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Philip N. Cohen

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The 'Sex Talk': Teaching Too Late (Education Before Infection)

Posted: 12/09/2009 8:42 am

Even when parents make an effort to talk to their kids about sex, adolescents' sexual experience is often a step ahead of them. Apart from its emotional consequences, the health implications of this disconnect are serious, and seriously unequally distributed.

A new study in Pediatrics shows that by the time many parents talk to their children about sex, they've already had sex. The exact numbers aren't important because the sample was not representative, but more than a third of children had already had intercourse before their parents discussed many sex specifics with them: how to identity sexually transmitted disease symptoms, how to use a condom, how to choose a method of birth control, or what to do if a partner refused to use a condom (in the case of girls).

FYI, the government's National Survey of Family Growth from NSFG in 2002 found that 30% of girls have had sex at age 16, 46% at age 17, and 67% at age 18.


Given that the majority is having sex before leaving high school, you might wish that schools would provide that kind of information - which they sometimes do.

But it's not getting through to enough kids in time, as we learn from another study - this one nationally representative. It shows that, among female teenagers who reported having had sex, 38% had at least one sexually transmitted infection. The most common (30%) was human papillomavirus (HPV), which clears up harmlessly on its own in most cases. But in about 10% of cases persists, and increases the risk of cervical cancer.

(There is an HPV vaccine recommended for all girls by the federal government's advisory committee, before they have sex for the first time. But many parents and abstinence-only proponents have opposed the vaccine, and laws providing for it, on the imagined grounds that it will encourage irresponsible sexual behavior. And, because parents' rights trump children's rights, the vaccine requirements proposed in some states have a parental op-out provision.)

The study also shows the teenagers' prevalence of chlamydia (7.1%), trichomonas (3.6%), gonorrhea (2.5%), and herpes (type 2, 3.4%). Although these are curable or treatable in most cases, they do increase the risk of contracting HIV.

The lack of information or other resources necessary to protect young women's health is, not surprisingly, concentrated among poor and minority - especially African American - women. Black adolescents are about twice as likely as Whites or Mexican Americans to have any STI (44% versus 19% and 18% respectively); and those below the poverty line had almost twice the rate of those above (34% versus 19%). This is partly because these groups are more likely to have had sex or more partners, but the race difference persisted when those factors were controlled.

To overcome the problem of sexually transmitted infection, and the disparities in its distribution, will require both real sex education and health coverage that includes vaccination, screening and other services.

Cross-posted from the Family Inequality blog.

 
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09:46 AM on 12/11/2009
Why do parents wait so long? Otherwise, pop culture and porn educate our kids about sex. I once reported a story 15 years ago: all the high school students said their sex ed was porn. Yikes.

The culture gives a fun, light, consumerist view of sex, health class gives a sickly deathly version, so it's up to parents to make it sound beautiful and goodly as it is
07:42 PM on 12/09/2009
The U.S. is definitely behind Europe when it comes to sex talk at least in the schools. Although these talks should be happening at home, schools could ensure sex education by making it a mandatory part of the curriculum. For an example of the openness and progessiveness of sex ed in some European countries in comparison to the U.S., see http://askthejudge.info/should-a-right-to-education-include-sex-education/3705/#more-3705
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thinkingwomanmillstone
great, green, globs of greasy grimey GOPerspeak.
05:14 PM on 12/09/2009
I never understood the reference to "the talk". Sex is an important part of life that should be addressed throughout a child's life. At two, when a child notices he's different from his sister.... At three there's good touch bad touch....at whatever age they walk in on Mommy and Daddy or take notice of things on TV. Whatever/Whenever. By building up a fear of the subject or keeping it an uncomfortable secret or taboo subject or not answering your child's questions matter of factly throughout his/her life, you are setting up your child for misinformation from his/her peers, imagination or the pervert next door. Isn't it time for this idea of a one time talk to end?
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Philip N. Cohen
05:40 PM on 12/09/2009
Thank you. I agree that "the talk" is an antiquated idea. (Actually, the intrepid HuffPo editors put that phrase in the title - it is a very recognizable phrase for this subject.) This didn't come across that well, but a good thing about the Pediatrics study I mentioned is that they broke down all the different kinds of information parents might give to their children - from "where do babies come from?" to "what if my partner won't use a condom?", and looked at the timing of each conversation piece. It is an ongoing process, as the article shows (hopefully in concert with school learning).
03:20 PM on 12/09/2009
I had the "talk" with my kids before the entered high school. I know that might not be timely enough, but you've got to make a decision at some point and that was my line in the sand.

I filled a basket with condoms and re-filled it regularly. I have no idea what happened to the condoms that disappeared but I re-filled it when it got low. If their friends took them, that';s their business not mine. This way, no parent could blame me for giving their kid a rubber. Teen's sexuality is none of a parents business but their ignorance is.
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Andrea Roberts
10:56 AM on 12/09/2009
If this isn't an argument for sex education, I don't know what is.