WASHINGTON (AP) – Teen-agers at high schools where condoms were available were no more likely to have sex than other teens, a study published Wednesday finds.
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May 29, 2003
By Robert H. Shmerling, M.D.
Harvard Medical School
How does this article relate to me?
It seems that with each passing year we learn that teen-agers are becoming sexually active at younger and younger ages. Efforts to discourage high school teen-agers from having sex have met with limited success; meanwhile, high school programs that encourage condom use have been controversial. Increasing condom use should reduce the risk of pregnancy and certain sexually transmitted diseases, including HIV, but some worry that making condoms easy to obtain in high schools might encourage sexual activity among teens who otherwise might abstain from sex.
The study described in this article is among the largest to measure the effect of a condom-availability program on the likelihood that students will be sexually active. The results provide some measure of reassurance: There was no clear increase in the number of sexually active teen-agers in schools with a condom program. In fact, fewer students were sexually active in those schools offering condoms.
What changes do I need to make?
It's not clear how best to address the issues of sexual activity, pregnancy and sexually transmitted disease among teen-agers. The study described here suggests that a condom-availability program in high school can be effective without leading to increased sexual activity.
For a number of reasons, however, it is unlikely that this study will be enough to convince all high school administrators and parents that every school should provide condoms to its students. For example, only 66 percent of sexually active students in schools with a condom-availability program reported using a condom when they last had sex. In addition, pregnancy rates were similar in schools with and without such programs. Regardless of whether their school made them available, equal numbers of students thought that condoms were easy to get. To make a big impact on the incidence of sexually transmitted disease and teen pregnancy, we will need more than school nurses and gym teachers providing condoms to those students requesting them.
As a physician and a parent, I believe that all high school students who are sexually active should be encouraged to use condoms. Teen-agers who are not sexually active should be supported and respected for this decision, especially because they may be pressured by their peers and by forces throughout popular culture to have sex well before they are ready.
What can I expect in the future?
The study described here is unlikely to be the last word on condom programs in high schools. Advocates of such programs will promote the findings as proof that they can provide essential education and reduce risky behavior without encouraging sexual activity. However, the success of the high schools that provided condoms was mixed at best. Fully one-third of sexually active students where condoms were available did not use them when they last had sex, and the programs did not seem to reduce teen pregnancy rates. In addition, these findings were based on a survey from 1995 — a similar study repeated now could find important differences. Finally, this study did not follow students over time to see if the condom program affected the likelihood of having sex. In fact, the findings described in this article might be due to differences in the communities studied rather than the condom-availability programs themselves. For example, perhaps the communities that allowed high schools to distribute condoms also made them more readily available outside of school when compared with communities that rejected high school condom programs.
You can expect the development of new programs that discourage sexual activity among high school teen-agers. Recent programs that discourage teen smoking may represent a model of how to reach teen-agers in innovative and powerful ways. You can also expect more research that tries to sort out whether any of these efforts are truly effective.
Although there may be little consensus about how best to deal with these important issues, the study reported here suggests that promoting safer sex among high school teens does not necessarily increase the likelihood of sexual activity. Given these findings, those who oppose condom programs in high schools may need to find new arguments to support their point of view.
Related Areas:
Sexually Transmitted Disease
Proper Use Of A Condom
Teen Health
Your Teen-ager And Sex
