- The Washington Times - Tuesday, February 16, 2010

Now that the Obama administration and Democrat-led Congress have jettisoned federal abstinence-education funding, sex education that stresses condom use to stop the spread of sexually transmitted diseases (STDs) will dominate classrooms and communities.

A new Indiana University School of Medicine study on chlamydia infections, however, hints at serious flaws in the condom approach.

Nearly 400 teenage girls were tracked for several years, according to the study published in January in the Journal of Infectious Diseases. Every three months, the girls saw health care workers and received sound public-health messages; i.e., if you want to avoid chlamydia, dont have sex, and if you must have sex, be sure to use a condom.

The teens were regularly tested for chlamydia and treated promptly if they had an infection, as happened with 54 percent of the girls. In fact, 120 teens got two or more chlamydia infections during the several years they were in the study.

What’s extraordinary is that these teens were in an optimal situation: They (and their parents) were eager to be in the study. The girls kept daily diaries for months, and talked about their boyfriends, sexual activity and condom use with concerned health care workers. The girls knew they were being tested for a STD and were very aware of the risks of unprotected sex, but still dozens of them stopped using condoms anyway.

Why?

The answer, according to Dr. Yolanda Wimberly, who was not part of the Indiana study but works with youths at Morehouse School of Medicine, is all about trust.

“I hear it all the time,” said Dr. Wimberly. “If you trust me, you will not make me use a condom when we have sex, period. And if you make me use a condom … then you just don’t trust me.”

In the real world, she explained, “no one is ever going to sleep with anyone they think has a STD. I mean, they’re just not. I’ve never had a patient come in and say, ‘Hey, Dr. Wimberly, I’m looking at this person, and I’ve decided I would have sex with this person, and I think they have an STD.’”

Most people — and especially teenagers — do not imagine that the person they are having sex with has an STD, she said. “They are thinking, ‘This person is a nice person, this person is a cute person, this person goes to my school, this person goes to my church.’”

So thinking about STDs — or a condom — “isn’t necessarily the first thought in their mind” when they lie down together, “especially if it’s someone that they love, someone they have a relationship with.”

When these real-world reasons for why people don’t use condoms aren’t addressed, the consequences of having unprotected sex just keep playing out, she said.

Even getting a diagnosis of chlamydia will set off trust issues.

Since chlamydia rarely has any symptoms, it’s a big shock for a young person to hear that he or she has an infection.

But then when the person tries to tell their sex partner that they have chlamydia, the conversation sounds like this, “‘Well, I don’t have anything, so what are youdoing?’ In other words, there’s accusations of cheating,” said Dr. Wimberly, who says she uses role-playing with her young patients to teach them how to handle this kind of news with other people.

Dr. Wimberly thinks that fighting STDs requires much more than just telling people to use a condom.

It’s about “behavior, behavior change and environment,” she said. For instance, if a couple tells her they have decided not to use condoms anymore, she recommends that they go to a clinic together, get tested and exchange test results. That way, they both know whether they are starting out with a clean bill of health.

In a nation where one in four of all U.S. teenage girls is getting at least one STD, as reported in a 2009 study in Pediatrics, Dr. Wimberly’s observations should not go unnoticed.

Cheryl Wetzstein can be reached at cwetzstein@washingtontimes.com.

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