Remarks of Sarah S. Brown

Thank you for including me in today’s event – and hello to all of you in other parts of the country.

My task in the next few minutes is to talk about ideas for using the abstinence funding through the MCH black grant. I do indeed have a few ideas, but before outlining them, I wanted to offer a few minutes of, as they say, the big picture.

People often ask us at the National Campaign to Prevent Teen Pregnancy (the Campaign) where we are on the abstinence issue – do we think this is a major path to preventing teen pregnancy? How do we view it in relationship to contraceptive services and education? Which is more important? How do we resolve this conflict? Or is this conflict driving us crazy?

In fact, we spend a lot of time talking about abstinence and our interests seem widely shared. First, we wanted to know where the U.S. population stands on this issue. (See attatched polling question #3 – 95% polled – teens and adults – felt it either very important or somewhat important for teens to be given a strong message from society that they should abstain from sex until they are at least out of high school). So, then, there is lots of support for this message. What then does the Campaign say about abstinence education?

Let me begin with several background, contextual observations:

1) NSFG and NSAM data released in early May suggest it is possible to decrease teen sexual activity – it is not a quixotic quest.

2) We know that many teenage girls report that they are not too happy about their sexual activity and often ask, in fact, how to say no without hurting their boyfriend’s feelings; remember three in four sexually active teens queried on a Ms. Foundation poll suggested that the main reason they were having sex was because their boyfriends wanted them to.

3) We also know that a later onset on sexual activity is associated with fewer sexual partners (which has major implications for overall STDs and for risk of infertility, among other things), an increased chance of good contraceptive use and therefore a lessened chance of teen pregnancy. For all these reasons and more, I think we should view the chance to invest in, as they say, postponing sexual involvement, with great interest. It is important to add, of course, that not all Americans share the view that reserving sex only for marriage is either desirable or even attainable, given what we know about the course of human history, but I’ll leave that for another day and another conference. Instead, I’d like to focus on the widely shared view that teens – especially those of school age – should be abstinent. In that context, let me remind you that in a poll the Campaign and ARHP conducted, we found support for abstinence. INSERT DATA PAGE (ATTACHED)

4) Prevention starts early. We need to encourage adults to talk to their children about sex, love, and values early on – waiting until a child is 15 of 16 to tell him or her what we expect and why is too late. This is not a 45 minute conversation, it is a lifetime one.

5) Two-thirds of adults say they have talked to their teen-aged children about these issues. Whatever we think we are saying is not getting through. We need to try harder.

6) We have a poster in our office that says: "One of the best ways to keep our daughters from getting pregnant is to talk to our sons." I think we are gender biased in this area. When we talk about abstinence, we really mean, in our heart of hearts, abstinent girls. The current fracas over sex in the military cozies up to the standard and I think that we should demand that if we are going down this road of abstinence that we be crystal clear that we mean boys as well as girls. As a matter of fact, I challenge at leat one member in our audience to apply for these abstinence funds to do a program focused only on encouraging abstinence among boys.

7) We need to see abstinece as a tool that requires motivation to use – just as contraception is. The truth is that at present in America, we havce a large number of teens who are sexually active but use contraception episodically at best. That is, they are neither abstinent nor use contraception. Why is this? Well, the best answer I have come up with is that kids will do neither – will neither be abstinent nor use contraception scrupulously unless they have a reason to do so. Advocating one or the other misses the point. Both require motivation, a reason, a context. So, I suspect that programs offering abstinence as a desired behavior will have little impact unless they are embedded in something larger – something that has to do with self-worth, future goals, resisting peer pressure, having tangible goals that are seen as realistic and are perceived to be more attractive than pregnancy, and that include generous amounts of adult supervision, investment and limit setting.

NOW THEN: What to do? Here are a few of the ideas that have occurred to us:

1) Develop programs that help parents talk with their children about sex, love, and values – early and often. This is a big gap that could be filled by parent groups, development of videos and books, school programs, church groups, and be distributed through any number of parent bodies.

2) Develop programs that encourage more adult mentoring of high-risk young people. We know that many teens drift into sexual activities because no adult is on their case day and night. We need to begin filling these voids. If we don’t, pre-mature sexual activity will begin.

3) Develop a program that offers after-school activities to kids – sports, community service, computers – the list is endless. Link these to a strong program of peer counseling. As one of our posters says: "It is hard to get pregnant while you are playing basketball."

4) Develop a media advocacy program whereby a state or community will confront the media about the amount of gratuitous, violent and casual sex portrayed in the entertainment media – 89% of sexual activity in the media is between unmarried people – and usually with no adverse consequences. We need to do something about that if we really want to change our moral fabric.

5) Develop a state or local media campaign that talks about abstinence, but in a way that avoids lecturing. Many groups are doing this or getting ready to do so (Note our state-based media conference at the end of June). Be creative – how about "Abstinence: it’s not just for girls anymore." Or try another approach as in California: Teen pregnancy is an adult problem. It is adults, after all, who create the environments in which kids grow, behave and get into different straits.

6) Develop a program that links senior citizens to latchkey kids – an old study that we all love but are not sure is true says that lots of sexual activity occurs between the hours of 3 and 6 when the adults are at work. If we can’t fund a community program to fill those hours, then how about getting some grandparents on the scene?

7) Develop a program to hold youth forums in communities and invite the kids to speak out about abstinence. Why it is and is not a good approach and what might increase it. I note so often that these conversations are always among adults. We need the kids to speak. They are, after all, the target audience.

8) Link the abstinence message to such traditional maternal and child health activities as home visiting and care management services, often health department based and Medicaid financed. More generally, always link, never isolate.

9) Finally, evaluate. My sources tell me that these monies can be used by states to evaluate the effects of their interventions. This is essential: we cannot allow it to be the case that after five years we will know nothing about the effectiveness of these interventions. I don'’ mean process data or program tracking. I mean the real thing – comparison groups, followed up over two or three years. Maybe states could pool resources to do one or two studies of programs in which they have the most confidence. Our recent review said, remember, that the jury is still out because we have not yet invested in good science, we don’t know enough here. Now some money is in hand. Some MUST be used to learn the merits of our efforts.

Go To: Abstinence Education Agenda
Summary of Survey about Teen Pregnancy
Appendix