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Give Condoms to Teens, Say Doctors

Teach abstinence, but distribute protection in schools, says AAP

TUESDAY, June 5, 2001 (HealthDayNews) -- Doctors and schools should distribute condoms to teens, the American Academy of Pediatrics (AAP) says.

In an updated policy statement, the AAP says abstinence should be encouraged, and doctors should make clear that giving condoms to teens is not a prescription for increased sexual activity.

But, the academy says condoms can protect teens from sexually transmitted diseases (STDs) and unwanted pregnancy.

"The statement from the AAP really addressees physicians, but obviously it is a very useful document for the country at large," says Dr. David Kaplan, chairman of the academy's Committee on Adolescence.

"I think because of the prevalence of STDs and unintended pregnancies -- which is still a huge concern among teen-agers -- not only do doctors need to talk to kids, but parents need to talk to their teen-agers about how to avoid a STD or pregnancy," he says.

Kaplan says the AAP reviews policy statements "every three years to incorporate any changes that take place in the scientific literature, or if there is any change in statistics or anything else that should be incorporated in these policy statements. And we know that condom use among teen-agers is up, which is good. And adolescents are more aware of the risks of getting an STD, specifically HIV, and are more concerned about having an unintended pregnancy. Those are certainly important changes in the statistics."

The Centers for Disease Control and Prevention (CDC) estimates that half of all HIV infections in the United States are among people under age 25. And HIV infection, which causes AIDS, is a leading cause of death among 15- to 24-year-olds. Government statistics says more than 13,000 Americans under age 24 have died since the AIDS epidemic began in the early 1980s.

In addition, 3 million cases of other STDs occur each year among U.S. teens, and up to 1 million teens become pregnant annually.

Statistics from the National Survey of Adolescent Males (NSAM) show that condom use among 15- to 19-year-old males increased from 56 percent to 69 percent between 1988 and 1995. A similar increase in condom use was reported among adolescent females in the same period, according to the National Surveys of Family Growth.

However, NSAM statistics show the majority of adolescent males don't use condoms consistently. Although the percentage of males using condoms during every act of intercourse increased between 1988 and 1995, only 45 percent of males in the 1995 NSAM sample reported using condoms consistently during the 12 months preceding the survey.

The CDC says the average age of first intercourse in the United States is 16, and 66 percent of high school seniors have had intercourse before they graduate.

Judy Harrigan, executive director of the National Association of School Nurses in Castle Rock, Colo., says, "The issue of distributing condoms at school is a controversial one."

"And while the National Association of School Nurses has a policy encouraging the teaching of human sexuality in schools, the option of the use of condoms should be left up to each individual school district. We do not have a position on the distribution of condoms in schools," she says.

Repeated calls for comment on the AAP's updated policy statement to SHARE (Sexuality, Health and Relationship Education), a Seattle-based group that advocates abstinence, were not returned.

What to Do: For more information on condom use, see the University of Massachusetts, or Avert.

SOURCES: Interviews with David Kaplan, M.D., M.P.H., FAAP, pediatrician, Children's Hospital, Denver, Colo., and chairman of the AAP Committee on Adolescence; Judy Harrigan, executive director, National Association of School Nurses, Castle Rock, Colo.; June, 2001 Pediatrics
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