Youth Actions Seen Unchanged By AIDS Scare
WASHINGTON--Young people know more about acquired immune deficiency syndrome as a result of AIDS-education efforts, a new federal report says, but few seem to be using that information to change behavior that puts them at risk of contracting the disease.
The report, "How Effective is AIDS Education?,'' examines programs targeted at both the general population and specific high-risk groups, such as young people, homosexuals, and intravenous-drug users. It was produced by the Office of Technology Assessment, a bipartisan research arm of the Congress.
"As about one-fifth of all people with AIDS are in their 20's, many are likely to have contracted the disease as teen-agers,'' the report says. But "few students reporting sexual activity appear to be changing their sexual behavior because of the threat of AIDS, and of those who are, few have implemented effective changes.''
Homosexuals and intravenous-drug users, in contrast, are responding to separate educational efforts aimed at them and are adopting safer behaviors, according to the report.
The authors said they based their conclusions about AIDS and young people on published surveys on teen-age sex and drug behaviors and on "a handful'' of evaluations of school-based AIDS-education programs.
They also drew on a much larger body of research on sexuality education in the nation's schools because they said those programs have a similar goal: convincing students to delay intercourse, reduce the number of sexual partners they have, and use birth control, such as condoms.
The lessons to be learned from school-based, sex-education programs are often discouraging, the report notes.
"Sexuality education increases factual knowledge about sexuality and sexually transmitted disease but has little measurable impact on attitudes,'' it says. The programs also have not persuaded young people to delay intercourse or engage in sexual activity less often, according to the report.
One difficulty in attempting to gauge the effectiveness of school-based AIDS education in a more direct manner, the authors note, has been that most evaluations of those programs focus only on changes in students' knowledge and attitudes--and not on their behaviors.
"I think there would perhaps be quite a bit of sensitivity toward gathering information on sexual behavior in schools,'' said Maria Hewitt, an analyst who worked on that section of the report.
In addition, noted Jane Sisk, the OTA study's director, student surveys are not always reliable because "people tend to respond the way they think others want them to.''
She said that kind of research is particularly lacking for minority youth, young male homosexuals, and young people, such as runaways, who do not attend school--groups that are statistically at greater risk of contracting the disease.
Speaking at a Senate hearing on AIDS education last week, Ms. Sisk and researchers from the General Accounting Office called for more comprehensive research on "what works'' in AIDS education.
The June 8 hearing, held by the Senate Subcommittee on Governmental Affairs, was intended as a progress report on AIDS education. It also featured testimony on a controversial federal amendment that some charge has had a "chilling effect'' on the development of AIDS-education materials.
The so-called Helms amendment, named after its sponsor, Senator Jesse Helms, Republican of North Carolina, bars the federal Centers for Disease Control from funding programs "that directly or indirectly'' promote homosexual activities or fail to emphasize the value of abstaining from nonmarital sex and illegal-drug use. It was attached to an appropriations bill passed by the Congress earlier this year.
Legislators sought to soften the amendment's impact in conference committee by stipulating that the measure did not "prohibit descriptions of methods to reduce risk of HIV (human immunodeficiency virus) transmission.''
Even so, local health officials and representatives of community groups involved in AIDS education testified that the amendment had inhibited their ability to reach some of their target populations, particularly homosexuals and drug users.
Senator John Glenn, an Ohio Democrat and chairman of the subcommittee that held last week's hearing, said health officials in five cities and states told his office that the new law had had an "actual or potential limiting effect'' on their efforts to prevent the spread of AIDS.
He said those five jurisdictions--Alabama, Connecticut, New Mexico, Washington, New York City, and San Francisco--were among 26 states and cities that had responded so far to a survey on that question being conducted by his office. Most jurisdictions reported no effect.
The law's impact on school programs has been less pronounced, some officials said last week.
"It frightens people who are out in the states because they feel they must be very careful,'' Katherine Fraser, the coordinator of AIDS-education efforts for the National Association of State Boards of Education said in an interview. "But I don't know of any specific instances where that has occurred.''