GAO Says Law Requires Information on Condoms in Abstinence Education The federal Government Accountability Office (GAO), the investigative arm of Congress, told the Department of Health and Human Services (HHS) October 18 that abstinence education materials that do not contain "medically accurate information about condom effectiveness" are in violation of a provision of the Public Health Service Act. The GAO did not identify which abstinence education materials prepared and used by federal grantees may be violating the law, but the agency advised HHS to "reexamine its position" on how condoms are to be discussed in federally funded sex education programs. The issue came up during a GAO investigation of abstinence education grants requested by members of Congress, after charges surfaced in recent years that abstinence-only sex ed programs funded by the federal government refer to condoms negatively and discourage their use. In a letter to Secretary of Health and Human Services Michael Leavitt, GAO General Counsel Gary Kepplinger said that in the course of its investigation, the GAO noted language in section 317P(c)(2) of the Public Health Service Act requiring that materials "that are specifically designed to address sexually transmitted diseases" must contain medically accurate information on condom effectiveness. That’s not how HHS is interpreting the law in its guidelines for abstinence-only education, the GAO pointed out. Currently, HHS takes the position that, while grantees may address issues related to sexually transmitted diseases in communicating the importance of abstinence, the programs are not primarily intended to address sexually transmitted disease, and therefore section 317P(c)(2) doesn’t apply. Calling the HHS argument "not persuasive," the GAO noted that the 2006 program announcement for community-based abstinence education programs instructs grantees to develop curricula around themes and further instructs them to "incorporate material around the subtheme of sexually transmitted diseases." The announcement offers illustrations of the use of disease-specific information and says abstinence-only programs may contain information on the limitations of contraception to consistently prevent sexually transmitted diseases, as well as information on the epidemiology of sexually transmitted disease in the United States. That is enough to bring abstinence-only education programs under SectionP(c)(2), the GAO said, and requires the programs to "include medically accurate information on condom effectiveness." "In light of our conclusion, we recommend that HHS reexamine its position and adopt measures to insure that, where applicable, abstinence education materials comply with this requirement," the GAO said. The GAO letter to Secretary Leavitt, "Abstinence Education: Applicability of Section 317P of the Public Health Service Act," is available online at http://www.gao.gov. Condom Use by Adolescents Noting that approximately 18.9 million new cases of sexually transmitted infections occur every year in the United States, half of them among 15-to-24-year-olds, researchers set out last year to test whether lack of condom use increased the risk of two of the most common infections—Chlamydia trachomatis and Neisseria gonorrhoeae—in a group of sexually active adolescent girls. In the study, non-pregnant, HIV-negative girls 13 to 19 years old received physical examinations and were administered questionnaires on condom use as well as information about their partners, sexual and reproductive peer norms, alcohol use, and self-esteem. The study evaluated the relationship between self-reported "correct and consistent" condom use and chlamydial and gonococcal infection in the group of high-risk girls. Reporting their findings, the researchers said correct and consistent use of condoms reduced the risk of gonorrhea and chlamydia by 90 percent, leading the researchers to conclude that "condoms remain the best STD and HIV prevention approach for adolescents whose sexual behaviors place them at risk for STDs. Although messages directed at adolescents encourage delaying initiation of sexual activity, many are already sexually active, and STDs are particularly common among this group. Thus, aggressive condom promotion must remain a key to reducing STDs and HIV." The research report, "The Effect of Correct and Consistent Condom Use on Chlamydial and Gonococcal Infection Among Urban Adolescents," was published in the June 2005 issue of the journal Archives of Pediatrics and Adolescent Medicine. |
