This essay's title is meant to help candidates like John McCain, who seems unsure about condoms. Asked in Iowa about his views on taxpayer funding of condom distribution in Africa, he sort of fumbled around. Asked about teaching students about contraception in public schools, he said he "support[s] the president's policy." The reporter asked:
Q: So no contraception, no counseling on contraception. Just abstinence. Do you think contraceptives help stop the spread of HIV?
Mr. McCain: (Long pause) You’ve stumped me.
But this question shouldn't stump him. It's been a major political issue for some time, and the current system encourages programs which lead children to experiment with anal and oral sex. Contraception works, abstinence-only programs don't.
The reporter was equally surprised that McCain couldn't give a straight answer to the question.
Q: I mean, I think you’d probably agree it probably does help stop it?
Mr. McCain: (Laughs) Are we on the Straight Talk express? I’m not informed enough on it. Let me find out. You know, I’m sure I’ve taken a position on it on the past. I have to find out what my position was. Brian, would you find out what my position is on contraception – I’m sure I’m opposed to government spending on it, I’m sure I support the president’s policies on it.
McCain, you see, has taken so many positions that he literally cannot keep track. The President's policies are failing Africa and failing our children. The policy that works in Africa and in America is to teach people these steps:
- Abstinence;
- Be Faithful to your partner; and
- Condoms
Where that program has been implemented, HIV and other disease rates have been controlled, unwanted pregnancies decrease, and people don't wind up with the crazy idea that anal sex "doesn't count."
The reporter, disturbed at the runaround on this important topic, pressed on:
Q: But you would agree that condoms do stop the spread of sexually transmitted diseases. Would you say: ‘No, we’re not going to distribute them,’ knowing that?
Mr. McCain: (Twelve-second pause) Get me Coburn’s thing, ask Weaver to get me Coburn’s paper that he just gave me in the last couple of days. I’ve never gotten into these issues before.
Really? Never got into the issue of whether condoms are effective at limiting HIV transmission? Not even when he was having one night stands with Brazilian models? Coburn is a kook, a Christian Reconstructionist who got in trouble for sterilizing a 20 year-old patient without permission, and then billing Medicaid for the illegal procedure (despite policy against Medicaid reimbursements for patients under 21). Coburn, as an OB/GYN, has performed abortions, but says that doctors who perform such procedures deserve the death penalty.
Of course, Coburn is also out in the wings with regard to condoms. He has waged an unceasing war to get labels onto condom boxes warning that they are not effective against some diseases, even after a major NIH review rejected that claim.
You'll note that my title contains the appositive phrase "properly used." Studies of pregnancy and disease transmission show that people who have been using condoms longer (and those who have been taught about them in school) have much lower failure rates. Someone worried about reducing transmission rates ought to support federally funded abstinence-plus sex ed, aka comprehensive sex ed. By opposing such education, Coburn reveals his true agenda, and by endorsing Coburn's views, McCain ties himself to that same horse, endangering children here and abroad.
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"Contraception works, abstinence-only programs don't."
Such a blanket statement is not only simplistic, it's untrue. Some comprehensive sex education programs have shown to reduce risk factors related to unwanted pregnancy and the spread of STD's, and some abstinence eduation programs have shown to have the same effects.
But an even greater problem with this type of approach is that it sets up the debate as an "either-or" proposition. This is far too simplistic. In reality life is certainly more complicated than that. We know from the data (both YRBSS and NSFG) that growing numbers of young people are choosing to remain abstinent from sexual behavior. Indeed, a majority of U.S. High School students tell us that they are abstaining from sexual activity. This was not the case just 12 short years ago. Given the relationship of this choice to many social problems, it makes good sense to have programs that support these choices that increasing numbers of teens are making.
But, we also know that not every person in America will make that choice. And so, hundreds of millions of dollars are spent through numerous federal funding streams (Medicaid, TANF, Family Planning, Indian Health Service) to help these citizens reduce their risk.
Why can't we have both programs -- supporting different populations -- for different, but complementary goals? It's not an "either-or" proposition, but rather a "both-and" proposition.
There are enough unintended pregnancies and STD's to go around. Why can't we give government managers, school teachers, public health officials and social service administrators as many choices as possible to help our young people?
"Someone worried about reducing transmission rates ought to support federally funded abstinence-plus sex ed, aka comprehensive sex ed."
That's what I said, and I stand by it. Comprehensive programs that emphasize abstinence but teach what comes next do exactly what you are describing.
"Condoms, properly used, . . . " reminded me that the Namibian Minister of Health (herself a doctor) described how she participated in a training program in which the women of the village were shown how to put on a condom, using a broom handle as the teaching aid. A couple of years later she went back and found a lot of small children - but a broom wearing a condom in each bedroom.
There, condom use is being heavily promoted, both on TV adverts and on billboards, in an effort to check AIDS. However, when I asked a local nun involved in the HIV/AIDS program whether people did not know or did not care she gave a dejected sigh and said she thought many just did not care.