April 23, 2008 -- At age 17, Max Siegel started a relationship and had unprotected sex with a man six years his senior. Siegel said he wanted to use a condom but his partner didn't. Siegel contracted HIV.
"I did not know how to assert myself further," said Siegel, now a 23-year-old policy associate with the AIDS Alliance for Children, Youth and Families. "I knew enough to suggest a condom, but I did not have an adequate understanding of the importance of using one, and even if I did, I had no idea how to discuss condoms with my partner."
At age 15, Shelby Knox took a virginity pledge at her church in west Texas. The pastor who initiated the ceremony also taught a secular abstinence-only program at her school. But Knox said just being taught not to have sex left her and her peers in the dark.
"I believed in abstinence in a religious sense, but it was clear that abstinence-only, as a policy for students who simply were not abstaining, was dangerous," said Knox, now a 21-year-old writer and speaker, advocating for youth and reproductive health. "Even if we did wait until marriage, we still lacked a basic understanding of our bodies, reproduction, and how to prevent pregnancy as well as a long list of sexually transmitted infections, and the skills to navigate conversations about sex and protection."
A discussion about how to best discuss sex in the classroom brought both Knox and Siegel to Capitol Hill Wednesday, as the House Oversight and Investigations panel held a hearing on the effectiveness of abstinence-only programs.
While everyone participating agreed their goal was to keep teens healthy and reduce sexually transmitted disease rates, they held widely divergent views about how to best do so.
Over the past ten years, the government has provided $1.3 billion for abstinence-only education programs. Coming on the heels of a recent report from the Centers for Disease Control and Prevention that found one in four teenage girls have a sexually transmitted infection, lawmakers are now considering whether those programs are working, and if they should continue funding the controversial program with federal dollars.
Speaking as parents and former health profesionals, lawmakers donned various other hats to examine the issue.
"I'm like most parents in that the current culture pushes against what we try to teach in the Brownback family," testified Kansas Republican senator Sam Brownback, the father of five children. "The parents of this country want their children to be abstinent."
Brownback and others said not all abstinence programs are created equal, and stressed that the government should work to replicate those that are working before eliminating the entire program.
But others countered that teaching more comprehensive sex education, in an age-appropriate way, and with consent from parents, is critical.
"I know from my firsthand experience what does and doesn't work with youth," said former school nurse, Rep. Lois Capps of California, who once directed a program for teenage parents who stayed in school.
"They were asking us for help because they got pregnant in the first place because they didn't know enough," Capps said.
Seventeen states, including California, have now opted out of accepting the federal money for abstinence-only programs. Commitee Republican Christopher Shays, whose home state of Connecticut is among them, said officials in Connecticut have rejected the money because, "they think it is ultimately going to result in young people being deprived of knowledge that will save their lives."
The American Public Health Association and the American Academy of Pediatrics are among several organizations that maintain abstinence should be one aspect of a larger sex education effort that also includes information about contraception.
"Umbrellas don't cause rain," Knox said. "Young people are smart enough to make responsible decisions when they're given all of the information."
Today, 95 percent of Americans have premarital sex, as people are having sex earlier and marrying later, said Dr. John Santelli, professor of clinical pediatrics at Columbia University's College of Physicians and Surgeons. Santelli told lawmakers that a recent decline in sexual activity appears to be unrelated to the abstinence-only program, but rather a product of contraceptive use.
Those who favor abstinence-only education over more comprehensive sex education programs also came armed with statistics.
Stan Weed, director of the Institute for Research and Evaluation, said he has studied more than 100 abstinence-only education programs and collected information from more than 500,000 teenagers. His work, he explained, reveals the programs are working, and are "much broader, much richer, much deeper" than many people think.
Weed cited anaylsis of three specific programs, all of which reveal how students in programs were about half as likely to initiatiate sexual activy than a comparable group of students who weren't.
The House Oversight panel heard from 11 people Wednesday, with just two who favor abstinence-only education over more comprehensive sex education programs. That imbalance did not go unseen, as Rep. Mark Souder, R-Ind., charged, "this is as stacked a panel as I have ever experienced."
Committee chairman Henry Waxman, D-Calif., said the panel accepted every witness who was recommended to it from the Republican side of the aisle.
A 2006 report from the Government Accountability Office voiced concerns about government-funded abstinence-only education programs and recommended the Department of Health and Human Services adopt measures to ensure that abstinence-only education materials contained medically accurate information about the effectiveness of condoms.
HHS has since taken steps to assess how abstinence programs are working to combat teen pregnancy and sexually transmitted disease, according to GAO health care director, Marcia Crosse.
"The administration continues to support abstinence education programs, as one among several methods used by educators, to address the continuing problems created by adolescent sexual activity, the result of which includes unacceptably high rates of non-marital child-bearing and sexually transmitted diseases among America's youth," said acting deputy assistant secretary for policy at HHS' Administration for Children and Families, Charles Keckler.