President Bush’s recent appointment of Michael Leavitt to head the Department of Health and Human Services (DHHS) and Margaret Spellings at Education signals the course of the administration’s drive against reproductive choice, its anti-gay agenda, and its obsession with manipulating the public health education agenda for its ideological purposes. One specific plan is to fund programs that attempt only to encourage youth to avoid sex until (heterosexual) marriage. This form of "sex" education, they believe, should replace reproductive choice, condom use, and what they deem as sexually explicit education and disease prevention workshops as the primary means of teaching youth about sexuality and health. Further, it strives to marginalize LGBT people as abnormal and withdraw needed federal aid for teaching disease prevention. But as numerous studies have shown repeatedly, abstinence programs fail to prevent teen pregnancies, reduce sexually transmitted diseases, or to encourage scientific understanding of human reproduction.

One of the main targets of the administration’s abstinence-only education policy is condom use. In 2002 the Centers for Disease Control (CDC), under orders from the administration, dramatically reorganized its views on condom use. According to a recent report on global HIV/AIDS publish by Human Rights Watch, the CDC and other US government programs removed information on the effectiveness of condom use from their websites. References to studies that inconveniently concluded that educating youth about condom use had little to do with when they chose to have sex for the first time were also removed. The CDC also discontinued its "Programs that Work" initiative, which identified sex education programs that were found to be effective through scientific studies, because those programs provided information about condom use as part of their main goal of distributing scientifically proven comprehensive HIV/AIDS prevention information.

In 2004, the CDC proposed new guidelines requiring AIDS organizations that receive federal funds to provide blatantly unscientific information about the "lack of effectiveness of condoms" in any HIV prevention educational materials that mention condoms. Additionally, in the effort to ensure that educational programs that receive federal funds will strictly conform to the new ideological playing field being laid out by the administration, the CDC wants them to "include a certification that accountable state, territorial or local health officials have independently reviewed educational materials" for compliance with federal legislation. In other words, programs that want money have to submit their educational materials for oversight to officials who sometimes will be driven more by a passion for rooting out what they feel is obscenity than with providing scientifically accurate information. Among its new rules, the CDC demands that programs receiving federal funds not conduct education that the administration thinks will promote sexual activity.

Since Bush has taken office these guidelines have prompted close scrutiny of numerous education programs. In the summer of 2003, after an ideologically-driven witch hunt by the DHHS concluded that classes taught by the STOP AIDS Project in San Francisco encouraged sexual activity, the CDC ordered the community program to cease the AIDS prevention workshops or face funding cuts.

When other organizations opposed the Bush administration’s agenda, they faced recriminations. Audits of Advocates for Youth (AFY) and the Sexuality Information and Education Council of the United States (SIECUS), non-profit organizations which provide information on comprehensive sex education, were requested soon after these organizations started a website opposing federal funding of abstinence education. The overall effect in the AIDS-prevention community has been a reduction in educational materials and programs that have been considered in educating people about preventing the spread of disease, but now might be considered controversial by the far right. In some states, public school districts that refuse to teach abstinence as 100 percent effective in preventing sexually transmitted diseases have seen funding cuts,

Meanwhile the Bush administration has dramatically increased funding for abstinence-only programs. In 2004, the federal government appropriated over $138 million for abstinence-only programs. Bush has requested an increase to $268 million dollars for abstinence-until-marriage programs for 2005. Federal law also mandates that states match every $4 federal dollars with $3 of their own. Further, these policies that undermine effective condom use and AIDS prevention education target poor families as large portions of the money are dispersed through programs that survived the welfare deform law of 1996.

So what’s wrong with abstinence-only programs? They simply don’t work. The American Medical Association, the American Academy of Pediatrics, the American Public Health Association, and the American College of Obstetricians and Gynecologists all support comprehensive sex education programs that encourage abstinence while also providing adolescents with information on how to protect themselves against sexually transmitted diseases. In fact, according to the Union of Concerned Scientists (UCS), a recent systematic analysis of pregnancy prevention strategies for adolescents found that, far from reducing unintended pregnancies, abstinence programs actually "may increase pregnancies in partners of male participants."

Instead of comprehensive sex education, according to Choice USA, a young women’s reproductive rights organization, "abstinence-only" programs offer incomplete medical information, especially about contraception. The content of the curricula is very limited, providing only information about the consequences of sexually transmitted diseases and unplanned pregnancies, contraceptive failure rates, and the importance of refraining from sexual activity outside the context of marriage. Abstinence-only programs often use fear-based tactics to scare and shame young people into not having sex. Essentially they don’t teach young people how to protect themselves from disease or unintended pregnancy. And despite success at getting youth to promise not to have sex until they are married, large majorities of those making these pledges, according to several academic studies, break them. The result is that a lot of youth end up having sex without adequate knowledge of how to protect themselves effectively, including by using condoms.

But the administration has worked hard to cover up the facts about the failures of abstinence-only programs. In addition to deleting scientific information from government websites that counter the administration’s ideological positions, UCS accuses the Bush administration of having "distorted science-based performance measures to test whether abstinence-only programs were proving effective, such as charting the birth rate of female program participants." Instead the Bush administration ordered the CDC "to track only participants’ program attendance and attitudes, measures designed to obscure the lack of efficacy of abstinence-only programs." In other words, the Bush administration refuses to publicize the results of studies that follow up with the people who have passed through abstinence-only programs to find out what they actually end up doing.

Comprehensive, age-appropriate, medically accurate sex education can help prepare young people for healthy sexual relationships, and teach them how to prevent unintended pregnancy and sexually transmitted diseases, including HIV/AIDS. Comprehensive sex education promotes the benefits of abstinence while also advocating responsible, healthy sexual behavior. This includes teaching about contraception and disease prevention, as well as providing information to help young people develop communication and decision making skills. In the drive to replace science with far-right ideology and Christian fundamentalist religious concepts, the Bush administration has ended up creating a setting in which the things it purports to want to stop – unintended pregnancy and sexually transmitted disease – actually grow.


--Joel Wendland is managing editor of Political Affairs magazine and can be reached at jwendland (at) politicalaffairs.net.