Abstinence-only message will not work
Published: Sunday | June 14, 2009
The following article for the Jamaica Youth Advocacy Network (JYAN) is a response to Esther Tyson's 'Debunking condom myths' published Sunday, June 7.
Early sex initiation is not a new fad and children are fully aware of this. In fact, many of us reading this article are products of teenage mothers or parents who were continuously taught about abstinence and valuing self but still engaged in early sexual relationships. On average, the age of sexual initiation in Jamaica for girls is 15 years and 13 years for boys, with some as early as nine years old. (Ministry of Health).
For some reason, many of us ignore these realities and continue to promote the failing abstinence-only sex education to our young people. Last week, Esther Tyson in a very misinformed and misguided article, 'Debunking condom myths', advocated for such programmes that do not provide young people with the information and services they need to make informed decisions about their sexual and reproductive health (SRH). Tyson's caustic argument reflects the still conservative nature of our sexual and reproductive health response and a misunderstanding of the human rights-based approach to SRH.
Unfortunately, she used most of the article talking about what condoms are not used for. Thus, she failed to acknowledge in her claims against the effectiveness of condoms its predominant use, which is very important to this issue. Her article reflects the popular Christian-fundamentalist view in response to the HIV pandemic, which entraps many Jamaicans, including policy makers, school administrators, teachers, religious leaders and other individuals who counsel and provide care for at-risk youth.
CONDOMS FOR SAFER SEX
Patrons attending the Ministry of Education's expo on 'National Sexuality and Reproductive Health' place a condom on a model penis at the National Arena in February 2008. Ignorance on how to use condoms properly is an obstacle to some sexual encounters. - File
Tyson's statement that "Condoms cannot protect the youth from being infected by the human Papilloma virus (HPV)" is incorrect. According to a "28-month study of 123 college women, researchers found that sexually active women who used condoms consistently were significantly less likely to contract HPV than women who had not used condoms." (The Effect of Consistent Condom Use on the Risk of Genital HPV Infection among Newly Sexually Active Young Women). Also, she attempts to devalue a statistic claiming that 100 per cent correct and consistent use of condoms reduces the risk of HPV contraction by 50 per cent, insinuating that this makes condoms ineffective tools for preventing transmission. Her proposal for providing no access to condoms for young people would not prevent any cases of HPV.
Additionally, consistent and correct use of condoms is effective in preventing some STIs, including herpes, gonorrhoea, chlamydia and HIV, among others. "Condoms also provide some protection against genital ulcer STIs - such as genital herpes, syphilis, and chancroid - which are transmitted through contact with mucosal surfaces or infected skin. Because these STIs may be transmitted across surfaces not covered or protected by the condom, condoms provide a lesser degree of protection against them." (CDC. Male Latex Condoms and Sexually Transmitted Diseases. Atlanta, GA: CDC, 2002, Holmes KK et al) but the reality is they are still much more effective than no protection at all.
We agree that the condom is no panacea for the health implications of risky sexual behaviour or the socio-cultural practices that lead to them, but an important tool for protection from STIs, HIV, and unintended pregnancies. There is supportive evidence in the Caribbean that condom use is at least partly responsible for declining or stabilising HIV prevalence in the region (PANCAP, UNAIDS, CAREC).
Youth need appropriate care and comprehensive sex education.
While the world can celebrate encouraging successes in HIV and AIDS statistics globally, the trend among adolescent/people of reproductive ages 15-49 (especially girls/women) is the opposite. As youth, we are disproportionally affected by the absence of SRH services.
In the Caribbean, our share of new HIV cases is increasing, largely due to inequalities in gender relations and socio-cultural patterns of behaviour that sometimes lead to risky sexual behaviours and lower power positions for girls (transactional and inter-generational relationships). While the Latin America and Caribbean has a relatively low maternal mortality rate, this rate is higher among young/teenage mothers who often engage in botched abortions or other risky activities to end their pregnancy.
Interestingly, this reality is sharper in Jamaica than in most other Caribbean countries, and the sex trade flourishes in all 14 parishes of Jamaica (CAREC) largely because of tourism. Therefore, catering to the health needs of us young people is vital to the HIV response, and in a demographic sense vital to the economic development of the region.
It is true that abstinence is the only 100 per cent effective way to prevent HIV/STI transmission and unintended pregnancy, but the reality is that in 2004, 74 per cent of Jamaican youth age 15 to 19, and close to 10 per cent of those age 10 to 14 reported being sexually active. Young people in Jamaica have been, and will continue to be, sexually active, even if a 'self-control and true love waits' sexual education campaign is established. It is the obligation of the State to protect the health and well-being of its youth. More so, it is the responsibility of the school system, teachers and family members to serve as mentors for the younger generations. This role includes starting a dialogue about safer sex and framing it in a positive way.
South Africa, which has more than five million HIV-positive people, is reporting successes in its ability to level off HIV-infection rate. The Human Sciences Research Council which conducted the study found that there is a big increase in the number of youth 15-24 using a condom. In the 12-14 age group, for example, the research revealed that the rate has more than halved, from 5.6 per cent in 2002 to 2.5 per cent last year.
Many people, like Tyson, do not realise that a referral programme, such as the Ministry of Education's, in a supportive legislative environment is useful to identifying these youth and providing appropriate counselling and care. The challenge is determining the right age and manner of sex education and access to which services.
It is developmentally appropriate for youth to be curious about sex. Ignoring that natural curiosity puts young people at unnecessary risk. Tyson claims "condoms do not protect the minds of our young from a twisted, perverted view of sex." That's true, but condoms aren't supposed to do that. Effective, comprehensive sexual education is supposed to positively inform young people's views on sex, and without it young people are forced to learn about sex on their own.
At its very core, this is not an issue of what condoms do and don't do - this is an issue of young people's rights to information and to health. By making these claims, Tyson is effectively advocating against the inherent right of Jamaican youth to protect themselves against harmful diseases and unintended pregnancies. Tyson's proposal will deny young people their right to access condoms.
By advocating for the Ministry of Education's referral system, JYAN is not encouraging sexual promiscuity among youth, it is fighting to protect young people's right to be informed and empowered to make responsible decisions about their sexual and reproductive health.
Our message to young people has to be more than 'Value self, value others; self-control and true love waits.' It has to be 'Value self, value others; protect yourself and act responsibly.'
Written for the Jamaica Youth Advocacy Network (JYAN)
www.j-yan.org | firstname.lastname@example.org
Compiled by Jaevion Nelson. Contributors: Advocates for Youth (Washington DC) and Norwell Hinds (Student, Guyana).