Panic in the sheets

Today's abstinence programs wrap themselves in a cloak of medical accuracy. Sulak stresses that she's only giving kids the often overlooked facts about condom failure. Unruh points out that kids aren't hearing "the truth about HPV." And when I clicked through an interactive CD-ROM sent by the National Physicians Center, an abstinence nonprofit run by doctors, I was greeted by the conservative radio host Dr. Laura Schlessinger, who informed me that "my friends at the National Physicians Center have provided medically accurate information."

Most of the medically focused abstinence programs (as opposed to the more religious curriculums that courts are beginning to bar from federal funding) use citations from established medical journals. But every one of them, in varying degrees, brings a conservative ideology to the analysis and to the choice of data emphasized. Comprehensiveness is nowhere to be found. Organizations like Sulak's "Worth the Wait" avoid the uncomfortable fact that for every study showing HPV's dangers or condoms' lack of usefulness, there seems to be another suggesting more nuanced conclusions.

For example, one of the documents most often mentioned by the abstinence education movement is a 2001 NIH report on condoms, which supposedly shows that, according to Sulak, "there's no scientific data showing that condoms prevent HPV." Other organizations make similar claims about the report. Unruh simply calls it "devastating" to those who favor safe-sex education.

But actually, the report argues that condoms do in fact "afford some protection in reducing the risk of HPV-associated diseases." Independent studies confirm these findings. The CDC, while acknowledging that abstinence is the best way to prevent HPV, also stresses that condoms reduce the virus' spread.

"Condoms don't necessarily protect against external spread of genital warts, but if you're trying to prevent cervical cancer, condoms clearly help," says Rothenberger at the University of Minnesota.

Neither Sulak's lecture (which I watched on video), nor the Abstinence Clearinghouse, nor the "Prescriptions for Parents" CD-ROM from the National Physicians Center mention these findings, which are widely accepted in the medical community. They also fail to point out that the NIH condom report begins by pointing out that latex condoms can effectively reduce the transmission of HIV/AIDS, an STD that has killed nearly 500,000 Americans in the past 20 years, far more than those who have died from cervical cancer.

The right-wing spin doesn't stop there, either. Students, teachers and parents who attend abstinence lectures or read their curriculums probably won't be told that warts are typically a minor problem that can be easily treated with topical ointments. While cervical cancer is serious, resulting in death in 30 percent of cases, the 15,700 America women who contract it each year could avoid the disease through proper screening, according to the National Cancer Institute. "Cervical cancer is preventable," says Shah at Johns Hopkins. "You could eliminate it from the world with regular pap smears."

Sulak says that she's trying to focus on the primary point of prevention. If kids stay away from sex, they're going to be safe. But not even abstinence may be able to stop the spread of HPV. The virus thrives in the skin, not just the genitals. "We're getting more and more evidence that HPV can be spread through fingers," says Rothenberger. "It's beginning to look like it's possible to get HPV even if you don't have sex."

Sulak, Unruh and most other abstinence educators argue that they're not trying to ignore these studies and others that cast doubt on their assertions. Sulak in particular stresses that she's making every possible effort to be scientifically accurate. "It's not that I'm against contraception," she says, noting that she often prescribes birth control for her patients. "It's just that I'm against what kids are being told about safe sex."

And yet, under the guise of accuracy, Sulak's lecture leaves the distinct, incorrect impression that sex is as dangerous with condoms as without, and that HPV is a problem that's nearly as urgent as AIDS. Other curriculums and videos, such as "No Second Chance" -- a video that equates premarital sex with death -- may go further, but at what point do such distinctions matter?

Each abstinence-education curriculum, even the most moderate, "is a political program with an agenda," says Kreinin at the Sexuality Information and Education Council. It's politics masquerading as science, experts say.

"I spent years arguing with individuals who focus on the supposed science of [condoms'] limited efficacy, and I stopped doing it because it's just biased," says Dr. Robert Johnson, director of adolescent and young adult medicine at the New Jersey Medical School and a board member of Physicians for Reproductive Choice and Health. "Once you have biases in science, you don't have science at all."

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