Transcript An Examination of College Student Sex Practices and History of Formal Sex Education Shelly Hook, MD, Robert Casanova, MD; Linda Brice, PhD, Lisa Welch,

An Examination of College
Student Sex Practices and
History of Formal Sex Education
Shelly Hook, MD, Robert Casanova, MD;
Linda Brice, PhD, Lisa Welch, MS,
Jennifer Holmes, MSIII
UNPLANNED (TEEN) PREGNANCY
Lubbock County 1999 - 2003
• Lubbock County (10-17 y/o): 106.6 per 1,000
• Texas (13-17y/o): 27.6 per 1,000
• U.S. (15-17 y/o): 22.4 per 1,000
Source: Texas Department of State Health Services – Family Health Research &
Program Development Unit
Reported Cases Sexually Transmitted Diseases
(Lubbock County, 2007)
• 1,139 cases of Chlamydia
(2005 – 1,279 Cases) (2006 – 1,417 Cases)
• 394 cases of Gonorrhea
(2005 – 429 Cases) (2006 – 489 Cases)
• 14 cases of syphilis (11 early)
(2006 – 13 Cases – 7 Early)
• 11 cases of HIV (2006 – 8 Cases)
• 1 case of AIDS (2006 - 3 Cases)
Source: Ricky Vaughn, LBSW, City of Lubbock Health Department - 2008
CHLAMYDIA & GONORRHEA: Cases & Rates
by Count (2005)
LOCATIO
N
U.S.
Texas
2005
CASES
Chlamydia
2005
RATES*
976,445
71,621
LOCATIO
N
332.5 U.S.
311.4 Texas
2005
CASES
Gonorrhea
2005
RATES*
339,593
115.6
26,016
113.1
Bell
2,229
872.6 Bell
975
381.7
Lubbock
1,279
501.6 Potter
411
346.1
Bexar
7,421
496.8 Dallas
5,037
213.9
Travis
3,679
426.0 McLennan
457
206.1
Dallas
9,816
416.9 Lubbock
429
168.2
El Paso
2,647
358.1 Travis
1,367
158.3
Tarrant
5,234
326.6 Tarrant
2,535
158.2
Harris
11,164
301.1 Bexar
2,194
146.9
Harris
4,371
117.9
342
46.3
Rates represent cases per 100,000 Population.
El Paso
Source: Teen Straight Talk: 2005 Texas HIV/STD Surveillance Report (Texas Department of State Health Services)
Chlamydia Cases by State (2005)
RANK
STATE
1
Mississippi
2
CASE
RATE/100,000
21,268
732.6
Alaska
4,355
664.4
LUBBOCK
1,279
501.6
3
New Mexico
8,456
444.3
4
South Carolina
18,296
435.8
22
New York
63,966
332.7
976,445
332.5
U.S.
24
Indiana
20,063
321.1
25
Texas
71,860
319.5
Source:Teen Straight Talk: CDC – 2005 STD Surveillance Report
Sexual activity Among Youth
• Adolescent period is marked many
physical changes, cognitive changes
and an interest in sexual activity
• “By the time they are in the 12th
grade, 65% of US high school
students have had sexual
intercourse.” (Eaton, 2008)
Abstinence Only vs. Comprehensive Sex
Education
• For more than 12 years there has been
federal funding for abstinence-only-untilmarriage (AOUM) sex education in spite of
a lack of evidence that these programs
reduce teenage pregnancy rates (Duffy et al
2008)
AOUM
• All programs receiving federal
funding must:
– Teach that abstinence is the only
certain way to avoid unplanned
pregnancy and STDs
– Any educational program that provides
information about contraceptive options
outside of failure rates can not receive
AOUM funding
Duffy, 2008
Abstinence Pledge
• Results show that those who pledge
to delay intercourse were less likely
to use contraception at first
intercourse
• 88% had intercourse before
marriage
Bearman & Bruckner, 2001
Abstinence Only vs. Comprehensive Sex
Education
• For more than 12 years there has been federal funding for
abstinence-only-until-marriage (AOUM) sex education in
spite of a lack of evidence that these programs reduce
teenage pregnancy rates (Duffy et al 2008)
• Formal sex education may reduce risky
sexual behavior among adolescents
(Meuller et al, 2008)
Abstinence Only vs. Comprehensive
Sex Education
• For more than 12 years there has been federal funding for
abstinence-only-until-marriage (AOUM) sex education in
spite of a lack of evidence that these programs reduce
teenage pregnancy rates (Duffy et al 2008)
• Formal sex education may reduce risky sexual behavior
among adolescents (Meuller et al, 2008)
• Knowledge about condom use leads to
‘safer-sex’ behavior and reduces the
prevalence of STDs (Gaydos et al, 2008)
Abstinence Only vs. Comprehensive Sex
Education
• For more than 12 years there has been federal funding for
abstinence-only-until-marriage (AOUM) sex education in spite
of a lack of evidence that these programs reduce teenage
pregnancy rates (Duffy et al 2008)
• Formal sex education may reduce risky sexual behavior
among adolescents (Meuller et al, 2008)
• Knowledge about condom use leads to ‘safer-sex’ behavior
and reduces the prevalence of STDs (Gaydos et al, 2008)
• Knowledge about contraceptive options
increased the use of contraceptives
(Peterson et al, 2007)
Abstinence Only vs. Comprehensive Sex
Education
• For more than 12 years there has been federal funding for
abstinence-only-until-marriage (AOUM) sex education in spite of
a lack of evidence that these programs reduce teenage pregnancy
rates (Duffy et al 2008)
• Formal sex education may reduce risky sexual behavior
among adolescents (Meuller et al, 2008)
• Knowledge about condom use leads to ‘safer-sex’ behavior
and reduced STD prevalence (Gaydos et al, 2008)
• Knowledge about contraceptive options increased the use
of contraceptives (Peterson et al, 2007)
• Knowledge about contraceptive options
leads to increased contraceptive use and
lower rates of teenage pregnancy. (ChungPark, 2008)
Materials and Methods
• Students participating in a Texas Tech University
sponsored health fair voluntarily completed a
survey requesting information about age, gender,
history of sex education and sexual practices.
• The Texas Tech University Health Sciences
Center’s Internal Review Board approved the
survey and only students 18 years and older
participated in the study.
Sex Survey
1. Age: ____
2. Sex:  M  F
3. Marital Status:  Single  Married  Divorced Separated Widowed
4. Race/Ethnicity: Caucasian  Black (African-American) Black (other) Asian
Hispanic Middle Eastern Other
5. First three digits of your HOME zip code __ __ __ XX
6. Did you have Sex Education in High School Yes No
7. If Yes, was it
Abstinence only
Abstinence and contraception
Abstinence, contraception and sexually transmitted infection
8. Are you sexually active? Yes No
9. How old were you when you first had vaginal/penile sex? ___
10. How old were you when you first had oral sex? ___
11. How many partners have you had in your lifetime? ___
12. How many partners have you had in the last 12 months? ___
13. Are you sexually active with same sex partners opposite sex partners both
14. Do you use condoms? Yes No
15. Do you use other forms of birth control? Yes No
16. Do you engage in oral sex? Yes No
17. Do you engage in anal sex? Yes No
18. Do you engage in vaginal/penile sex? Yes No
19. Have you ever had Chlamydia Gonorrhea Herpes Syphilis HPV HIV
Data Summary
•
•
•
•
•
520 surveys completed
Mean age of 20.73 (SD 2.47)
Males: 277 (53%)
Females: 243 (47%)
Mean age of initiation of sexual activity
– *Oral sex: 16.71 (SD 2.32)
– *Vaginal/Penile sex: 17.11 (SD 2.15)
– Significance p ≤ 0.015
Sexually Transmitted Diseases
•
•
•
•
•
•
Chlamhydia
Gonorrhea
Herpes
Syphilis
HPV
HIV
7 (1.3%)
3 (0.6%)
3 (0.6%)
2 (0.4%)
7 (1.3%)
2 (0.6%)
Type of Sex Education
90
80
70
60
50
40
30
20
10
0
Sex Education
Abstinence Only
Abstinence & Contraception
Abst, Contraception, & STD
Type of Sexual Activity
90
80
70
60
50
No Sex Education
Abstinence Only
40
Abstinence & Contraception
30
Abstinence, Contraception, STD
20
10
0
Sexual Activity
Vaginal/ Penile
Oral Sex
Reported Condom Use
100
90
80
70
60
50
40
30
20
10
0
No Sex Education
p< 0.014
Abstinence Only
Abstinence & Contraception
Abst, Contraception, STD
Conclusions
• Type of sex education does not influence
reported sexual activity
• Those with comprehensive sex education are
less likely to engage is risky sexual behavior
by using barrier contraception (condoms) than
those with abstinence only sex education
• An interesting trend is that the data suggests
that those with no formal sex education are
more likely to report condom use than those
with abstinence only education (75% vs 68%).
References
1. Bearman P, and Bruckner H, Promoising the future: virginity pledes and the transition to first intercourse.
American Journal of Sociology, 2001, 106: 859-912.
2. Centers for Disease Control – 2005 STD Surveillance Report
3. Chung-Park MS, Evaluation of a pregnancy prevention program
using the contraceptive behavior change model. Journalcompilation Blackwell Publishing Ltd,
2007, 1: 81-84.
4. City of Lubbock Health Department – 2008 surveillance data
5. Duffy K, Lynch DA and Santinelli J, Government support for abstinence-only-until-marriage education. Clinical
Pharmacology & Therapeutics, 2008, 84(6): 746-748.
6. Eaton D, Youth risk behavior surveillance - United States, 2007. MMWR Surveillance Summary, 2007, 57, 1131.
7. Gaydos CA, Hsieh YH, Galbraith JS, Barnes M, Waterfield G and Stanton B, Focus-on-teens, sexual riskreduction intervention for high-school adolescents: impact on knowledge, change or risk-behaviors, and prevalence
of sexually transmitted diseases. International Journal of STD & AIDS, 2008, 19: 704-710.
8. Mueller TE, Gavin LE and Kulkarni A, The association between sex education and youth’s engagement in
sexual intercourse, age at first intercourse and birth control use at first sex. Journal of Adolescent Health, 2007, 42:
89-96.
9. Peterson R, Albright J, Garrett JM and Curtis KM, Pregnancy and STD prevention counseling using an
adaptation of motivational interviewing: a randomized controlled trial. Perspectives on Sexual and Reproductive
Health, 2007, 39(1): 21-27.
10. Texas Department of State Health Services – Family Health Research & Program Development Unit, 2005
Texas HIV/STD Surveillance Report
Questions?