FAMILY RESEARCH REPORT	Journal of the Family Research Institute Founded 1982
Condoms for Africa			Vol. 16 No. 6 Oct 2001

Are the solutions to all man’s problems to be found in the rubber-tree plant? In America, gays tout their ability to continue practicing anal sex as long as they use a condom to make it ‘safer.’ After all, U.S. Surgeon General C. Everitt Koop gave the ‘OK’ years ago. The Centers for Disease Control (CDC) has likewise turned to the condom as ‘the answer’ to adolescent sexuality. Condoms, the CDC has said, not only inhibit pregnancies, but also lower sexually transmitted disease (STD) rates, including HIV, gonorrhea, syphilis, etc. Of course, as it turns out, a number of the herpes viruses are not significantly inhibited by condoms, and a fair number of other STDs still ‘get around’ even with the use of condoms.

Nevertheless, it is no surprise that condoms have been recommended as an international problem-solver. This includes Africa, where much emphasis has been placed on ‘getting condoms there and getting the natives to use them.’

Researchers put this condom wisdom to work in Kenya, Africa.

Six matched pairs of tea, coffee and flower plantations were selected. In one of each pair an information and motivation campaign was launched about sexually transmitted diseases and the efficacy of condoms. All of this should sound familiar; it is, after all, ‘the way it’s done’ in the civilized nations of the West.

The control plantations were given male condoms and some information. The experimental plantations were given unlimited female and male condoms and even more information. Overall, about 960 subjects in each set of plantations participated in this fairly decent study.

After a year, a final assessment was made.

When the program started, sexually transmitted diseases were present in 23.9% of the subjects. Rates like this are close to, but probably a tad higher, than those seen in U.S. prostitutes or homosexuals. At the sixth month assessment, 17.4% of the control and 16.5% of the experimental subjects had an STD. There was no difference between the two groups in a statistically-significant sense.

At the twelfth month assessment, 18.5% of the control and 18.3% of the experimental subjects had an STD. Again, no difference of any consequence. However, during the course of the study, there were significant minorities - about a fifth of men and about 10% of women - who reported always using either their male or female condom for sex. So at least some people were always using condoms, and there was limited evidence that this use had resulted in an overall decline in STDs.

Conclusions?

Clearly, not too many plantation workers could be ‘scared’ or ‘educated’ into always using condoms. Most people would not go to the trouble. They wanted sex, and they didn’t want to fool around with condoms first.

Secondly, while there was a small decrease in the STD rates from baseline (23.9%) to completion of the 12 month study (18.4%), there was also a sense of diminishing returns. The condom message seemed to ‘work’ somewhat for a while, but then it started to ‘wear out.’ This ‘law of diminishing returns’ seems to be the repeated experience of condom campaigns. Some individuals wear condoms religiously, but they are the exception. Most try them or try them for a while, but then just chuck them. Sex with condoms is simply not as much fun as sex without. After all, it is a bit off-putting to have to gear-up for each sexual encounter; and it certainly isn’t ‘natural’ to have to ‘rubber up.’

On the other hand, the program of dispensing condoms did not result in the STD rate going up. Perhaps the condoms helped to keep sexually transmitted diseases in check.

Reported condom use in the U.S. has generally increased. Unfortunately, blacks report the highest rates of condom use in the U.S., but still continue to have the highest rate of STDs among the racial groups. There has also been a slight decline in STD rates in the U.S. in the near past, but an increase over the past two years. Whether this increase is due to ‘condom education’ is not completely clear. It could just be a secular trend; such trends both upward and downward often occur without any obvious explanation.

What is called ‘abstinence education’ has a decent track record in the shorter run, but what its long-term success rate will be remains to be seen. The results so far indicate that a minority of teens delay their sexual debut for a year or two and sometimes longer if they are subjected to the ‘abstinence’ message. That, of course, impacts to some degree the average age of sexual debut of the cohort to which these teens belong.

But nothing being done today holds a candle to our former societal-wide agreement that sex ‘belongs in marriage’ - that sex out of marriage is wrong, and that those discovered to be fornicators or adulterers should be made social outcasts.

Through the 1950s, that social agreement produced remarkable results. As near as we can tell, the average age of loss of virginity through the 1950s was in the late-teens for boys, and perhaps the very late teens or early twenties for girls. FRI suspects that in a modern society ‘that’s about as good as it gets.’

Today, inundated with all kinds of sexual stimulation, sex education, condom education, and a policy of nondiscrimination against those who engage in sex outside of marriage, the average age of loss of virginity has dropped to the mid-teens for boys and later teens for girls. All in all, about a 3 or 4 year decrease between the 1950s and 2000. That decrease has brought with it many more pregnancies, abortions, and, of course, STDs.

Condom education has not been shown to be particularly effective at slowing - much less stopping - the spread of STDs. Pushing condoms as the solution to ‘Africa’s problems’ may make our elite feel better about having tried to ‘do something.’ But the empirical evidence - done on the ground in real time in Kenya - suggests that condom education does not have much to offer Africa.

Reference:
Feldblum PJ, Kuyoh MA, Bwayo JJ, et al. Female condom introduction and sexually transmitted infection prevalence: results of a community intervention trial in Kenya. AIDS, 2001, 15, 1037-1044.

In almost any large organization, the left hand often doesn’t know what the right hand is doing. No different with the federal government. Consider the following documents, all recently issued by the Centers for Disease Control (CDC).

In Health, United States, 2001 the government is back again trying to make the population “safer and healthier.” So what things should be studied and what kinds of things does the CDC feel it should do? Topping the list is smoking. A bad thing to do, to be sure. And those who live in rural areas are more apt to smoke. So what is to be done about this fact? Or the fact that murder is about seven times higher in central urban areas than in rural areas? Do these two factors ‘cancel each other out?’ We can’t be sure.

There is more poverty in central urban areas than elsewhere. Also the birth rate to teenagers is highest there (although the birth rates to teenagers in rural areas are almost as high). But the number of dentists and M.D.s per thousand people is least in rural areas. And the same is true for drug and alcohol treatment centers.

While motor vehicle deaths have declined, they still account for over 40,000 deaths per year - with relatively few deaths in the poorer and less automobile-populated city centers.

As one might expect, the ‘usual suspects’ are all here. But the pattern of successes is growing. Cancer rates are down. Heart disease rates are down. Stroke rates are down. Even unintentional injuries that result in death are down. In short, the health of the average citizen has mostly gone up over the past decade.

Unfortunately, more kids are being born out of wedlock. Yet Health, United States 2001 says nothing about the health effects of this fact. Indeed, the social decay associated with ill-health was largely ignored by Health, United States 2001. And it isn’t clear just what the assembled facts mean. That is, what is the government supposed to do about these facts?

You might think the CDC would want to strengthen and encourage the institution of marriage. Especially when you consider the following excerpts from another of its publications, First Marriage Dissolution, Divorce, and Remarriage: United States [Advance Data, #323]:

“Marriage is associated with a variety of positive outcomes, and dissolution of marriage is associated with negative outcomes for men, women, and their children.... Compared with unmarried people, married men and women tend to have lower mortality, less risky behavior, more monitoring of health, more compliance with medical regimens, higher sexual frequency, more satisfaction with their sexual lives, more financial savings, and higher wages.... A lower mortality risk among those who are married has been shown to persist even after health in early adulthood was controlled. This suggests that at least part of the benefit of marriage is not the result of selection [of healthier people].”

“Compared with married individuals, divorcees exhibit lower levels of psychological well-being, more health problems and greater risk of mortality, more social isolation, less satisfying sex lives, more negative life events, greater levels of depression and alcohol use, and lower levels of happiness and self-acceptance.”

“Adverse outcomes accrue to children of divorce and children raised in single-parent families. Although not all single-parent families are the result of divorce and not all divorced mothers remain single, virtually all children of divorce spend some time in a single-parent household until the mother remarries. Even when the mother does remarry, studies suggest that children in stepfamilies are similar to children in single-parent families; both groups of children do worse than children living with two parents in terms of academic achievement, depression, and behavior problems such as drug and alcohol abuse, premarital sexual intercourse, and being arrested.”

“Compared with two-parent families, single-parent families demonstrate lower levels of parental involvement in school activities and lower student achievement. Children raised in single-parent families are more likely to drop out of high school, have lower grades and attendance while in school, and are less likely to attend and graduate from college than children raised in two-parent families. They are more likely to be out of school and unemployed and are more likely to become single parents than children raised in two-parent families. Studies have found that compared with children in two-parent families, children of divorce score lower on measures of self-concept, social competence, conduct, psychological adjustment, and long-term health.”

What an amazing and refreshing contrast to the priorities of Health, United States, 2001. Well… almost. When answering the obvious question of what should be done, First Marriage Dissolution, Divorce, and Remarriage: United States suggests that “The positive health benefits of marriage and the negative consequences of divorce illustrate the importance of...”

All right, how would you finish the sentence? ‘Supporting marriage and discouraging divorce?’ How about ‘a war on divorce’, like our ‘war on smoking?’

Not even close! The CDC ends the sentence with “examining trends and differentials in the patterns of marriage and divorce over time.” We know all these good things about marriage and all these bad things about divorce - so let’s study them more!

Which leads us to the third CDC publication, Births to Teenagers in the United States, 1940 - 2000. [National Vital Statistics Reports, 49, #10]

Births to Teenagers is just about as cheery as a government publication gets. It asserts that “teenage childbearing has been on a long-term decline in the United States since the late 1950s, except for a brief, but steep, upward climb in the late 1980s through 1992. The declining teenage birth rate has had an impressive impact on the number of babies born to teenagers.” “The factors accounting for these declines include decreased sexual activity reflecting changing attitudes towards premarital sex, increase in condom use, and adoption of newly available hormonal contraception, implants, and injectables.”

Great news, eh?

Well, not as ‘great’ as it first seems. If having a mother who is a teenager is bad, per se, then a victory celebration is in order. There are many fewer teenage mothers. But there is more to the story. Certain facts are seldom referred to in Births to Teenagers, but pack a punch. Yes, it’s true that the birth rate per 1,000 women aged 15-19 yr. was 54.1 in 1940, hit a high of 96.3 in 1957, and has declined to 48.7 in 2000. Socially, however, a lot has changed and these raw figures need to be understood within those changes.

In 1940, there were 301,000 babies born to teenage mothers. But only 14% of the mothers were unmarried. That is, 86% of the babies - 259,000 of them - had a father as well as a mother. In 2000, 471,000 babies were born to teenage mothers. But only 21% of the mothers were married, so 372,000 didn’t have a legal daddy while only 99,000 did.

No sudden ‘switch’ turned on to bring about this change. The 14% of babies born to unmarried mothers turned to 16% in 1961 and steadily increased thereafter. The percentage of babies born to unmarried mothers was in the 20s in the 1960s, in the 30s in the 1970s, up to the 50s in the 1980s, and in the 70s in the 1990s.

A child is much better off being born to a married mother in her teens than an unmarried mother in her 20s or 30s. Yet the health bureaucracy chooses to ignore the importance of marriage, in favor of fretting whether kids are smoking, using contraceptives, or wearing their seatbelts!

The same institution that would have us rubberize sex is reluctant to support marriage! The CDC wants to make the world safe for those who practice homosexuality, who fornicate, or who shack-up, but only wants to ‘study marriage and divorce’ apparently lest people ‘feel bad about their sexual choices.’ The beneficial effects of marriage on children are greater than whether or not the children smoke, or skip school, or wear their seatbelts, or have access to a dentist. But the CDC wants to ‘leave moral issues alone.’ What bunk!

Much effort has been spent to get people to be aware if they are HIV infected. Does such awareness lead HIV-positive individuals to better protect their own sexual partners?

The answer is far from a simple “yes.” Indeed, knowing one’s HIV status may be associated with more, not less, risk to one’s sexual partners.

For instance, many studies have shown that “partnered” gays are more apt to be infected with HIV than those who are unpartnered. A recent study in this regard was conducted in Amsterdam. 144 homosexuals who had not been infected at the beginning of the study in 1984 but who were infected by 2000 were asked about their sexual habits. Among younger gays, “steady partners” were the source of most of the infections.1 Yet public health authorities constantly advise ‘partnering’ for gays and also testify that homosexual ‘partnerships’ are the equivalent of heterosexual marriage.

Another study casts doubt on the notion that transmission of the virus can be slowed or decreased by letting people know their HIV status.2 In this study, 206 HIV-infected men in Los Angeles were asked about their sexual practices, including to what degree they practiced sex with a condom and whether they told their partner about their HIV infection.

The sample was made up of 76% who engaged in homosexuality, and 24% who only engaged in heterosexuality. 40% were Black, 39% Hispanic, and 21% white; most had tested positive within the past 3 years, while 32% had full-blown AIDS.

The results? 50% of the homosexuals versus 59% of the heterosexuals told their sexual partner(s) that they were HIV-infected. That is, about half knew they could infect someone else and yet still had sex without warning their partner(s). Only 35 of 65 who had AIDS told their partner of the possibility of infection - that is, only 54% of AIDS sufferers declared their condition. And generally, it made no difference whether or not the subjects knew their partner’s HIV status.

Those who were ‘in love’ with their last sexual partner were more apt to tell that partner (55 of 83 [66%] did) than if the partner was a pick-up - only 52 of 123 (42%) did in this situation. Still, most of these men were not ‘in love’ with their most recent partner.
What do we glean from this study?

First, there is no evidence that knowing that one could infect someone else has any particular effect upon the sexual activities of the HIV-positive. Knowledge does not translate into ‘being kind and honest.’ Having gone to college was associated with a tad more truthfulness, but not by much: 49 of 84 (58%) with some college versus 58 of 122 (48%) without told their partner(s) they were infected. Similarly, female partners were somewhat more likely to be told (58%) than male sex partners (49%). However, ‘being in love’ was a stronger predictor of disclosure than either educational attainment or the gender of the partner.

One can of course speculate as to how many of these infected men assumed they didn’t need to tell their partners if they used condoms. About 75% of all respondents reported using a condom at their last sexual encounter. But no matter how you cut these data, it is obvious that a significant minority admitted to both not disclosing and not using condoms while engaging in sex. It would seem that no amount of education works with those of inferior character, certainly not a strategy that says ‘let’s test them anonymously so that they will know and protect their partners.’

References:
1. Davidovich et al, Increase in the share of steady partners as a source of HIV infection: a 17-year study of seroconversion among gay men. AIDS 2001, 15, 1303-1308
2. Marks G, Crepaz, N. HIV-Positive Men’s sexual practices in the context of self-disclosure of HIV status. Journal of Acquired Immune Deficiency Syndromes 2001, 27, 79-85

One of the myths of female-female sexual relations is that they are ‘safe.’ That is, it is often opined - and in the past touted by the Centers for Disease Control - that lesbian sex is safe sex and that lesbians rarely, if ever, need be concerned about sexually transmitted disease (STD). Well, such is not the case.

286 women attending a “Twin Cities Gay/Lesbian/Bisexual/Transgender Pride Festival” were asked about their kinds and numbers of sexual partners as well as whether they had ever gotten an STD1. The women ranged in age from 18 to 83 years, but only 5 (2%) were aged 55 or older. 69% of the women who responded called themselves ‘lesbians’ (a mere 24% of whom reported only having had sex with women); 17% called themselves ‘bisexual,’ and 12% called themselves ‘heterosexual.’

Overall, 21% reported having had at least one of the following STDs: HIV, hepatitus B, gonorrhea, syphilis, chlamydia, genital warts, genital herpes, trichomoniasis, or pelvic inflammatory disease. 13% of women who only reported sex with women reported having had an STD. Among those who identified themselves as ‘lesbians,’ 15% said that they had had an STD.

These figures are not all that different to what FRI reported back in 1985 concerning our nationwide sexuality study2. While we queried our respondents about a broader range of sexually transmitted conditions and did not ask about precisely the same set of STDs, the FRI study found that 11% of lesbians and bisexual women reported a history of syphilis, 9% had a history of gonorrhea, 10% had a history of genital warts, and 1% reported infection with hepatitis. Fully 31% of the homosexual women in the FRI study reported a history of at least one of 11 different STDs.

While most research - including that reported by FRI - indicates that sex between women is ‘safer,’ it is far from ‘safe.’ As the authors of this latest study note, “Women who report sexual relations only with other women do become infected with STDs.”

References:
1. Bauer GR, Welles SL. Beyond assumptions of negligible risk: sexually transmitted disease and women who have sex with women. American Journal of Public Health, 2001, 91, 1282-1286.
2. Cameron, P, Proctor, K, Coburn, W, & Forde, N. Sexual orientation and sexually transmitted disease. Nebraska Medical Journal, 1985, 70, 292-299.

Corner

The End of History??

The triumph of Americanism hit the pages of the Wall Street Journal on October 5. Francis Fukuyama, who got world-wide attention for arguing that the arrival of liberal democracy and capitalism meant that mankind had reached ‘the end of History,’ penned “history is still going our way.” Fukuyama held that “socialism, monarchy, fascism, and other types of authoritarian rule” had been discredited by history - only “liberal democracy and markets” survived, and we are the pinnacle of success.

Perhaps. But consider the three Centers for Disease Control government publications that we review in this issue of FRR. Our government and our intellectual elite regard the condomization and contraception of fornication as a major victory. By our actions and our preachment, our society has mostly let marriage ‘slide.’ As the divorce rate testifies, those who get married no longer take the institution as seriously, and our government is scrambling to let gays get married - California governor Gray Davis being but the latest example. Further, if they survive the abortion mills, an ever larger proportion of the nation’s children have no legal or residing father.

If there is a God, and He is the God of Moses and Jesus, might He not be displeased with us? Has He not said that He “hates divorce,” and that He cares for the orphan? Has He not said that he hates adultery, fornication, and homosexual activity?

America was a “liberal democracy with markets” in 1940. Was the U.S. at ‘the end of history’ at that time? Marriage was very big in 1940. Fornication obviously happened, but at a much lower rate. Almost every one of the nation’s children had a daddy. Few of our children were lost to abortion. And homosexual activity was illegal - everywhere.

On the TV opinion shows, O’Reilly has opined that we ought to ‘bomb Afghanistan to rubble.’ Regardless of those who are innocent there, by golly, we lost Americans on September 11, and ‘people pretty much get the government they deserve.’ A few days later Chris Matthews registered shock that the Taliban didn’t want women to work and ‘didn’t accept gays’ and therefore, obviously, deserved to die.

Are we - today - the end of history? Or were our fathers and mothers of the 1940s? Then, among other differences, almost all children had a daddy, the U.S. didn’t accept homosexuals (indeed, gay was a happy term), and many women regarded motherhood and the role of a housewife as a noble calling.

It is always tempting to think that our generation - the one alive now, with our present government - is “it.” But there are so many cultural differences between the U.S. of the 1940s and the same country in the 1990s, it would not seem likely that both could be “the end of history.” Technological progress cannot be undone, but the cultural substratum of societies can change for the better or the worse.

The World War II battle of Midway, where U.S. forces soundly defeated a well-prepared Japanese fleet, seems almost a miracle. The Japanese did almost everything wrong and our side did almost everything right. Coincidentally, at the time, for a modern society, the U.S. was about as ‘obedient to the law of God as it practically gets.’ It would be tempting to see ‘the hand of God’ steering the course of history at Midway.

But how about September 11th? Not everything went right for the terrorists, since they lost one of 4 planes. But close to the maximal damage was wrought with the limited assets they had. And of course the U.S. is retaliating - and it should get the guys behind this act. But nowhere, except for Rev. Jerry Falwell and Pat Robertson, did I hear the possibility that our society might have been sent a message. And that repentance, as well as anger, might be in order.

As there are individual unintended consequences for sexual immorality, there may also be unintended consequences for collective sexual immorality.

Family Research Report critically examines empirical data on families, sexual social policy, AIDS, drug addiction, and homosexuality, digging behind the 'headlines' and breaking new scientific ground.

FRR is published 8 times/year by the Family Research Institute.

Dr. Paul Cameron, Publisher

Dr. Kirk Cameron, Editor

Subscriptions: $25/yr ($40 foreign)

©2001

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