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Safe Sex and the Facts
Raymond G. Bohlin, Ph.D.
At age 16 John had sex with Andrea. Just one time. He enjoyed the
experience but felt guilty and decided the risk of sexually transmitted
diseases (STDs) and pregnancy were just too great. He did not have sex again
until nine years later when he married Cindy, who was a virgin. Three months
after their wedding Cindy began having painful symptoms. Unknowingly John, who
had never had any symptoms of disease, had brought two STDs into his marriage.
But John and Cindy were lucky; they both responded to treatment and are
healthy today. Many others, however, are not so fortunate. Today STDs are at
unprecedented and epidemic proportions. Thirty years of the sexual revolution
is paying an ugly dividend, and those most at risk are teenagers. This is true
partially because teenagers are more sexually active than ever before, but
also because teenage girls are more susceptible to STDs than males or adult
females.
While a few STDs can be transmitted apart from sex acts, all are
transmissible by the exchange of bodily fluids during intimate sexual contact.
I want to discuss the severity of the problem as well as what must be done if
we are to save a majority of the next generation from the shame, infertility,
and sometimes death, that may result from STDs.
If you are not aware of some of the following statistics, then prepare to
fasten your seat belt because what I have to report is not pretty. The
information I am about to share is from data gathered by the Medical Institute
for Sexual Health in Austin, Texas.(1) All of these statistics are readily
available from reputable medical and scientific journals.
Today, there are approximately 25 STDs. A few can be fatal. Some are
relatively harmless, but all are humiliating. Many women are living in fear of
what their future may hold as a result of STD infection. It is estimated that
1 in 5 Americans between the ages of 15 and 55 are currently infected with one
or more viral STDs, and 12 million Americans are newly infected each year.
That's nearly 5% of the entire population of the U.S.! Of these new
infections, 63% involve people less than 25 years old.
This epidemic is a recent phenomenon. Some young people have parents who
may have had multiple sexual part-ners with relative impunity and conclude
that they too are safe from disease. However, most of these diseases were not
around 20 to 30 years ago. Prior to 1960, there were only two prevalent
sexually transmitted diseases: syphilis and gonorrhea. Both were easily
treatable with antibiotics.
In the sixties and seventies this relatively stable situation began to
change. For example, in 1976, chlamydia first appeared in increasing numbers
in the U.S. Chlamydia, particularly dangerous to women, is now the most common
bacterial STD in the country. In 1981, human immuno-deficiency virus (HIV),
the virus which causes AIDS, was identified. By early 1993, between 1 and 2
million Americans were infected with HIV or AIDS, over 12 million were
infected worldwide, and over 160,000 had died in the U.S. alone. Then herpes
was added to the mix. This STD now infects 30 million people.
In 1985, human papilloma virus (HPV) began a dramatic increase. This virus
can result in venereal warts and will often lead to deadly cancers.
By 1990, penicillin-resistant strains of gonorrhea were present in all
fifty states, and by 1992 syphilis was at a 40-year high. As of 1993, pelvic
inflammatory disease (PID), which is almost always caused by gonorrhea or
chlamydia, was affecting 1 million new women each year. This includes 16,000
to 20,000 teenagers. This infection can result in pelvic pain and infertility
and is the leading cause of hospitalization for women between the ages of 15
and 55, apart from pregnancy.
Pelvic inflammatory disease can result in scarred fallopian tubes which
block passage of a fertilized egg. The fertilized egg, therefore, cannot pass
on to the uterus, and the growing embryo will cause the tube to rupture. From
1960 to 1990 there was a 400% increase in tubal pregnancies, most of which
were caused by STDs. Making matters even worse is the fact that 80% of those
infected with an STD don't know it and will unwittingly infect their next
sexual partner.
The Medical Facts of STDs
Syphilis is a terrible infection. In its first stage, the infected
individual may be lulled into thinking there is little wrong since the small
sore will disappear in 2 to 8 weeks. The second and third stages are
progressively worse and can eventually lead to brain, heart, and blood vessel
damage if not diagnosed and treated. The saddest part is that syphilis is 100%
curable with penicillin, yet there is now more syphilis than in the late
1940s, and it is spreading rapidly.
Chlamydia, a disease which only became common in the mid-1980s, infects 20
to 40% of some sexually active groups including teenagers. In men, chlamydia
can cause infertile sperm, a condition reversible with antibiotics. In women,
however, the infection is devastating. An acute chlamydia infection in women
will result in pain, fever, and damage to female organs. A silent infection
can damage a woman's fallopian tubes without her ever knowing it. A single
episode of chlamydia PID can result in a 25% chance of infertility. With a
second infection, the chance of infertility rises to 50%. This is double the
risk of gonorrhea.
Treatment with antibiotics is not always successful. One study reported
that 18% showed a recurrence of infection within 3 weeks. As many as 14% of
teenagers do not respond to treatment, and ultimately require a hysterectomy.
It is an overwhelming burden for an 18- or 19-year- old girl to have to face
the fact that she will never be able to bear a single child.
The human papilloma virus (HPV) is an extremely common STD. One study
reported that at the University of California, Berkeley, 46% of the sexually
active coeds were infected with HPV. Another study reported that 38% of the
sexually active females between the ages of 13 and 21 were infected.
HPV is the major cause of venereal warts which are extremely difficult to
treat and may require expensive procedures such as laser surgery. HPV can
result in pre-cancer or cancer of the genitalia. By causing cancer of the
cervix, this virus is presently killing more women in this country than AIDS,
or over 4,600 women in 1991. HPV can also result in painful intercourse for
years after infection even though other visible signs of disease have
disappeared.
And of course there is the human immunodeficiency virus, or HIV, the virus
that causes AIDS. The first few cases of AIDS were only discovered in 1981;
now, in the U.S. alone, there are between 1 and 2 million infected with this
disease. As far as we know, all of these people will die in the next ten to
fifteen years. As of early 1993, approximately 160,000 had already died.
In 1991 a non-random study at the University of Texas at Austin showed that
1 in 100 students who had blood drawn for any reason at the university health
center was HIV infected.
While the progress of the disease is slow for many people, all who have it
will be infected for the rest of their lives. There is no cure, and many
research-ers are beginning to despair of ever coming up with a cure or even a
vaccine (as was eventually done with polio). In 1992, 1 in 75 men was infected
with HIV and 1 in 700 women. But the number of women with AIDS is growing. In
the early years of the epidemic less than 2% of the AIDS cases were women. Now
the percentage is 12%.
Teenagers Face Greater Risks from STDs
One of the statistics I have mentioned is that teenagers are particularly
susceptible to STDs. This fact is alarming since more teens are sexually
active today than ever before. An entire generation is at risk, and the
saddest part about it is that most of them are unaware of the dangers they
face. Teenagers must be given the correct information to help them realize
that saving themselves sexually until marriage is the only sure way to stay
healthy.
The medical reasons for teens' high susceptibility to STDs relates
specifically to females. The cervix of a teen-age girl has a lining
(ectropion) which produces mucus that is a great growth medium for viruses and
bacteria. As a girl reaches her 20s or has a baby, this lining is replaced
with a tougher, more resistant lining. Also during the first two years of
menstruation, 50% of the periods occur without ovulation. This will produce a
more liquid mucus which also grows bacteria and viruses very well. A
15-year-old girl has a 1-in-8 chance of developing pelvic inflammatory disease
simply by having sex, whereas a 24-year-old woman has only a 1- in-80 chance
in the same situation.
Teenagers do not always respond to antibiotic treatment for pelvic
inflammatory disease, and occasionally such teenage girls require a
hysterectomy. Infertility is an increasing problem in our society. It is
estimated that one-fourth to one-third of all female infertility in marriage
is a result of STDs.
Teenagers are also more susceptible to human papilloma virus, HPV. Rates of
HPV infection in teenagers can be as high as 40%, whereas in the adult
population, the rate is less than 15%. Teenagers are also more likely to
develop precancerous growths as a result of HPV infection than adults. These
precancerous growths in teenagers are also more likely to develop into
invasive cancer than in adults.
Apart from the increased risk from STDs in teens, teen-age pregnancy is
also at unprecedented levels. In 1985 there were over 1 million teen-age
pregnancies; 400,000 of these ended in abortion. Abortion is not a healthy
procedure for anyone to undergo, but this is especially true for a teenager.
Not getting pregnant to begin with is far better. Oral contraceptives are not
as effective with teenagers, mainly because teens are more apt to forget to
take the pill. Over a one-year period, as many as 9 to 18% of teenage girls
using oral contraceptives become pregnant.
Finally, when teenagers start having sex earlier in life, they are much
more likely to have multiple sexual partners, a behavior that puts them at
greater risk for STD. When teenagers become sexually active before they are 18
years of age, 75% of them will have more than 2 partners and 45% of them will
have 4 or more partners. If sexual activity begins after the 19th birthday,
only 20% will have 2 or more partners and only 1% will have 4 or more
partners. (These statistics were reported by the Centers for Disease Control
after interviewing people in their 20s.)
Is Safe Sex Really the Answer?
I must now take a hard look at the message of safe sex which is being
taught to teens at school and through the media.
Some people believe that if teens can be taught how to use contraception
and condoms effectively, rates of pregnancy and STD infection will be reduced
dramatically. But common sense and statistics tell us otherwise. At Rutgers
University, the rates of infection of students with STD varied little with the
form of contraception used. For example, 35 to 44% of the sexually active
students were infected with one or more STDs whether they used no
contraceptive, oral contraceptive, the diaphragm, or condoms. It is
significant to note that condoms, the hero of the safe sex message, provided
virtually no protection from STDs.
Will condoms prevent HIV infection, the virus that causes AIDS? While it is
better than nothing, the bottom line is that condoms cannot be trusted. A
study from Florida looked at couples in which one partner was HIV positive and
the other was negative. They used condoms as protection during intercourse.
After 18 months, 17% of the previously uninfected partners were HIV positive.
That is a one-in-six chance, the same as in Russian roulette.
Condoms do not even provide 100% protection for the purpose for which they
were designed: prevention of pregnancy. One study from the School of Medicine
Family Planning Clinic at the University of Pennsylvania reported that 25% of
patients using condoms as birth control conceived over a one-year period.
Other studies indicate that the rate of accidental pregnancy from
condom-protected intercourse is around 15% with married couples and 36% for
unmarried couples.
Condoms are inherently untrustworthy. The FDA allows as many as one in 250
to be defective. Condoms are often stored and shipped at unsafe temperatures
which weakens the integrity of the latex rubber causing breaks and ruptures.
Condoms will break 8% of the time and slip off 7% of the time. There are just
so many pitfalls in condom use that you just can't expect immature teenagers
to use them properly. And even if they do, they are still at risk.
Studies are beginning to show that school-based sex education that includes
condom use as the central message, does not work. A study in a major pediatric
journal concluded that the available evidence indicates that there is little
or no effect from school-based sex- education on sexual activity,
contraception, or teenage pregnancy.(2) This study evaluated programs that
emphasized condoms. In addition, programs that emphasize condoms tend to give
a false sense of security to sexually active students and make those students
who are not having sex feel abnormal.
The list of damages from unmarried adolescent sexual activity is long
indeed. Apart from the threat to physical health and fertility, there is
damage to family relationships, self-confidence and emotional health,
spiritual health, and future economic opportunities due to unplanned
pregnancy. Condom-based sex- education does not work.
Saving Sex for Marriage is the Common Sense Solution.
The epidemic of sexually transmitted diseases is running rampant in this
country and around the world. Diseases such as chlamydia, human papilloma
virus, herpes, hepatitis B, trichomonas, pelvic inflammatory disease, and AIDS
have joined syphilis and gonorrhea in just the last 30 years. There is no
question that the fruits of the sexual revolution have been devastating. I
have also shown how our teen-agers are at a greater risk for sexually
transmitted diseases than are adults and that sex-education based on condom
use is ineffective and misleading. There is only one message that offers
health, hope, and joy to today's teenagers. We need to teach single people to
save intercourse for marriage.
Sex is a wonderful gift, but if uncontrolled, it has a great capacity for
evil as well as good. Our bodies were not made to have multiple sex partners.
Almost all risk of STD and out-of-wedlock pregnancy can be avoided by saving
intercourse for marriage. And it can be done.
Statistics show clearly that in schools that teach a sex education program
that emphasizes saving intercourse for marriage, the teen pregnancy rate drops
dramatically in as little as one year. In San Marcos, California, a high
school used a federally funded program ("Teen Aid") which emphasizes saving
intercourse until marriage. Before using the program there were 147
pregnancies out of 600 girls. Within two years, the number of pregnancies
plummeted to 20 out of 600 girls.(3) As of 1992, San Marcos was still using
this program and was still satisfied with it. In Jessup Georgia, upon
instituting the "Sex Respect" program, the number of pregnancies out of 340
female students dropped from 17 to 13 to 11 to 3 in successive years.
Delaying intercourse until teens are older is not a naive proposal. Over
50% of the females and 40% of the males between 15 and 19 have not had
intercourse. They are living proof that teens can control their sexual
desires. Of those who had at least one sexual experience, 20% had sex in the
past but were not currently sexually active. Therefore, a minority of students
are sexually active.
Condom-based sex-education programs basically teach teen-agers that they
cannot control their sexual desires, and that they must use condoms to protect
themselves. It is not a big leap from people being unable to control their
sexual desires to being unable to control their hate, greed, anger, and
prejudice. This is not the right message for our teenagers!
Teenagers are willing to discipline themselves for things they want and
desire and are convinced are beneficial. Girls get up early for drill team
practice. Boys train in the off-season with weights to get stronger for
athletic competition. Our teens can be disciplined in their sexual lives if
they have the right information to make logical choices.
Saving sex for marriage is the common sense solution. In fact, it is the
only solution. We don't hesitate to tell our kids not to use drugs or
marijuana, and most do not. We tell our kids it's unhealthy to smoke, and most
do not.
It is normal and healthy not to have sex until marriage. STDs are so common
that it is not an exaggeration to say that most people who regularly have sex
outside of marriage will contract a sexually transmitted disease. Our
sexuality should blossom within the confines of a mutually faithful monogamous
relationship. We need to reeducate our kids not just in what is healthy, but
in what is right.
Raymond G. Bohlin is executive director of Probe Ministries. He is a
graduate of the University of Illinois (B.S., zoology), North Texas State
University (M.S., population genetics), and the University of Texas at Dallas
(M.S., Ph.D., molecular biology). He is the co-author of the book The
Natural Limits to Biological Change, served as general editor of
Creation, Evolution and Modern Science, and has published numerous journal
articles. Dr. Bohlin was named a 1997-98 and 2000 Research Fellow of the
Discovery Institute's Center for the Renewal of Science and Culture. He can be
reached via e-mail at
rbohlin@probe.org.
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