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A Decade of Denial

Select Committee on Children, Youth, and Families, House of Representatives, 102nd Congress. (1992, December 22). A Decade of Denial: Teens and AIDS in America

. (Report No. 102-1074). Washington, D.C.

OVERVIEW

(Download Decade of Denial overview as a PDF)


  • There has been a 70% increase in the number of teens with AIDS over the past two years.
  • AIDS is now the 6th leading cause of death among youth ages 15-24.
  • Over 5,000 children and young adults have died as a result of AIDS.
  • In 1991, the estimated national cost of treating HIV and AIDS was nearly $6 billion.
  • Even with no new infections, the future cost of treating the one million Americans now infected with HIV and AIDS is astronomical.
  • Less than 5% of the current federal AIDS budget goes to teenagers.

Among 19-year-olds

  • 68% of females are sexually active.
  • 25% with 6 or more partners.
  • 47% report use of condoms.
  • 86% of males are sexually active.
  • 20% with 6-10 partners.
  • 55% report use of condoms.

GENERAL STATISTICS

  • 3 million teens are infected with sexually transmitted diseases (STDs) annually.
  • In 1990, nearly two-thirds of 12 million STD cases were among persons under 25 years of age.
  • Lesions from STDs increase risk of HIV.
  • 20% of American men report homosexual experiences, implying a significant amount of anal sex among male teenagers.
  • Studies have reported 9-37% of male adolescents having had same-gender sexual experiences.
  • More than 25% of girls in New York City clinics report anal sexual experiences.
  • In 1990, 2.9% of high school seniors reported injecting steroids; 1.3% injecting heroin.
  • 3.5% reported using crack cocaine associated with unprotected sexual behavior.
  • 40% or 8 million high school juniors and seniors reported weekly alcohol consumption; 5.4 million of these binged on more than 5 drinks in a row.
  • In 1983, there were 11 reported cases of AIDS in the 13-19 year-old age group. By 1991, there were 789 reported cases.
  • In 1983, among 13-24 year-olds, there were 136 reported cases of AIDS. By 1991, there were 8,949 reported cases.
  • Thousands more teens are HIV positive.
  • Most contracting HIV in teenage years are not aware of it and do not report it until their 20s. More than half of the AIDS cases in the 13-24 year-old age group have been reported in the past 36 months.
  • Young people are now a high-risk population.
  • Sexually abused teenagers, high school dropouts, juveniles in prisons and detention centers, and homeless street kids are especially high-risk.

RECOMMENDATION OF REPORT

Notes the report, "The most effective way to prevent infection from HIV and other STDs is to abstain from sexual intercourse. For those who are engaging in sexual intercourse, however, various studies among adults have found that the correct and consistent use of latex condoms lubricated with the spermicide nonoxynol 9 provides an effective barrier to prevent transmission of STDs, including HIV." (p. 43)

According to Dr. Lloyd Kolbe, Director of the Division of Adolescent and School Health of the CDC, "Although latex condoms have reduced the risk of contracting STDs in both laboratory and clinical studies, effectiveness has varied. Several studies show 100% effectiveness for latex condoms."

The reports adds, "While the ‘typical’ failure rate of condoms as contraceptives is approximately 10-20%, condom effectiveness as a contraceptive increases with experience, and failure rates as low as 0.6% have been documented...Manufacturing defects are quite uncommon." (p. 43)

ADDITIONAL VIEWS

The committee suggests, "The first line of defense, the most effective way to prevent HIV infection, is to abstain from sexual intercourse and injecting drugs...Since abstinence is the best way for teenagers to avoid HIV infection, it is important that programs promote abstinence." The committee’s report clearly states that such programs are most effective when they are comprehensive programs providing individual attention and social skills training, including assertiveness, refusal skills, interpersonal problem solving, and decision making. These types of programs have resulted in young teens delaying the initiation of sexual activity.

"Unfortunately, we apparently have much more to learn about how to motivate older teenagers who are already sexually active to choose abstinence." (Additional views, p. 341)

CRITIQUE AND DISSENTING MINORITY VIEWS

"The Majority Report is entitled, ‘A Decade of Denial...’ " Critics wholeheartedly agree with this characterization. However, they suggest that the denial stems from those who view the problem primarily as a health problem. Skeptics of the report assert that the AIDS epidemic is a behavioral issue. The dilemma is planted in the substandard culture of values that many teens follow today:

Behavior is strongly influenced by culture. To help change behavior we need to change the messages we transmit about the appropriateness of teenage sexual activity...Currently, the cultural messages we...virtually ignore the values of self-restraint, self-control, fidelity, and respect for oneself and others. In the words of Dr. Bill Bennett, ‘cultural problems demand cultural solutions.’ One solution is abstinence-based programs. Abstinence programs go beyond the symptoms and address the root problems associated with early sexual activity.

We believe that young people today are not inherently weak, or less capable of self-restraint than young people in the past. We recognize that the culture in which they are growing up has changed. And it is this culture that needs to be recreated to keep all our teenagers healthy and capable of achieving their full potential.
—Dissenting Minority View, p. 343ff

QUESTIONS FOR REFLECTION AND DISCUSSION

  1. What affects you most about the government report on teenagers and AIDS?
  2. To what extent are young people you know aware of the risk of early and unprotected sexual intercourse? To what extent does it influence their behavior?
  3. What viewpoints are represented in this report? What theoretical and practical weaknesses do you see in each as it translates into public policy? What is lacking in the Comprehensive Proposed Programs of the Majority? How do the dissenters hope to "recreate our culture?" Which of the viewpoints, do you think, has the best chance of saving young American lives?
  4. Is it more important to save lives or to better our society? Is there a strategy that can do both?

 

IMPLICATIONS

    • The personal devastation of AIDS and its rising cost to our nation are two reasons the crisis must be addressed at all levels and from all perspectives of our society.
    • Comprehensive programs demand comprehensive understanding of the whole context of a given problem. The Dissenting Opinion must be regarded when it urges us to consider family, values, and the way our culture socializes its young people. The Majority Report must be heeded as it deals with the realities of life for teenagers without family and social support. Treating the AIDS epidemic as a public health problem does not mean that we must dismiss the cultural issues of values and sexuality. A "both/and" rather than an "either/or" approach is critical to this alarming crisis.
    • Cooperation among families, communities, schools, churches, and government is needed. Parents, teachers, youth leaders, and young people themselves must look for answers that work in a pluralistic society.
Dean Borgman cCYS