LINE ON LIFE

5/17/89

AIDS and Teenagers *

David A. Gershaw, Ph.D.

A 1989 report on AIDS by the National Academy of Sciences (NAS) reemphasizes the importance of public education and behavior change, but recommends that these messages be adapted for young teenagers. NAS recommends that all young teenagers receive sex education in school that includes specific an explicit information about preventing HIV the virus that leads to AIDS infection.

This 580-page report is similar to earlier reports in emphasizing education and behavioral change as the only available methods for stemming the spread of AIDS. However, it differs from previous reports on the need to focus on teenagers.

"Evidence from national studies of contraception and teenage pregnancy suggests that young people are not particularly skilled in managing their sexual lives."

Recommendations for explicit sex education run counter to what William Bennett, Education Secretary in the Reagan administration, had recommended. Bennett, currently head of the Office of National Drug Control Policy under President Bush, favored merely advising teens to postpone sex until marriage.

Unfortunately, since a large portion of teenagers is sexually active, they are not likely to follow Bennett's advice. Building a program around only that advice "is likely to put that population at risk." It was noted that sex education in Europe is generally more explicit than it is in the United States and that European countries have lower teenage pregnancy rates.

The report urges TV networks to accept commercial advertising for condoms and present more public service announcements about the dangers of unprotected sexual intercourse. The messages must "strike a balance between creating fear of the disease and offering advice on how to avoid it."

"The level should be sufficiently high to motivate individuals to take action but not so high that it paralyzes them with fear or causes them to deny their susceptibility."

Evidence from other health campaigns has shown that "messages based on moral dictates do not work." Some other conclusions are evident in the report:

  1. Changes that are consistent with an individual's beliefs and values are more likely to be adopted.
  2. For some people, modifying behavior through step-by-step changes is easier to achieve than overall changes in lifestyle.
  3. Offering alternative behaviors from which people can choose is preferable to dictating "appropriate" behavior.
  4. Some people believe in the usefulness of a particular behavior, but do not believe that they can do it successfully. For these people, skills training can be helpful.
  5. Most people will need assistance and support to change from unhealthy to healthy behaviors. Also, most will not be completely successful in sticking to their newly developed patterns of behavior.
  6. Anonymous HIV antibody testing with appropriate counseling should be made available on a voluntary basis for anyone who desires it. However, HIV testing should not be a substitute for greater efforts in education and intervention.

Unfortunately, in order to develop an effective education program, more reliable information about the spread of HIV infection among teenagers is needed. "There is no reliable data on the current prevalence of HIV in the United States." NAS also noted the "underdeveloped state of sex research in the United States." Current information about sexual conduct is fragmentary, and research data is often unreliable.

The data on sexual conduct most often cited are those from Alfred Kinsey and his colleagues collected in the 1940s. The defects of his work are widely known. For example, subjects were mainly drawn from the Midwest and college campuses and do not adequately represent the entire population.

In an all-out attempt to gather the most accurate information about the sex life of Americans, a pilot study is being geared up that would begin with interviews of 2,300 subjects about their most intimate behaviors. This effort is designed to provide information on how and to what extent the general population is engaging in behavior that puts them at risk for AIDS. This survey would be the first step in a larger study planned by the National Institute of Child Health and Human Development (NICHD).

Before the study could be run, stories were published about the study. These stories prompted letters and some newspaper columns ridiculing the nature of the study, especially the intimate nature of the questions the survey will use. In contrast, over 40 mental health and health organizations wrote and solicited support for the study.


To avoid the risks of STDs and unwanted pregnancies,
teenagers need to be given accurate information
before they become sexually active.


Essentially, these organizations say that education is the major way to reduce the spread of AIDS. The education must come before young people start to engage in high-risk activities. However, without up-to-date information, it is difficult to provide adequate education. Is silence about sexual behavior important enough to put your child at risk for AIDS?


* Adapted from Susan Landers' article, "AIDS Study stresses need to focus on teens," The American Psychological Association Monitor, April, 1989, page 28.

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