Condom distribution overview

The use of condoms to prevent unintended pregnancies and the spread of sexually transmitted diseases (STDs) remains a common practice in the United States, where nearly $400 million worth of condoms were sold in 2005. The distribution of condoms to certain social groups, such as prostitutes, prison inmates, and recipients of U.S. government aid programs for developing nations, nonetheless continues to foster debate. However, the most intense controversy has centered on the distribution of condoms to public high school students.

Many opponents feel condom distribution is immoral and that public funding should not be used to condone what they regard as illicit sexual behavior, especially among adolescents. But many in this camp also claim pragmatic reasons for their position; according to their perspective, providing condoms to high-risk populations encourages sexual activity and therefore increases the very risks condom use is intended to prevent. Perhaps one of the most outspoken supporters of this view was Pope Benedict XVI, who—during a 2009 visit to Africa—proclaimed that condom use actually increases the spread of HIV, rather than stemming it. Besides encouraging promiscuity, opponents believe condom distribution programs mislead young people into believing that condoms are 100 percent effective in preventing human immunodeficiency virus (HIV) and other STDs. According to opponents, abstinence-only education, which encourages teens to delay sex until marriage, is the best way to prevent unwanted pregnancies and stem the spread of STDs.

Advocates of condom distribution counter that is inappropriate to inject morality into what they perceive as an urgent public health problem. They claim that the distribution of condoms is a realistic, practical response to human sexual behavior—not as some critics wish it were, but as it actually occurs. They point out that more than half of all Americans between the ages of 15 and 19 have had sex and that nearly 70 percent of 18-year-olds have done so. Every day in the United States, 10,000 young people contract a sexually transmitted disease, 2,400 teens become pregnant, and 55 contract HIV. Furthermore, a 2008 study found that at least half of all teen girls in the United States were sexually active and one in every four was infected with a sexually-transmitted disease.

Understanding the Discussion

Condom: A flexible sheath, usually made of thin rubber or latex, designed to cover the penis for the purpose of contraception and protection from sexually transmitted diseases.

Abstinence-Only Sex Education: Sex education materials that meet the eight-point federal definition of abstinence education, as established in section 510 of the 1996 Welfare Reform Act. According to the definition, an abstinence-only program exclusively teaches the social, physiological, and health advantages of abstaining from sexual activity. In addition, it specifically teaches that abstinence from sexual activity outside marriage is the expected standard for all school-age children; abstinence from sexual activity is the only certain way to avoid an out-of-wedlock pregnancy, sexually transmitted diseases, and other associated health problems; a mutually faithful monogamous relationship in the context of marriage is the expected standard of human sexual activity; sexual activity outside of the context of marriage is likely to have harmful psychological and physical effects; bearing children out-of-wedlock is likely to have harmful consequences for the child, the child’s parents, and society; and it is important that young people know how to reject sexual advances and are aware of how alcohol and drug use increases vulnerability to sexual advances.

Comprehensive Sex Education: Sometimes referred to as “abstinence-plus,” comprehensive programs emphasize the benefits of abstinence while also teaching about contraception and disease-prevention methods, including condom use.

STD: Acronym for “sexually transmitted disease.” According to the Centers for Disease Control and Prevention (CDC), the most common STDs in the United States are bacterial vaginosis (BV), chlamydia, lymphogranuloma venereum (LGV), gonorrhea, viral hepatitis, genital herpes, human papillomavirus infection (HPV), pelvic inflammatory disease (PID), syphilis, trichomoniasis, and HIV/AIDS.

History

In 1987, Surgeon General C. Everett Koop publicly recommended that people use condoms to prevent the transmission of HIV. On the heels of Koop’s urging, condom use among the American general public surged.

In a 1991 effort to prevent HIV infection among sexually active teenagers, several New York City public high schools began handing out free condoms, the first large-scale program of its kind in the nation. Although a handful of schools followed suit, such programs immediately sparked intense debate. That debate partly helped drive Congress’ 1996 mandate of abstinence-only education as a provision to the welfare-reform legislation signed into federal law by President Bill Clinton. The authors of the legislation stated that the explicit goal of abstinence-only education was to change both behavior and community standards for the good of the country. The terms of the 1996 legislation effectively prohibited the use of federal funds for programs that distributed or in any way encouraged the use of condoms.

In 2001, the office of Surgeon General David Satcher released a report entitled, “The Call to Action to Promote Sexual Health and Responsible Sexual Behavior,” which recommended providing adolescents with information on both abstinence and contraception. The report was widely attacked by conservative groups for its position on condom distribution.

In 2002, Congress reauthorized the abstinence-only provisions of the 1996 welfare reform law, a decision applauded by opponents of condom distribution. Advocates of comprehensive sex education, however, strongly criticized the continuing emphasis on abstinence-only education as unsound public health policy. These critics contended that there is no credible scientific evidence that the availability of condoms is causally linked to increased sexual activity among young people. That same year, free condoms were distributed to athletes at the 2002 Winter Olympic Games in Salt Lake City. Protests by social conservatives led to a significant scaling back of the program.

In 2003, the debate over condom distribution moved into the foreign policy realm when, as part of George W. Bush’s proposed President’s Emergency Plan for AIDS Relief (PEPFAR), Congress adopted the so-called Pitts amendment. This amendment mandates that one-third of American international AIDS relief funding be spent on abstinence-until-marriage programs that do not promote the use of condoms. While social conservatives hailed the amendment, it came under fire from public health experts who believed that condom distribution was a proven and critical tool to reduce the staggering rates of HIV infection in the developing world, especially southern Africa.

Under the direction of President George W. Bush, funding was granted to programs that encouraged abstinence until marriage rather than condom distribution and use. From 1996 through 2005, Congress committed over $1.1 billion, through both federal and state matching funds, to such programs.

Condom Distribution Today

In the absence of dedicated federal funding for comprehensive sex education in schools and in the face of mounting clinical evidence that condom education and availability programs do not contribute to increased sexual activity among adolescents, two members of Congress introduced the so-called Responsible Education about Life (REAL) Act in 2005. The bill never made it out of committee, but was reintroduced in 2007, where it again failed. If passed, REAL would have appropriated $206 million annually through 2010 to help schools implement what REAL supporters characterize as evidence-based, medically accurate, age-appropriate information on how to prevent teenage pregnancy and STDs, from both a values and public health perspective. It would have simultaneously promoted abstinence and provided information about the use of and access to contraception, including condoms.

In the autumn of 2006, California governor Arnold Schwarzenegger vetoed a bill that would have permitted not-for-profit organizations to distribute condoms to California’s 162,000 prison inmates. Opponents celebrated the veto of a measure that they believe sanctions morally objectionable sexual activity and poses a security risk wherein condoms can potentially be used to smuggle drugs into prisons. Proponents of the prison condom distribution plan pointed out that a combination of unprotected sex and intravenous drug use in American prisons, 95 percent of which have condom distribution program bans in place, has created an AIDS infection rate that is nearly five times greater among the incarcerated than among the general population.

In 2009, the Institute on Religion and Democracy spoke out against plans by the United Church of Christ (UCC) to distribute condoms program in houses of worship. The plan was supported by President Barack Obama, a prominent member of the UCC. While the previous presidential administration supported an abstinence-only approach to sexual education, President Obama has stated that he supports a comprehensive science-based, age-appropriate sexual education program for school-age children.

These essays and any opinions, information or representations contained therein are the creation of the particular author and do not necessarily reflect the opinion of EBSCO Information Services.

Bibliography

Books and Reports

National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Division of Adolescent and School Health. “HIV and Other STD Prevention and United States Students.” Atlanta: CDC, 2013. PDF file.

Periodicals

“AIDS Healthcare, Foundation. “‘International Condom Day’ 2012: AHF & Partners to Distribute over One Million Free Condoms Worldwide.” Business Wire 10 Feb. 2012: n. pag. Points of View Reference Center. Web. 16 Oct. 2015.

“All Age Groups Need More Education on Condom Use.” Practice Nurse 36.9 (2008): 6. Academic Search Premier. Web. 22 Mar. 2009.

Associated, Press. “CDC: Utah Has Fewest Students Taught about Condoms.” AP Regional State Report - Utah 13 Apr. 2012: n. pag. Points of View Reference Center. Web. 16 Oct. 2015.

Berenstein, Nadia. “Condoms = Arrest?” Ms. 1 Jan. 2010: 14. Academic Search Complete. Web. 16 Oct. 2015.

Burke, Ryan, et al. “NYC Condom Use and Satisfaction and Demand for Alternative Condom Products in New York City Sexually Transmitted Disease Clinics.” Journal of Urban Health 88.4 (2011): 749–58. Print.

Cohen, Deborah A., and Thomas A. Farley. “Social Marketing of Condoms Is Great, but We Need More Free Condoms.” Lancet 364.9428 (2004): 13–14. Academic Search Premier. Web. 19 Mar. 2009.

“Early Adolescent Abstinence Program Found to Help Delay Intercourse.” Contemporary Sexuality 44.4 (2010): 7. Academic Search Complete. Web. 16 Oct. 2015.

Frieden, Thomas R. et al. “Applying Public Health Principles to the HIV Epidemic.” New England Journal of Medicine 353 (2005): 2397–2402. Print.

Harawa, Nina. “The First Condom Machine in a US Jail: The Challenge of Harm Reduction in a Law and Order Environment.” American Journal of Public Health 100.6 (2010): 982–85. Academic Search Complete.

Hollander, Dore. “Sexual Behavior Is Safer When Students Can Get Condoms at Their Schools.” Perspectives on Sexual & Reproductive Health 35.5 (2003): 236–37. Academic Search Premier. Web. 19 Mar. 2009.

Lefkowitz, Jay P. “AIDS and the President An Inside Account.” Commentary 127.1 (2009): 24–29. Academic Search Premier. Web. 22 Mar. 2009.

Malhotra, Sheetal. “Impact of the Sexual Revolution: Consequences of Risky Sexual Behaviors.” Journal of American Physicians & Surgeons 13.3 (2008): 88–90. Academic Search Premier. Web. 20 Mar. 2009.

“Parental Veto of Condom Distribution Upheld.” Human Events 50.2 (1994): 4. Academic Search Premier. Web. 20 Mar. 2009.

Websites

Medical News Today. “Pope Benedict Speaks Out against Condom Distribution in Africa.” 19 Mar. 2009. Web. 23 Apr. 2009.

United Church of Christ. “UCC’s Health Advocates Press for Increased Condom Distribution.” 20 Mar. 2009. Web. 23 Apr. 2009.