In a book published this month by the Henry J. Kaiser Family Foundation, educators, researchers, and public-opinion pollsters examine the highly charged debate over the availability of condoms in public schools.
The book, Condoms in the Schools, is drawn from papers presented at a forum sponsored by the foundation in Menlo Park, Calif., last summer.
In the six papers, the authors survey the state of condom-availability in the nation’s middle and high schools, the attitudes of school and community leaders, and the research challenges these programs face.
The authors note that 68 percent of adults believe that public schools should distribute condoms, according to a Gallup poll taken last summer.
But only 8 percent of high school and middle school students are in districts that have approved condom-distribution programs, according to a 1992 survey of 299 high school officials conducted by Louis Harris and Associates.
The survey, published in the book, is said to be the first national study of condom programs to look at the debate and the approval process in public school districts.
Currently, three out of five middle and secondary school students across the United States live in districts where the issue of condom programs has “at least been broached,’' but one-third live in districts where the discussion has been minimal, according to the survey.
Condom-availability programs are concentrated in large urban areas, in the East and West, in low-income districts, and in areas with larger minority student populations, the survey says.
In a majority of the districts, condoms are dispensed beginning in the 9th grade. All the district programs require that condom distribution be supplemented by information and counseling, the report says.
Some programs are informal ones in which teachers keep condom supplies in a desk drawer, while others are formally administered by the school districts or by nurses or counselors in school-based clinics, another article notes.
Little Data on Effectiveness
The effectiveness of these programs in guarding against pregnancies and sexually transmitted diseases is more difficult to quantify, however. No research exists on whether condom programs have had an impact on teenage sexual activity, according to an article by Douglas Kirby, the director of research at E.T.R. Associates in Scotts Valley, Calif.
In part, that is because research methods are not compatible from state to state, Mr. Kirby says. In his article on research and evaluation methods, he suggests that schools begin to keep track of how many condoms are distributed, and, whenever possible, participate in studies to measure student behavior before and after condoms are made available.
He also writes that data from several smaller studies suggest that making condoms available for sale through vending machines is not an effective method. Rather, he says, providing them free of charge through “condom bowls’’ and school-based health centers “may be very effective.’'
“It appears unlikely that there are any ‘silver bullets’ that will dramatically increase condom use or decrease unprotected sex,’' Mr. Kirby writes. “But it is important to identify and evaluate, and replicate promising approaches.’'
A Hotly Debated Issue
Although “scores of local school districts’’ are implementing or considering programs to make condoms available, the issue remains a hotly debated one.
To some, offering contraception helps a sexually active population protect itself from pregnancy and disease. One million, or one in 10, teenage girls become pregnant each year, and eight in 10 teenage pregnancies are unintended, according to the Alan Guttmacher Institute, a family-planning research group.
Others object to condom-availability programs on moral grounds.
In this political climate, schools are willing to play a supporting, but not a leading, role, said Brenda Greene, who oversees AIDS-education efforts for the National School Boards Association.
“Schools cannot be expected to initiate these efforts,’' she writes in an article that recounts discussions among school board members and superintendents from rural and urban areas about their experiences with condom programs in their schools.
Ms. Greene said that educators “will not be the first to raise their hands saying ‘put condoms in schools.’'' But, she added, “If the public-health people demonstrate the needs, then the school will follow.’'
Single copies of the book are available at no charge from the Henry J. Kaiser Family Foundation, 2400 Sand Hill Rd., Menlo Park, Calif. 94025; (415) 854-9400.
