It’s time for evidence-based sexual education to meet teens where they are—online, argue a pair of authors in a JAMA Viewpoint today.
Providing adolescents with factual information about sexual health in public schools, particularly information about contraception, remains controversial in the United States—a situation reflected in the larger ongoing debate in US society about public policy and contraception.
This debate is a long-standing one. A 1966 JAMA editorial (reprinted in JAMA Revisited), noted that the American Medical Association took a stand to support the provision of contraception as an essential part of comprehensive health care, noting that some legal barriers to contraceptive access had been removed and that certain religious groups had softened their position on contraception. Last week, nearly a half century later, the US Supreme Court’s rule to affirm the right of certain employers to forgo providing health coverage for contraception based on religious grounds set off renewed debate about the intersection of public policy, sexual health, and religious convictions.
One way that educators and public health organizations can sidestep the controversy and educate teens about sexual health is to leverage digital tools to make comprehensive sex education (including information about contraception) available online, argue Victor C. Strasburger, MD, of the department of pediatrics at the University of New Mexico School of Medicine and Sarah S. Brown, MSPH, of the National Campaign to Prevent Teen and Unplanned Pregnancy.
Strasburger discussed the issue with news@JAMA.
news@JAMA: What is the current state of sex education in the United States?
Dr Strasburger: Sex education has been controversial since I was a teen, and it really shouldn’t be. We really do a terrible job of educating kids about sex. Every other western country knows that teaching kids about sex makes them more knowledgeable. Some people think teaching them comprehensively will make them more sexually active, which isn’t true.
Teens get a lot of sex “education” from the media, which doesn’t provide good information about preventing pregnancy and the spread of sexually transmitted disease. It’s foolish to think 1 semester in middle school or high school can counteract the 15 000 sexual references they will see in the media each year.
We’ve come a long way with drug abuse prevention and bullying. But we haven’t made a lot of progress with sex education since I was growing up in the ’60s and ’70s.
news@JAMA: What are the advantages of online sex ed?
Dr Strasburger: The primary advantage is you don’t have to go through a conservative school board to get it implemented. The Internet offers free access to all. It’s also there 24/7. Teens need constant access to information about sexual health. They have questions that develop as situations arise. The Internet is always there. It’s a major resource that we have yet to use appropriately.
news@JAMA: What are the downsides?
Dr Strasburger: There’s a lot of bad information and pornography online. It’s unregulated. We worry that if health professionals create websites, they might be seen [by teens] as too totalitarian. You need teens involved in creating websites that are appealing. You can’t put a textbook online and expect it to be effective.
news@JAMA: How might local programs leverage online materials?
Dr Strasburger: We both feel the good will outweigh the bad if more people join in. It will give local communities more control. Communities vary in how conservative they are in their thinking. Communities can set up their own websites or text answer services.
The Internet can be a useful adjunct to traditional sex education. MTV has an app to identify the nearest place to find condoms. There is a website called bedsider.org that has good information and very funny videos. It takes the stigma out of teaching kids about sex.
news@JAMA: What’s your take-home message?
Dr Strasburger: Kids are getting a lot of sex education now, but it’s the wrong kind. We can use new technology wisely and in ways they will enjoy.
The controversy that exists around sex education is unnecessary and unscientific. There is no evidence that making kids smarter about sex makes them sexually active at a younger age. It’s time for the controversy to end.