous sex with a person who is not infected. 3) If the above are not possible, to report that consistent condom use can reduce, but not eliminate, the risk of AIDS transmission. There is now considerable scientific evidence to suggest that it is a mistake to omit this abstinence message: firstly, scientists are calling for this message to be introduced as a priority in schools (McIlhaney JS, Am J Obstet Gynecol 2000;183:334-9). Secondly, at the congress on AIDS held in Durban in the summer of 2000, the seriousness of status in different African countries became very clear. In Uganda, however, the incidence of AIDS virus infection has been greatly reduced through health Education programmes, appeals to delay sexual debut in young people and against promiscuous sex outside a steady partner. Finally, we can point out that recent reviews of evidence-based medicine by the prestigious Cochrane Foundation (specialised in carrying out critical reviews of all the scientific evidence that exists on a given topic ) clearly indicate that condoms reduce the probability of infection by the AIDS virus by 80%, far from the 100% suggested by our campaigns, which are clearly misleading (Weller S, Davis K, Cochrane Review, Issue 4, 2001).
With all these data, which anyone can consult, we cannot but wonder how it is possible that our young people, and all of us, are able to abstain from sleeping if we want to play an early morning game, to abstain from watching television if we want to approve an exam, to abstain from a per diem expenses to keep in shape or even not to eat during a hunger strike to defend an ideal, and yet it is not possible to speak of abstinence in sexuality. Perhaps we should take a closer look at experiences in other countries (such as the example of Uganda or the new American law mentioned above) in order to assess to what extent at least some of the decisions that are being taken can be useful to us. In reality, today's youth are clearly misled and consequently cannot be fully free in the field of sexuality. Until they are made clear to report that abstinence is the best guarantee against these problems and until they are made clear to report that condoms only reduce the risk of transmission by 80%, we cannot speak of real freedom of choice.