'Just say no' doesn't work?

US teens do not seem to be getting smarter about sex. It raises doubts about the effectiveness of 'abstinence-only' sex education, a cornerstone of the US administration's social agenda.

The prevalence of sexually-transmitted diseases among adolescent girls -- a study conducted in 2003-4 by the US Centers for Disease Control and Prevention (CDC) found that one in four teenage girls in the United States has an STD -- suggests that teens are embarking on sexual activity without the knowledge of the risks involved or how to protect themselves. It will lead to calls for a new health and educative approach.

CDC's findings should not be a source of surprise. In 2007, the Journal of the American Medical Association reported that one in four young women between the ages of 14 and 19 in the United States were infected with human papilloma virus, a necessary factor in the development of nearly all cases of cervical cancer. Nearly half of 20 to 24 year olds were carriers of the virus.  

This may mean that lawmakers will give serious consideration to proposals to vaccinate schoolgirls against HPV, a move that will be opposed by some parents on the grounds that it will encourage promiscuity. 

CDC recommends that girls and women between the ages of 11 and 26 be fully vaccinated against the virus (in the UK, all girls aged 12 and over are currently vaccinated for free and the vaccination will become standard NHS practice by 2009). The US Food and Drug Administration (FDA) has already approved Gardasil, a vaccine that protects against the four types of HPV that cause 7 out of 10 cases of cervical cancer and 9 out of 10 cases of genital warts.

From 1996 through federal fiscal year 2007, Congress committed more than $1.4 billion dollars to abstinence-only education programmes. The  New York Times says that the campaign was always driven more by ideology than sound public health policy and has had little effect on children's sexual behaviour.

Bodies such as the American Psychological Association, the American Medical Association, the National Association of School Psychologists, the American Academy of Pediatrics, and the American Public Health Association all maintain that sex education needs to be comprehensive to be effective.

This suggests that the Responsible Education About Life Act, a bill to provide funding for programmes which include information about both abstinence and contraception and condoms introduced in the Senate and the House of Representatives a year ago, could be a more effective way to protect the health US teens.