According to Tamara Kreinin, president of the Sexuality Information and Education Council of the U.S., "Manipulating facts about condoms is using a scare tactic to try and get kids not to be sexually active" (Morse, 2002).
One of the consequences of a lack of full and complete information to youth actually causes self-imposed ignorance of their own safety. If adolescents do not get the proper education on protecting themselves from STDs, it is unlikely they will get much beyond playground rumor. In several reviews conducted by the U.S. Surgeon General and by the Committee of HIV Prevention, abstinence only programs have little to no effect on the sexual behavior of adolescents ("Abstinence"). Further, denying young people full and accurate information about sex, contraception, and prevention of sexually transmitted diseases puts them at needless health risks. The reality is that teens will talk about sex, will experiment, and will likely have a sexual experience prior to age 15 -- in light of that reality, is it not better to promote abstinence but teach facts? The more sexual behavior and information are hidden from teens, in fact, results in a greater likelihood of them engaging in behavior without enough information to be responsible. Abstinence only programs, without information on STDs, HIV, and sexual activity are simply headed in the wrong direction for the reality of contemporary adolescent culture (Basso, 2003).
In addition, most scholars agree that by informing youth about the dangers of unprotected sexual activity will result in fewer teenage pregnancies and sexually transmitted diseases (Braithwaite, 2008). and, these same scholars point out that the programs of the past have not worked. Unfortunately, for example, America has one of the highest teenage pregnancy rates among all industrialized nations (Philliber, 2002). Similarly, countries with more open attitudes about human sexuality, and more factual and informative programs within their public schools have fewer teen pregnancies, fewer incidents of STDs, and a lower incidence of HIV among non-drug using teens (Valk, 2000).
Planning and Nursing Actions - Such programs are encouraging teens to ask for help and make the right decision with all the information provided. Holland for instance has the lowest teen pregnancy rate in Europe (only 8.4/1,000). Concepts as frank as condom use, sexual experimentation, and explicit answers about sexual activity are seen as the reason for this success in family planning. Sexuality is taught as part of biology, and since 1993, textbooks have been rewritten to reflect more modern views. The school system sees its role as "helping to make good decisions," but the Dutch healthcare system, non-judgmental and completely private, is also a part of the mix. Finally, scholars who have studied the Dutch model say, "parents in the Netherlands take a very pragmatic approach. They know their children are going to have sex, and they are ready to prepare them and to speak with them about their responsibility. This is the key word" (Ibid). In the 21st century, though, it is not enough to just talk about condom usage -- there are numerous STDs and the threat of HIV that may have lifelong effects, and clearly it is up to the Public School system to inform and develop program standards to reflect the reality of life, rather than the morals of individual teachers (Kapp, 1980).
The nursing profession is in a unique position to mitigate some of the stringent issues surrounding the prevention of teen pregnancy, reduction of disease, and general health considerations. Within the national environment, there are programs available to help teens through these trials that nurses can actively participate in. For instance, the campaign Fight for Your Rights: Protect Yourself, which informs and empowers youth on the issues surrounding their sexual health (Rollins). According to the Global HIV Prevention Working Group 45 million more people will become infected with HIV by 2010 (Lite). Thus, HIV is a pandemic and part of medical culture for younger people, and, like any other disease, must be part of the curriculum at an understandable and appropriate level for each age group (Weinstein, 2005).
One of the major differences between Europe and the United States, at least in terms of teaching about human sexuality, is that in Europe the culture is open to the realization that sexuality is part of the human condition; ignoring sex as part of human behavior is as ridiculous as ignoring any other facet of the human body. Humans have sexual desires, humans will act upon those sexual desires, and even with the threat of HIV, and they will experiment with sex. However, HIV prevention, like teen pregnancy prevention, does work when it is part of a reproductive health program and is given a serious place within the curriculum (Bruess, 2008).
In a similar vein, teens are noticing changes in their bodies, and the raging hormonal surges that are changing their looks, voice, body shape and tone, are also sending messages to their brains. Open conversation regarding masturbation, homosexuality, and sexual practices that will pleasure one without risking health or conception need to be discusses as well (Fausto, 2000). Research has shown that young people are instinctively curious about their own bodies, and the bodies of other members of their same gender, as well as the opposite. They are also curious about the changes that are happening to them -- insatiable erections in boys, feelings and desires in both genders, and for some, an unexplainable attraction to members of their own gender. Within both the school, public health, and clinic/hospital environment, then, the nursing profession has the opportunity to help increase the educational services for teens (See: Pasco, 2007; Toleman, 2005).
Most importantly, there should not be such a contradiction between educating youth on the basics of science, math, and reading -- much has been said in the media about the standards American schools fail to reach in comparison with foreign countries. The nursing profession can actively reach out to the school system with informational sessions, advocacy groups, phone numbers, help lines, and above all; access to preventive care. but, the reality of human sexuality and health are just as crucial to help our youth become adults and citizens of the world. Our nation's children should not be viewed as individuals who need to have only certain truths, but the whole truth pertaining to sexual education. This does not mean that one gets an introduction to completely human anatomy at eight- instead, it is the appropriate level of truth -- not falsehoods, but perhaps not the entire story until the child is ready for that level of information (Bell, 1998). Just as the system first teaches addition and subtraction, then multiplication and division; human sexuality can easily be broken into easily understood and non-frightening modules to protect young children from predators and inappropriate behavior, moving through body changes, into sexual activity (Kapp; Mayo Clinic, 2009).
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