U.S. Needs Effective HIV Prevention, Sex Education Policies, Opinion Piece Says

Main Category: HIV / AIDS
Also Included In: Sexual Health / STDs;  Pediatrics / Children's Health;  Preventive Medicine
Article Date: 03 Jun 2010 - 3:00 PDT

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"Now more than ever, it is politically possible for the federal government to fully support comprehensive sex education and effective public health messaging," American Prospect Web editor Phoebe Connelly writes in an opinion piece tracing the history of prevention messages in U.S. public health policy.

In the nearly three decades since HIV/AIDS emerged in the U.S., public and private organizations have "struggled with how best to spread the message of prevention," Connelly writes, adding that in the last decade, "both the general population and specific demographics where HIV infection rates are the highest have had limited exposure to safe-sex messaging." She notes that federal efforts to include lessons about sexually transmitted infections in public schools are "chronically underfunded," with HIV prevention funding reduced to less than 50% of levels in the 1990s, partly because of the "counterproductive policy of funding abstinence-only curricula."

Although the federal government helped lead HIV/AIDS awareness efforts and safer-sex messages through the 1980s, it "began to falter" in the early 1990s with the "increasing dominance" of abstinence-only approaches to sex education, Connelly writes. Under the Clinton administration, $50 million annually was set aside for abstinence-only sex education programs as part of Title V of the 1996 welfare reform efforts. The "steady erosion of federal prevention efforts" continued under the George W. Bush administration, Connelly adds. While prevention-related funding dropped from 10% of the federal HIVAIDS budget in 1995 to 4% in 2006, funding for abstinence-only education increased to more than $200 million annually.

Connelly writes that abstinence-only programs "weren't merely taking up funding that could have been used for educating students about proven prevention methods; they were also sowing misinformation." A 2004 report released by Rep. Henry Waxman (D-Calif.) found that more than 80% of programs that received federal abstinence-only grants provided "false, misleading or distorted information about reproductive health," including that HIV can be spread through sweat and tears and that condoms fail to prevent HIV transmission as often as 31% of the time during heterosexual intercourse, according to Connelly.

Meanwhile, HIV and other STI rates in the U.S. continue to increase. A February editorial in the New England Journal of Medicine "noted that infection rates in certain U.S. communities rival those of countries in sub-Saharan Africa," Connelly writes. For example, the black community is disproportionately affected by HIV, and black women are 22 times more likely than their white counterparts to be diagnosed. According to Connelly, syphilis also "has re-emerged as a prevalent threat, with women's infection rates increasing 36% from 2007 to 2008."

Connelly writes that a shift in effective public-health messaging about STI prevention "won't happen without external public pressure and some internal leadership from the Obama administration," which "has a mixed record so far." The Centers for Disease Control and Prevention in 2009 launched a five-year public awareness campaign aimed at reducing the number of new HIV infections, and the Office of National AIDS Policy is creating the first national strategy to combat HIV/AIDS.

However, "even implementing a national AIDS strategy doesn't mean we're closer to a major federal push for safe sex," Connelly writes. She notes that the federal health care reform law (PL 111-148) includes a provision to continue federal funding for abstinence-only programs. However, another provision allocates $75 million annually over five years for comprehensive sex education programs.

"Ultimately, the battle is not over preventing any one disease or educating any one community about sexual health," Connelly states, continuing, "It's about sending a broad public message about the importance of responsible sexual behavior -- be that monogamy, condom use or regular testing -- and ensuring the funding is available to target the most-at-risk populations" (Connelly, American Prospect, June 2010).

Reprinted with kind permission from http://www.nationalpartnership.org. You can view the entire Daily Women's Health Policy Report, search the archives, or sign up for email delivery here. The Daily Women's Health Policy Report is a free service of the National Partnership for Women & Families.

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