HIV and infectious disease experts are urging the federal government to stop funding unproven strategies, like abstinence-only sexual health education, to prevent sexually transmitted infections (STI).
The Infectious Diseases Society of America (IDSA) and the HIV Medicine Association (HIVMA) say these programs must be replaced with STI prevention policies that are based on sound science, not ideology.
Federal funding for programs teaching abstinence until marriage as the only way to avoid STIs has been increasing since the late 1990s, to nearly $170 million this year. An increase of $39 million is included in President George W. Bush's 2006 budget proposal. Furthermore, US law requires the $15 billion program providing AIDS relief to developing countries to allocate one-third of its prevention funds to abstinence-only education.
However, there is very little credible, peer-reviewed, published scientific evidence that abstinence-only sexual health education programs can prevent STIs. The preponderance of evidence backs comprehensive sex education programs that address the correct and consistent use of condoms.
"There's no doubt that the best way to prevent sexually transmitted infections is to abstain from sexual activity, or to be in a monogamous relationship with an uninfected partner. But we have to face reality," says Walter E. Stamm, MD, president of the Infectious Diseases Society of America (IDSA). "Most teenagers have sex before they graduate from high school. Millions of young people, as well as adults, are sexually active outside of monogamous relationships. We need to supply them with the tools to make wise choices."
"When spending taxpayer dollars, the federal government has an obligation to provide accurate information to sexually active people," adds Paul Volberding, MD, chair of the HIV Medicine Association Board of Directors. "The evidence shows using condoms reduces the risk of STIs. The evidence just doesn't support abstinence-only education."
The two organizations have approved a policy statement, available online at www.idsociety.org and www.hivma.org, calling for science-based government policies on preventing HIV and other STIs. The statement comes in response to a spate of ideologically driven federal policies, including evidence that federally funded abstinence programs promote misinformation about condoms and sexual risks, the Centes for Disease Control and Prevention (CDC)'s revision of their condom fact sheet to qualify the efficacy of condoms in STI prevention, and, congressional efforts to challenge peer-reviewed federal research grants addressing issues of human sexuality.
A large body of scientific evidence links correct and consistent condom use with prevention of HIV, syphilis, gonorrhea, chlamydia, and herpes. A growing number of studies show condoms reduce the impact of HPV infection.
IDSA and HIVMA are calling for legislation funding abstinence-only education programs to be modified to reflect scientific evidence. They also call for repeal of the requirement that one-third of prevention funds in the President's Emergency Plan for AIDS Relief be targeted to abstinence-only programs.
Volberding notes, "The number of new HIV infections in the United States was as high last year as it ever was. We are struggling to control this pandemic. We need to use every tool available to prevent new infections. Telling people to 'just say no' just doesn't work."
"Ideology should not be driving our STI prevention strategy," adds Stamm. "Science should. For the sake of public health, the federal government has a responsibility to provide comprehensive information about how to control sexually transmitted infections."
Source: Infectious Diseases Society of America