At what price, abstinence?

Cervical cancer, which afflicts about 10,000 American women a year and kills nearly 4000, could soon become history. Scientists are testing a vaccine that, so far, is highly effective in preventing infection with the virus that causes most cervical cancer. As Ellen Goodman discovered, this is not welcome news for those who have been using the disease to promote their religious agenda for sexual “purity.”

For the abstinence-only camp, preserving virginity until a proper, traditional marriage is far more important than preventing a deadly disease. Leslie Unruh of the National Abstinence Clearinghouse remarked, “I personally object to vaccinating children against a disease that is 100 percent preventable with proper sexual behavior.” And they'll define what's "proper," thank you very much. The group’s mission is “to promote the appreciation for and practice of sexual abstinence (purity) until marriage through the distribution of age appropriate, factual and medically-referenced materials.” Public health? Disease prevention? Preventing death? Not so much.

Needless to say, these folks are not talking about waiting until same-sex marriage. To qualify for the millions of dollars Bush has funneled to abstinence-only programs, curricula must emphasize that “a mutually faithful and monogamous married relationship is the standard for sexual activity.” These curricula have nothing to offer gay youth except to say, “Don’t be gay.” Well, that’s not going to happen, so the gay youth, who are at high risk for HIV, are left without the life-saving skills that greatly reduce the risk of infection.

The wait-until-marriage crowd always claims that abstinence is the only 100 percent effective protection against sexually transmitted disease. But, as the Alan Guttmacher Institute points out, abstinence is an effective method, but only when it’s used perfectly. In real life, people slip, or deliberately abandon pledges of abstinence. For those that have been taught that condoms are ungodly and ineffective, the abstinence message ultimately results in more unsafe sex, not less.

But proselytizing to American teens is not enough to satisfy the neo-puritans. They’ve taken their message of chastity on the road—to Africa. Continuing to prove he’s the best ex-president ever, President Jimmy Carter is laying into the Bush Administration and a conservative Congress for reversing public health successes in countries like Uganda. It’s a little surreal to hear the famously Baptist Carter talk about promoting condoms—but here’s one old fellow who realizes that his own religious beliefs should not interfere with public health.

In the 90s, Uganda addressed its exploding AIDS epidemic with a program preaching “Abstinence, Be faithful, and Condoms.” According to Carter, the highly successful campaign reduced the rates of HIV infection from 13 percent of the adult population down to 6 percent. But the Bush Administration and the social conservatives in the Congress came along with abstinence-until-marriage campaigns, ignoring the fact that many married men carry the virus. The result is that the rate of infection has again increased to 9 percent.

Abstinence-only programs, at best, can claim to delay sexual activity among a few people in the margin, and only for a few months, on average. But the people far from the margin, those who don’t respond to the abstinence message, those who are sexually active, do not deserve death when we have the ability to prevent it. It’s time to leave public health to those who actually care about public health.