January #131 : The Kids Aren't Alright - by Tim Murphy

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Table of Contents
 

Labors of Love

The Kids Aren't Alright

With Honors




A Little Something on the Side

Even Combos Get the Blues

The Load Not Taken

HIV Bytes

Don't Get Fresh With Me

Discounted Labels

Thai-ing the Knot

Don't Leave Work Without It

Teen Angel

While You Weren't Sleeping

High Definition




Isn't That Special?

Prison Break

Anywhere but Here

Death and the Maidens

Diplomatic Immunity

Very Adult Education

On the Download

Face for the Cure

Tales From the Crib

Big Med on Campus




Editor's Letter-January 2007

Mailbox-January 2007

Catch of the Month-January 2007



 
Most Popular Lessons

The HIV Life Cycle

Shingles

Herpes Simplex Virus

Syphilis & Neurosyphilis

Treatments for Opportunistic Infections (OIs)

What is AIDS & HIV?

Hepatitis & HIV



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January 2007


The Kids Aren't Alright

by Tim Murphy

Amid the heated, fiercely politicized debate between sex ed that teaches condom use versus sex ed that preaches abstinence, young people who have contracted HIV through sex share what they wish they’d learned beforehand

It’s hard to hear the story of NaomI (who asks that her last name not be used) without feeling that she embodies an abject failure of sex education in America. The African-American Houston native, now 19, lost her virginity at 10, with a boy her age, while avoiding the funeral of her grandmother, whom she remembers as “my life—the backbone of our family.” Three years later, at 13, and with only a sketchy idea—from a movie she watched in science class—of how to avoid HIV, she was having sex with Derrick, a friend of a friend whom she says was about 28 at the time.

Naomi says they used a condom maybe two of the four times they had sex. Then a friend told her she’d heard that Derrick had “the shit”—street slang for HIV. Derrick showed Naomi some medical-looking papers to disprove the rumor, but “I didn’t even know what the papers were,” Naomi says. After Derrick disappeared, there was unsafe sex with other men, then a gonorrhea diagnosis from a teen clinic—where Naomi also tested positive for HIV.

“I was like ‘What, are you serious?’” Naomi says. “I was crying, and I told my friend and my sister, and I called my mama and said, ‘My test came back positive.’ So I went home, and that was the start of everything.”

Now, six years later, Naomi is working part-time at a grocery store and is seeing a 31-year-old man with whom she says she has safe sex. She says her lab numbers are good and that she’s been able to delay starting HIV meds, which terrify her. She urges young people in her community to get tested for HIV. And after dropping out of school for a few years, she’s a senior at an alternative high school where “we talk about STDs, gonorrhea, HIV, drug use, condoms,” she says. “I could tell you everything about sex now. My friends come to me.”

However, she says, “I wish I had stayed a virgin till I got married, like my mama. Abstinence is the best way, like they say.” But if it sounds like Naomi got the abstinence-only-until-marriage (AOTM) sex education that the Bush administration funded to the tune of $176 million last year, think again. Until recently, that science class film is the only sex ed she received. “Kids are messed up,” she adds. “They make mistakes. So they should know to use a condom 100% of the time.”

Naomi’s story is somewhat extreme because her sex life started so early. According to the most recent research from the Centers for Disease Control and Prevention (CDC), only about 7% of black female teenagers report having had sexual intercourse before 13. But as young people reach high school, the picture gets more randy: One-third of all ninth-graders report having had intercourse, as do 47% of all high-school-age kids (with numbers as high as 75% for black males and 63% for high school seniors).

Such stats are cited by those who feel that sex ed should teach young people everything they need to know to protect themselves—especially because 12% of the 40,000 annual new HIV infections in the U.S. occur among people between the ages of 13 and 24. Such folks are enraged by the roughly $1 billion the federal government has funneled into AOTM programs since 1996, with a sharp ramp-up during the Bush administration. Meanwhile, the feds give no money specifically for so-called comprehensive sex-ed (comp-ed) programs that teach abstinence along with a “Plan B” of condoms, birth control and safer-sex negotiation skills.

The disparity has fueled the widespread perception that abstinence-only programs have hijacked sex ed in the United States. The reality is both less and more disturbing. Just talk to the young people who were sexually infected with HIV in their teens and to  their advocates. Think it’s because rigorous abstinence-only programs taught them that condoms don’t work, as such programs often do? Occasionally—but more likely, it’s because they received virtually no sex ed of any sort.

With the recent takeover of Congress by Democrats (who support comp ed far more than Republicans), as well as a new nonpartisan government report blasting the Bush administration’s lax oversight of fed-funded AOTM programs, there’s hope on the horizon. But American sex ed remains highly problematic, a crazy, hard-to-track patchwork of comp ed, AOTM and nothing at all. Even though there’s no federal mandate for sex ed, roughly 20 states require some form of it, while nearly 40 require some form of HIV/AIDS education. But what actually gets taught, and how, varies wildly by state, county, school district—even by school.

Good stats are rare too. A 2002 Kaiser Family Foundation national survey found that about 60% of teachers and principals reported teaching comp ed and 34% reported teaching strict AOTM. That ratio sounds generally up to date, according to Max Ciardullo of the Sexuality Information and Education Council of the United States (SIECUS), a comp-ed leader. Ciardullo says it’s hard to be sure because what’s actually taught in the classroom is often meager compared with what is mandated on paper or reported in a survey. For example, “they have comp-ed guidelines in New York City,” he says, “but if you talk to teachers or young people, they’ll tell you it’s crap. No one’s keeping track of it, and the only thing our federal government is doing is throwing money at [AOTM] programs that don’t work.”

That critique gained momentum in 2004, when a Government Accountability Office (GAO) report found that 11 of the 13 most popular fed-funded AOTM curricula contained glaring inaccuracies and distortions, among them the notion that HIV could be transmitted through tears or sweat. Yet more than two years later, the AOTM money is accepted by all but four states—California, Pennsylvania, Maine and New Jersey. (Localities within states may decline the funding.) A GAO follow-up report late last year found that the feds had done hardly anything to ensure such programs’ medical accuracy.

Despite all this, abstinence-only groups defend their programs. Colleen Clark, community outreach director for the Phoenix-based Passion & Principles, a federally funded program that she says has reached more than 10,000 students since its 1994 launch, told POZ: “Teens who complete [our] curriculum are presented with a remarkable opportunity for freedom. Unlike ‘comprehensive’ sex ed, we desire to empower teens to build the confidence and courage that sexual self-control requires.” According to Clark, the program derives its science from the Medical Institute of Sexual Health (MISH), a leading AOTM group close to the Bush administration. A 2004 Washington Post story said that an MISH manual was cited in the GAO report because it claimed that teens could get pregnant through mutual masturbation. (Neither MISH nor Abstinence Clearinghouse, another prominent national group, responded to multiple requests to be interviewed for this story.)

AOTM programs are more prevalent in the religiously conservative red states than in the Northeast. Still, nearly every state has accepted the funds—a mark of the utter lack of federal dollars for any other kind of sex ed. “At the end of the day, it continues to be all about the money,” says SIECUS public policy VP Bill Smith. “Young people are still not getting proven, medically accurate sex education in the vast majority of schools. Until we have funding and policies that make this a safe issue to address, we’ll have the same hodgepodge of programs with very little effect on behavior.”

How does that information gap play out in the nation’s schools, shopping malls and car backseats? Some young people, like Naomi, know virtually nothing about protecting themselves during sex; then there are others, like Houston’s Charles Scott, 24, a straight black man who got HIV from a college girlfriend who, he says, waited months to tell him that she had been born with HIV. They’d forgo condoms “in the heat of the moment,” says Charles—even after she divulged her status. How could Charles continue to put himself at risk? “She wouldn’t get real wet,” he says, mistakenly thinking his girlfriend’s light vaginal secretions made the sex safer. “When we went over STDs in gym class, HIV wasn’t touched on.”

Or consider Monica (not her real name), 24, a straight white woman from North Carolina who was diagnosed with HIV four years ago. Monica says that she didn’t get good, clear HIV prevention information until college. That was more than four years into a relationship with her high school sweetheart, in which they abandoned condoms because her partner, she thought at the time, was faithful to her. Before college, Monica says, all she learned was that “AIDS will kill you, and you get it from needles and sex,” she says. “I didn’t think it hit good-looking, healthy normal people.”

As for young HIV positive gay men, many got a sex-ed double whammy, lacking not only prevention basics but even a cursory acknowledgment of gay sexuality. Socially ostracized, they often plunged, demoralized, into alcohol, drugs and unsafe sex with little social or emotional support. Growing up a gay Latino on New York City’s Staten Island, Avery (not his real name), now 23, says that before he was diagnosed with HIV at 16 after having unprotected sex with his first partner, he’d learned nothing about HIV prevention in school: “They taught about gonorrhea,” he adds, but not HIV.  What about condoms? “I thought of them only as a contraceptive,” he says, “and thought that since I wasn’t a female, I didn’t have to worry.” His diagnosis, he says, led to crack use and more risky sex.

Max Siegel, 22, an Arizona State University senior, says he was diagnosed with HIV five years ago, after having unprotected sex with a man he was dating, who was 23 at the time. During his years attending public schools in Mesa, Arizona, he remembers only “a wait-until-marriage speech in gym class—never anything about how to put on a condom.” Still, Siegel adds, he knew enough to offer his boyfriend a condom before they first had sex—but the boyfriend waved it away. “I wish I’d had the skills to deal with that situation,” he says, “that I had demanded he use a condom. I wish I’d had some kind of exposure to someone living with HIV or STDs because they were completely abstract ideas to me.”

Of course, some young HIV positive people did receive abstinence-only sex ed. Chris Rothermel, 23, of Washington, DC, was diagnosed with HIV two years ago. As a student at a Catholic boys’ junior high school in New Orleans, he learned “that “condoms were not effective and that homosexuality and masturbation were evil,” he remembers. “That stuck in my head and scared me because I was 13 years old and jerking off 20 times a day!” Hitting the bawdy New Orleans gay scene as a teen, he learned that condoms indeed provided protection—but drugs and depression made it hard for him to use them consistently.

Comp-ed and gay advocates contend that AOTM programs send a devastating message. Eliza Byard, deputy executive director of the Gay, Lesbian and Straight Education Network, says that programs discouraging sex outside of traditional, legal marriage leave no place for young gay people. The group’s nationwide survey of 1,200 lesbian/gay/bisexual/transgender high-schoolers found that those in schools with AOTM programs experienced higher levels of harassment and had fewer teachers or staffers with whom they could discuss LGBT issues. Such students “were more likely to skip school because they felt unsafe,” says Byard.

Meanwhile, AIDS Alliance for Children, Youth and Families(AACYF), a comp-ed supporter, is conducting a study of the impact of AOTM programs on HIV positive students. “They’re totally stigmatizing,” says AACYF’s Diana Bruce, who adds that some programs tell students not to marry HIV positive people. “People ignore the fact that there are kids who are already positive sitting in these classrooms,” she says.

Bruce cites a recent version of the aforementioned Passion and Principles (P&P) program that tells students that if they get HIV, “You’re heading straight to the grave—no cure” and claims, “Nearly one in three will contract AIDS from infected partners with 100% condom use.” (That is refuted by a European study of 124 serodiscordant couples that found zero incidence of HIV transmission with consistent condom use over two years.) P&P’s Clark avows that the “straight to the grave—no cure” line is “a completely inaccurate statement” and that it was revised last fall, as was the one-in-three statistic.  

Increasingly, HIV positive youth, school staffers and parents are all fighting back and mobilizing against AOTM programs. Through AACYF, both Max Siegel and Monica have publicly denounced them. And in Atlanta, a group of parents recently ousted an AOTM program, Choosing the Best, that included a video featuring a young woman who was supposed to be HIV positive and was “looking absolutely awful,” says Sue Briss, who led the parental rebellion. “This program was so fear- and shame-based,” she says. “It says to be tested [for HIV], but it doesn’t give any information on where or how it’s done. It just turned my stomach.”

In Albuquerque, New Mexico, parents outraged at the distorted AOTM programs that their teenage children were receiving got the state to restrict such programs to sixth grade and below, freeing room for comp ed in the upper grades. Susan Rodriguez, one of the parents behind the crusade, said that the religiously tinted AOTM info her daughter was getting “was very antiabortion and very antisex. Do we really want to teach our children that sex is filthy?”

HIV positive youth are finding stealthy ways of reaching students within AOTM programs, urging protection for those who do have sex. “The facilitator [at such a forum] just shut the door and told me, ‘Do what you do—they need to hear it,’” says Monica, now an AIDS caseworker in a North Carolina city where AOTM programs hold sway. That facilitator, who spoke anonymously for fear of losing her job, said she routinely directs students privately to Monica or comp-ed groups outside school. “I’ll give them numbers to call and say, ‘You make a decision about how you want to handle this,’” she says.

Max, who also speaks before young people in Arizona AOTM programs, echoes Monica: “You just kind of work around it. Abstinence-only in written policy is a little bit different from when you’re actually there.”

But, at just such an appearance in Houston, Charles was so disgusted when a school administrator forbade him from explaining how HIV is transmitted that he walked out. “If it were up to me, I would gather seven busloads of kids and go to Washington,” he says, his soft voice rising in anger. “These young ones—13 to 15—they’re not getting proper [sex] education. I didn’t get it, and this whole predicament [his own HIV diagnosis] could have been avoided.” (He blames himself, too, for not sticking to condoms—but not as much as he does his lack of good sex ed.)

A change may be looming. In 2006, the Senate nearly passed legislation authorizing a comp-ed funding stream to rival the river of AOTM money. A few years earlier, such a close vote would have been impossible. SIECUS’ Smith attributes it to the fact that even many Republicans have been swayed by events like the scathing 2004 GAO report and its follow-up, plus a more recent GAO decision that AOTM programs are not exempt (as the administration had asserted) from federal rules stating that U.S.-funded health programs have to show strict medical accuracy.

And with comp-ed-supporting Democrats now in the congressional majority, the REAL Act, another bill to green-light comp-ed funding, may gain momentum. “We’ll be pushing this bill at every possible turn,” says SIECUS’ Smith, adding that comp-ed advocates are redoubling efforts to reduce AOTM dollars. In fact, notes Smith, this year was the first ever that Congress didn’t up the funding. “We also have opportunities to [make AOTM funding] more flexible so it can be used” for non-AOTM programs.

Many of the HIV positive youth who spoke for this story said they felt that if someone young and HIV positive—someone who looked like them—had told them his or her story when they were young, it might have made all the difference. “I was one of those kids saying [about other girls], ‘Ooh, she got that thing—don’t talk to her!’” recalls Monica. “I didn’t know that I was just as much at risk.”

They wish they’d been taught before their own HIV infections—and they all call for sex ed that’s frank, complete, detailed—and phased in appropriately, starting as early as third grade. Asia Johnson, 25, who found out that she was both HIV positive and pregnant with her second son when she was 21, says that even elementary schools can start the process, by teaching students the right names for genitalia.

“No wee-wee and ding-a-ling,” she says. “It’s a penis. I didn’t even know that my stuff was called a vagina.” Today, she teaches safe sex not only in the HIV positive youth group she leads but at as many schools and churches as she can. “Just someone having a little basic information can do the trick,” she says.

What’s appropriate for middle and high school students? Teach it all, says Charles—as early as possible. “In the HIV positive youth group I cochair, I have people in there as young as 14 and 15,” he says. New York City’s Johnny Guaylupo, 25, diagnosed with HIV when he was 17 after having unprotected gay sex (he received no sex ed in Catholic boys school), works for the AIDS organization Housing Works. He cochairs the organization’s Youth Caucus and is helping it try to bring condom demonstrations and distribution to the city’s high schools. “Teach kids what HIV is, how you get it and how to stay safe,” he says.

As for Naomi, she’s doing better than you might think. Last summer, she joined two dozen other people her age, some HIV positive like her, in Chicago for a youth activism workshop sponsored by the national group Campaign to End AIDS. Now she’s planning a campaign to get more Houston high-schoolers tested for HIV.

And if it seemed that HIV broke her spirit when it first arrived in her life, she’s since reclaimed it with that easy courage peculiar to the young. Recently, she told one of her best friends, who’s named Madonna, that she is HIV positive. “She starts crying in the street,” Naomi explains. “She said, ‘Every time I get close to someone, they die of AIDS, like my mama did.’”

Naomi paused. “I said to her, ‘HIV pricks me once in a while, but I don’t let it control me. I’m not dying—I’m living, just like you.’”


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