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YOUTH & ADOLESCENCE

AIDS Alliance for Children, Youth and Families: Hope for Youth?

by David C. Harvey executive director, aids alliance

It is hard to believe in 2002 that America continues to debate how sex education is taught in schools and whether condoms should be made available to young people. Politicians haggle over the effectiveness of condoms and whether warning labels should be placed on condom wrappers about failure rates. The right and the left are polarized on these issues and no one seems to want to listen to each other.

Meanwhile, while there has been progress in the larger community in understanding that this is increasingly an epidemic of low-income communities of color, the AIDS and public health community have been slow to recognize that it is also an epidemic increasingly defined by age as well, and that it largely affects young people aged 13 to 24. These youth are either perinatally infected and living into young adulthood, or are teens and young adults who become infected through their behavior.

Much of what we have come to know about HIV/AIDS prevention, care, and research in the first two decades of the disease has now been called into question by one unavoidable fact: Young people in America affected by HIV/AIDS are not responding in the same way older generations did. And the political, AIDS, and public health communities are confused about how to retool HIV prevention, research, and care programs for youth. In fact, we have barely tapped into the tremendous energy, passion, and expertise that young people themselves have to offer in the field of HIV and AIDS prevention.

The abstinence-only sex-education debate currently playing out in Congress is just one example of current political confusion. Recently, the US House of Representatives voted to reauthorize welfare reform legislation that contains a provision allotting $50 million a year to states for "abstinence-only" education programs.

Backers of such programs believe that abstinence until marriage is the best way to prevent pregnancy, HIV, and other sexually transmitted diseases (STDs) among teens. Opponents favor more broad-based sex-education curriculums because they think the wait-until-marriage approach won't work for all youthÑespecially gay youth who cannot marry.

A moderate approach, such as the one advocated by Secretary of State Colin Powell, would teach youth to abstain, but would also educate sexually active youth about condoms and safer sex.

Although everyone can agree that teaching youth to abstain until one is in a committed and loving relationship is a good thing, some abstinence-only sex education instills fear and confusion. Some programs, for example, exaggerate condom failure rates and teach that sex before marriage is likely to be "psychologically and physically harmful."

Scaring young people into abstinence has yet to prove effective and can often be a recipe for disaster. Research has shown that youth who receive such education are actually less likely to use condoms if they do have sex because they've only learned that contraception and condoms don't work.

Abstinence-only education proponents currently have a presidential administration and a currently Republican-controlled House of Representatives that vocally support their cause. The President has proposed nearly doubling spending for abstinence-only education. This comes at a time when the administration has recommended level funding for domestic HIV/AIDS prevention and treatment programs.

Advocates for comprehensive sex education have overwhelming support among the public. Research shows that 88 to 94 percent of parents support comprehensive sex education that teaches youth not only the benefits of abstinence but also how to reduce their risks for pregnancy, HIV, and other STDs.

What is most troubling about abstinence-only programs is that they receive federal funds but they aren't accountable. During the House debate on welfare reform, Representative Lois Capps (D) of California, a nurse by education, offered an amendment that would have required abstinence-only programs to equip youth with information that is scientifically sound and medically accurate. A committee defeated the amendment before the bill reached the House floor in a party-line vote. Such a provision would have allayed some of the concerns of comprehensive sex education advocates.

Today, half of all 15 to 19 year olds have had sex. By age 18, 70 percent of youth have had sex, and the percentage spikes even higher for 19 year olds.

If someone found the formula to motivate a generation of youth to delay sex until adulthood, we would firmly support it. In the meantime, let's equip the young with a broad base of information that will inform them about the benefits of delaying sex while also educating them about how to reduce their risks for HIV.

The AIDS Alliance is the only national organization focused solely on the needs of children, youth, and families living with, affected by, or at risk for HIV/AIDS. Many of our group or individual members provide or receive services through Title IV of the Ryan White CARE Act. The AIDS Alliance for Children, Youth and Families also provides information, resources, and support to consumers and providers of HIV/AIDS Services. With our 500 community-based organization members who provide direct HIV care, research and prevention services throughout the United States, the AIDS Alliance recently started the HOPE (Health, Opportunities, Prevention, and Education) Campaign for Youth. The HOPE Campaign, supported by funding from the Ford Foundation and the Centers for Disease Control and Prevention, has three goals: (1) to train a new generation of youth and HIV prevention leaders; (2) to provide technical assistance to community-based organizations serving youth; and (3) to serve as a national policy forum to exchange ideas on ways to support and improve HIV prevention for youth.

David C. Harvey is founding executive director of AIDS Alliance for Children, Youth and Families, a national education, training and advocacy organization. This article was produced with the assistance of Jenice Robinson, AIDS Alliance public affairs associate.

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