Future of abstinence-only funding is in limbo

NEW YORK – With the exit of the Bush administration, critics of abstinence-only sex education will be making an aggressive push to cut off federal funding for what they consider an ineffective, sometimes harmful program.
How quickly and completely they reach their goal is uncertain, however, as conservative supporters of abstinence education lobby Congress and President-elect Barack Obama to preserve at least some of the funding, which now totals $176 million a year.
And even if federal funding is halted, some states — such as Georgia — are determined to keep abstinence programs going on their own, ensuring that this front in the culture wars will remain active.
Obama is considered an advocate of comprehensive sex education, which — unlike abstinence-only curriculum — includes advice to young people about using contraceptives if they do engage in sexual activity. However, Obama spokesman Tommy Vietor declined to elaborate on what the new president would propose in his own budget plan.
Cecile Richards, president of the Planned Parenthood Federation of American, depicted the federal abstinence-only program as "an utter failure that has wasted more than $1.5 billion" over the past decade. Like other critics, she noted that several major studies — including a federally funded review — have found no evidence that the abstinence-only approach works in deterring teen sex.
"Talking with Obama, he totally understands the need for young people to have comprehensive sex education — they need information that protects their health," Richards said. "I hope that will be the position of the administration, but when Congress gets involved, sometimes things get more complicated."
Even after Democrats took control of Congress in the 2006 elections, liberals lacked the votes to end abstinence-only funding, and President George Bush stuck by his strong support for it.
But Rep. Louise Slaughter, D-N.Y., said the 2008 elections not only put Obama in the White House but also increased the ranks of senators and representatives who share her opposition to funding abstinence education.
"We believe the amount of money that goes into it would be so much better used on things to prevent unwanted pregnancies," she said. "I think we'll have enough votes to deal with it."
Slaughter is a lead sponsor of the Prevention First Act, introduced this month in the House and Senate, that proposes multiple initiatives to reduce unintended pregnancies. One component calls for promoting "medically accurate" comprehensive sex education.
Supporters of abstinence education acknowledge the shift of political power in Washington, but they have appealed to Obama to preserve some federal funding for their programs.
Valerie Huber, executive director of the National Abstinence Education Association, suggested that one option would be for Congress "to allow true choice" by approving funding for both comprehensive and abstinence-focused programs.
Referring to recent data showing increases in teen births and sexually transmitted diseases among young people, she said, "Now is not the time to remove even one of the tools that can help teens."
However, Slaughter said she would oppose any effort to fund both approaches.
"We can't have both, because abstinence-only doesn't work," she said.
Among the organizations attempting to bridge the ideological divide on sex education is the National Campaign to Prevent Teen and Unplanned Pregnancy.
Its director, Sarah Brown, said the campaign's approach is "science-driven" — favoring comprehensive sex education over the abstinence programs.
"In a highly constrained fiscal environment, it's critical to focus precious dollars on programs that have evidence of good effects," Brown said. "When you look at the best science, the abstinence-only programs come up short."
Still, she said there could be a long-term benefit to conducting research on whatever abstinence programs do endure.
"I suspect that if research community keeps testing them, there might be a couple that do have an effect," she said.
Georgia supplements its federal abstinence money with more than $500,000 of state funds.
"Abstinence education will remain a strategy of our youth development initiative regardless of what happens at the federal level," said Jen Bennecke, executive director of the Governor's Office for Children and Families.
She credited the Georgia program — which includes character-development curriculum — with contributing to a 50 percent decrease in teen pregnancies since its inception 11 years ago.
Roughly half the states receive federal abstinence funding — the others have spurned the program, under which instructors are directed to teach that sexual activity outside of marriage is likely to have harmful psychological and physical effects.
Supporters of abstinence education say it promotes the only method that's 100 percent effective in preventing pregnancy and sexually transmitted disease. Critics say the abstinence programs don't deter teens from having sex, leave them without crucial information on avoiding pregnancy and STDs, and in some cases provide false information about condoms' reliability.
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On the Net:
Abstinence Education Association: http://www.abstinenceassociation.org/
Campaign to Prevent Teen Pregnancy: http://www.thenationalcampaign.org/default.aspx

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New 'Joy of Sex' Slim on Science

An updated edition of "The Joy of Sex" is newly released this month with more sexological detail, but the how-to manual remains scientifically superficial on the topic of anatomy.
In 1972, the British doctor Alex Comfort published "The Joy of Sex," an illustrated guide for couples of a newly liberated generation. His goal was to remove shame and confusion from an act that he saw as intrinsically human and healthy; as he wrote in 1991, he had hoped his book would "undo some of the mischief caused by the guilt, misinformation, and lack of information."
There have been several editions of "The Joy of Sex" in subsequent years, the most recent being Susan Quilliam's "Ultimate Revised Edition" (Crown, 2009).
Quilliam removes some of Comfort's more dated passages - including racist undertones and the encouragement of open relationships - while adding the findings of "key scientific discoveries in recent years in the fields of physiology, psychology, psychotherapy, and medicine." In addition, as she writes in the preface, "the advent of sexology - the specialist study of sexual matters - has resulted in both rigorous academic research and a more widespread public awareness of, and skill in, sex."
Most of these key scientific discoveries come early in the book, in a section called "Ingredients" ("The Joy of Sex" was modeled on "The Joy of Cooking," and uses culinary metaphor throughout).
Topics in "Ingredients" include pheromones, which are thought by some to be responsible for the correlation of desirability and smell; hormone replacement therapy; and sex education, where it is noted that "sex education actively raises the age at which adolescents first have sex and lowers the number of partners they have and the number of risks they take."
In "Appetizers," Quilliam offers three pages on STDs, including a step-by-step illustration of proper condom use. Readers might also be interested to learn that a man's average ejaculate is approximately 5 calories and contains "a dose of vitamin C."
Despite these additions, "The Joy of Sex" is by no means a scientific treatise: Its most popular section has been and will likely remain "Main Courses," which features instructional illustrations of different sexual positions. There is also some unscientific wording surrounding body parts and their functions: the scrotum is "basically, a sperm factory," and the vagina is almost always called the "p****." (The penis, it should be noted, is never given a more colloquial name.)
Scientific or not, the new edition continues its tradition of good intentions. The first ingredient of sex is listed as "tenderness," which is defined as "a constant awareness of what your partner is feeling, plus the knowledge of how to heighten that feeling, gently, toughly, slowly, or fast." That's experimentation that anyone can conduct.
The Sex Quiz
Video - Aspirin and Sex Drive
Top 10 Bad Things That Are Good for You
Sally Law has written about health and sexuality for the Cleveland Clinic, and has appeared regularly as a guest host on Sirius Radio. Her column, The Science of Sex, appears weekly on LiveScience.
Original Story: New 'Joy of Sex' Slim on ScienceLiveScience.com chronicles the daily advances and innovations made in science and technology. We take on the misconceptions that often pop up around scientific discoveries and deliver short, provocative explanations with a certain wit and style. Check out our science videos, Trivia & Quizzes and Top 10s. Join our community to debate hot-button issues like stem cells, climate change and evolution. You can also sign up for free newsletters, register for RSS feeds and get cool gadgets at the LiveScience Store.

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U.S. Chlamydia Infections Hit All-Time High

TUESDAY, Jan. 13 (HealthDay News) -- The number of Americans newly infected with the sexually transmitted diseases chlamydia and syphilis continues to rise, federal health officials reported Tuesday, with chlamydia infections hitting a record million-plus new cases annually.


The numbers, from 2007, show that cases of chlamydia as well as syphilis rose for the third year in a row, according to a report by the U.S. Centers for Disease Control and Prevention (CDC).


"The bad news from last year has continued," said Dr. John M. Douglas Jr., director of the CDC's Division of STD Prevention. "These infections remain at very high levels, and frankly, unacceptably high."


Chlamydia and gonorrhea, the two most commonly reported infectious diseases in the United States, together accounted for almost 1.5 million reported cases of sexually transmitted disease (STD) in 2007.


"Chlamydia is at a new all-time record 1.1 million cases -- it went up about 7 percent since 2006," Douglas said. "Gonorrhea is about at 355,000 cases."


STDs, although easily diagnosed and treated, frequently occur without symptoms and may go untreated. Left untreated, chlamydia and gonorrhea can result in pelvic inflammatory disease -- a condition that causes as many as 50,000 U.S. women to become infertile each year, according to the report, Sexually Transmitted Disease Surveillance, 2007.


The overall rate of chlamydia infections among women was 543.6 cases per 100,000 females, almost three times the rate among men -- 190 cases per 100,000 males, the report said.


The increasing number of chlamydia cases is actually a reflection of more people being screened, not a greater incidence of the disease in the population, Douglas said. "It's kind of a mixed piece of good news. We wish those numbers were going down, but we know they have to go up before they go down," he said.


Gonorrhea rates have been stable for about the last 10 years, Douglas said. "This is stable at quite a high level. It represents an example where we have a job half done. Gonorrhea has come down since its highpoint in the 1970s, but we just got stuck in the late 1990s, and we've been stuck ever since then," he said.


Rates of gonorrhea were also higher among women -- 123.5 per 100,000 women -- compared with 113.7 per 100,000 men, according to the report.


But these numbers are probably just the tip of the iceberg, Douglas noted. The CDC estimates that only half of all new chlamydia and gonorrhea infections are reported, bringing the actual number of infected people to more than 3 million.


"We think there are really 2 to 2.5 million cases of chlamydia a year," he said.


The report also found continued increases in rates of syphilis. On the verge of elimination just a decade ago, syphilis rates began increasing in 2001 and rose 15.2 percent between 2006 and 2007, Douglas said.


"We got set back in a recurrence of syphilis among men who have sex with men," Douglas said. "There has been limited success in trying to curb that, but we have begun to see a slide in some of the better-controlled populations."


The increases in syphilis in 2007 were predominately among women. "We have seen increases in babies, which is the ultimate innocent bystander population," Douglas said.


What's more, if you have syphilis, you also have a 50 percent chance of being HIV-positive, he added.


The report found continued racial disparities for STD cases. Gonorrhea was 19 times more common among blacks than whites; chlamydia was eight times more common; and syphilis was seven times more common, Douglas said.


Black women 15 to 19 years old had the highest rates of both chlamydia (9,647 per 100,000 population) and gonorrhea (2,956 per 100,000 population), according to the report.

Sexually transmitted diseases take a significant economic toll -- the CDC estimates that STDs cost the U.S. health-care system an estimated $15.3 billion annually.

Douglas said greater public health campaigns are needed to reverse the trend.

"These diseases can be treated, and we need to have better awareness about how extensive these infections are and what the prevention opportunities are," he said.

Dr. David L. Katz, director of the Yale University School of Medicine Prevention Research Center, said sexually transmitted diseases are a considerable public health burden.

"By serving up crucial details on where and in whom sexually transmitted diseases are most likely, this report helps inform disease-control programs. By highlighting the persistent prevalence of these diseases, it also issues a call to action," he said.

More information

To learn more about sexually transmitted disease, visit the U.S. Centers for Disease Control and Prevention.

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Sexually spread diseases up, better testing cited

ATLANTA – Sexually spread diseases — for years on the decline — are on the rise, with reported chlamydia cases setting a record, government health officials said Tuesday.

The increase in chlamydia, a sometimes symptomless infection that can lead to infertility in women, is likely because of better screening, experts said. In 2007, there were 1.1 million cases, the most ever reported, said officials at the Centers for Disease Control and Prevention.

At least 15,000 women become infertile each year because of untreated chlamydia and gonorrhea infections, said Dr. John M. Douglas Jr., director of the CDC's Division of STD Prevention.

Syphilis cases, which number only in the thousands, also rose modestly, while the number of gonorrhea cases remained roughly the same. Syphilis can kill, if left untreated, but chlamydia and gonorrhea are not life-threatening.

Chlamydia can infect men, but rates are nearly three times higher for women. That's at least partly due to 1993 federal recommendations that emphasize testing for sexually active women age 25 and under. That focus on screening in recent years is no doubt driving the record numbers, said Dr. Jonathan Zenilman, a professor of infectious diseases at the Johns Hopkins University School of Medicine.

"The issue with chlamydia is the more tests, the more you'll find," Zenilman said.

The percentage of young women being tested for the infection rose by double digits from 2003 to 2007, according to the National Committee for Quality Assurance, a nonprofit that monitors health care.

The latest case numbers for chlamydia translate to a rate of 370 cases per 100,000 people in 2007, up 7.5 percent from 2006.

The reported cases are just part of the picture. Health officials believe as many as 2.8 million Americans get chlamydia each year.

Many men and women have no symptoms from it. Some women experience pain in their lower abdomen or notice a burning sensation or a pus-like discharge when they urinate. Some men may also feel a burning during urination or have a discharge.

Gonorrhea cases appear to have plateaued and are currently at about 356,000 cases. Syphilis was on the verge of being eliminated in the United States about 10 years ago, but lately has been inching up. More than 11,000 new cases of the most contagious form of the disease were reported in 2007.

Syphilis is relatively rare but has become a growing threat, particularly for gay and bisexual men, who accounted for about 65 percent of the 2007 cases.

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On the Net:

The CDC report: http://www.cdc.gov/std/ ..read more...

CDC: Salmonella outbreak numbers increase slightly

ATLANTA – Health officials say the number of people sickened in a national salmonella outbreak involving peanut butter has grown to 485 cases.

The U.S. Centers for Disease Control and Prevention said Tuesday the number has been inching up as lab tests confirm that new cases have the same genetic fingerprint as the outbreak strain. The illnesses have been reported in 43 states and Canada, and may have contributed to the deaths of six people.

The Food and Drug Administration has traced the outbreak to a Georgia plant owned by Peanut Corp. of America, which makes peanut butter and peanut paste.

The government says consumers should avoid cookies, cakes and other foods containing peanut butter pending the results of the investigation. Peanut butter sold in jars to consumers is not included.

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