The Medical Institute for Sexual Health (a conservative abstinence advocating health group) has created an STD Wizard to help people realize which STDs they are at risk for. I applaud the idea. People way underestimate their risk for chlamydia and HPV, and the latter is extremely extremely common. The only reason why many people who have had sex test negative is because they had the virus and then cleared it.
So I was looking forward to hearing them say that. I went through their quiz, filling in age, region of country, gender, race, drug use and STD history, and some yes/no sexual activity and drug questions. Not as fun as the purity test "Have you done it in a box? Have you done it with a fox?" They don't ask lifetime number of sex partners, only whether you have recently been raped or gotten a new sex partner.
And my results were. . .
I should take an HIV test, based on the fact that I haven't had a test in the past 12 months.
A healthy woman having unprotected vaginal sex with an HIV+ person has less than a 0.1% chance of contracting HIV. On the other hand, she is more than 2 orders of magnitude more likely to contract chlamydia or HPV if she's having sex with a person with those.
They follow this by, "Note: Even though many sexually active people have herpes, testing is rarely recommended."
And then, "Fact sheets for STDs you may have:" with links to HIV/AIDS fact sheets.
Way to go with the inaccurate fear-mongering. There is plenty of risk you could talk about.
Wednesday, February 25, 2009
Thursday, February 19, 2009
Pastor calls to end virginity pledges
A Christian clergy member calls for churches to stop using abstinence pledges. Amusingly, one of his criticisms is that they are "pharisaical".
(In fact the Pharisees would not allow them: pledges have always been forbidden by rabbinic law!)
(In fact the Pharisees would not allow them: pledges have always been forbidden by rabbinic law!)
Speaking of religious kids' decisions to have sex
The Bristol Palin interview reminded me of the strange wrong number 6 months ago from the 25 year old yeshiva kid from Brooklyn thinking about having sex with his girlfriend for the first time. I wonder what happened. Did they have sex? Are they still together? Did they get engaged? They could have even gotten married by now.
Is abstinence realistic?
The liberal reactions to Bristol Palin's statement that abstinence is not realistic were expected. The religious ones haven't gotten much attention.
One evangelical site says abstinence is an obligation so not up for discussion; instead society must be made so that abstinence becomes realistic. There are certainly groups of teenagers with lower (but non-zero!) rates of sexual activity than evangelical teenagers. I'm just not sure that those models work in the evangelical context. The whole principle of evangelical Christianity going back to Paul is to have a relatively low admission price in terms of obligations, so not everyone will be as committed and so may not be as likely to change their dating habits as in religious groups where adherents also have to change their diet or dress style. One admission price is attending an evangelical school as this person notes, so norms can be more successfully perpetuated in this environment in which everyone has already made a substantial commitment to even be there. It will be interesting to see whether more evangelical groups change their culture to become more conservative and separate the sexes more.
Bristol Palin's statement comes with very good timing. Hints at the future of abstinence-only education for FY 2010 will come at the end of the month when Obama submits his budget. Separately, according to the Economist Louise Slaughter's bill for medically-accurate sex education is likely to pass.
One evangelical site says abstinence is an obligation so not up for discussion; instead society must be made so that abstinence becomes realistic. There are certainly groups of teenagers with lower (but non-zero!) rates of sexual activity than evangelical teenagers. I'm just not sure that those models work in the evangelical context. The whole principle of evangelical Christianity going back to Paul is to have a relatively low admission price in terms of obligations, so not everyone will be as committed and so may not be as likely to change their dating habits as in religious groups where adherents also have to change their diet or dress style. One admission price is attending an evangelical school as this person notes, so norms can be more successfully perpetuated in this environment in which everyone has already made a substantial commitment to even be there. It will be interesting to see whether more evangelical groups change their culture to become more conservative and separate the sexes more.
Bristol Palin's statement comes with very good timing. Hints at the future of abstinence-only education for FY 2010 will come at the end of the month when Obama submits his budget. Separately, according to the Economist Louise Slaughter's bill for medically-accurate sex education is likely to pass.
Monday, February 2, 2009
Girls and casual sex: syphilis epidemic, but no rainbow parties
I've read a few accounts lately about girls and young women in casual sexual relationships, and the same pattern emerges. These women started a behavior for adventure and experimentation, but when they decide they've had enough of the behavior they feel unable to step away from the behavior pattern due to social pressure.
Hooking Up by Katherine Bogle is about casual relationships in college. She studied two colleges: one small and religious, and one secular and larger. Freshman young women hook-up initially out of a mixture of curiosity, interest, exercising independence from earlier restrictions, and perhaps because it's what others are doing. By hooking up these college students mean anything from kissing to oral or vaginal sex, with or without alcohol, but according to their reports one time hookups are more likely to be at the less intimate end of the spectrum and alcohol is a good social excuse ("beer goggles"). Hooking up is almost always with an acquaintance or an acquaintance of an acquaintance: the closed atmosphere of a college makes women feel safe being alone with someone they just met. Within a year or two, most of the women report that they stopped being so interested in hooking up: they want a real relationship. The dynamic on campus, though, is still aimed at hooking up. The guys who are unassertive are not part of the hook-up culture at all, and they don't date much either. The guys who are assertive are part of the hook-up culture, and seem to have numbers in their favor: they can almost always find a woman willing to hook up with them, so a woman who wants to have any sexual contact and sees her dating pool as comprising such guys has the choice between hooking up or not hooking up: they do not feel that they have the option of a relationship. Some women hook up and hope for a relationship, and are inevitably disappointed. They don't talk about why they don't go for relationships with the nice guys, though probably for the clicheed reasons.
After college, the women are able to assert themselves: they are meeting people outside their comfort zone, hooking up would be with relative strangers and does not feel safe to anyone, and perhaps the men mature as well. Women can insist on real dates and relationships in this new social environment.
Bogle describes a limited time period in which women get involved in casual sex for a time, get tired of it and want real relationships, but don't feel that they have other options. These women seem to feel coerced into hook-ups: not at a level of sexual contact beyond their comfort level, but in a non-relationship context that is beyond their comfort level. After college, women find more power in the romantic arena and are able to have relationships as they want.
This reminds me of the story of the group sex in Atlanta suburbs hosted by 13-16 year old girls that led to a syphilis outbreak. This interview talks about how the girls say that they started having group sex parties partially out of boredom, and partially for similar motivations as the freshman college women reported for hook-ups: curiosity, interest, independence. After awhile, though, the girls felt that they couldn't control the situation any longer: both within an actual event and over many events. At a single event as activity escalated, girls felt unable to slow or stop the activity, especially when with multiple males simultaneously. After going to a few activities, girls felt unable to turn down future activities. The girls engaged in sexual activity with each other as a means of controlling the activity together. Reading that description, I keep thinking of some generally misogynist contexts --- women trafficked into commercial sex work, perhaps --- and have to remind myself that these are upper middle class girls in the US who are told they can become doctors and lawyers and astronauts.
The girls here clearly seem to have less control than the hook-up case because they feel out-numbered and pressured by other attendees, and are obviously less mature and less confident and below the age of consent. Nonetheless, it's interesting that there is a similar dynamic here as well: becoming involved completely willingly initially, and ending up feeling coerced or forced into sexual contact that they did not want both within a single episode and within their social context.
College graduation and syphilis, respectively, intervened, but what if they hadn't? It seems so easy for an outsider to say that a woman should just walk away from a situation she is so uncomfortable with, and yet clearly they didn't feel able to. What inner resources do women need in order to extricate themselves from an uncomfortable situation filled with social pressures? It looks so easy on Degrassi Junior High: one girl finally gets uncomfortable enough to say "Enough! This is not cool." and then everyone suddenly realizes she is right. If nothing else surely these girls have seen Degrassi Junior High or similar! Clearly it's not that easy, and eventually it sounds like the girls did stand up and stop this, maybe before the syphilis, but not after they'd been well past the point of feeling forced and out of control and like they might be traumatized for their future sexual experiences.
No answers, just questions.
Hooking Up by Katherine Bogle is about casual relationships in college. She studied two colleges: one small and religious, and one secular and larger. Freshman young women hook-up initially out of a mixture of curiosity, interest, exercising independence from earlier restrictions, and perhaps because it's what others are doing. By hooking up these college students mean anything from kissing to oral or vaginal sex, with or without alcohol, but according to their reports one time hookups are more likely to be at the less intimate end of the spectrum and alcohol is a good social excuse ("beer goggles"). Hooking up is almost always with an acquaintance or an acquaintance of an acquaintance: the closed atmosphere of a college makes women feel safe being alone with someone they just met. Within a year or two, most of the women report that they stopped being so interested in hooking up: they want a real relationship. The dynamic on campus, though, is still aimed at hooking up. The guys who are unassertive are not part of the hook-up culture at all, and they don't date much either. The guys who are assertive are part of the hook-up culture, and seem to have numbers in their favor: they can almost always find a woman willing to hook up with them, so a woman who wants to have any sexual contact and sees her dating pool as comprising such guys has the choice between hooking up or not hooking up: they do not feel that they have the option of a relationship. Some women hook up and hope for a relationship, and are inevitably disappointed. They don't talk about why they don't go for relationships with the nice guys, though probably for the clicheed reasons.
After college, the women are able to assert themselves: they are meeting people outside their comfort zone, hooking up would be with relative strangers and does not feel safe to anyone, and perhaps the men mature as well. Women can insist on real dates and relationships in this new social environment.
Bogle describes a limited time period in which women get involved in casual sex for a time, get tired of it and want real relationships, but don't feel that they have other options. These women seem to feel coerced into hook-ups: not at a level of sexual contact beyond their comfort level, but in a non-relationship context that is beyond their comfort level. After college, women find more power in the romantic arena and are able to have relationships as they want.
This reminds me of the story of the group sex in Atlanta suburbs hosted by 13-16 year old girls that led to a syphilis outbreak. This interview talks about how the girls say that they started having group sex parties partially out of boredom, and partially for similar motivations as the freshman college women reported for hook-ups: curiosity, interest, independence. After awhile, though, the girls felt that they couldn't control the situation any longer: both within an actual event and over many events. At a single event as activity escalated, girls felt unable to slow or stop the activity, especially when with multiple males simultaneously. After going to a few activities, girls felt unable to turn down future activities. The girls engaged in sexual activity with each other as a means of controlling the activity together. Reading that description, I keep thinking of some generally misogynist contexts --- women trafficked into commercial sex work, perhaps --- and have to remind myself that these are upper middle class girls in the US who are told they can become doctors and lawyers and astronauts.
The girls here clearly seem to have less control than the hook-up case because they feel out-numbered and pressured by other attendees, and are obviously less mature and less confident and below the age of consent. Nonetheless, it's interesting that there is a similar dynamic here as well: becoming involved completely willingly initially, and ending up feeling coerced or forced into sexual contact that they did not want both within a single episode and within their social context.
College graduation and syphilis, respectively, intervened, but what if they hadn't? It seems so easy for an outsider to say that a woman should just walk away from a situation she is so uncomfortable with, and yet clearly they didn't feel able to. What inner resources do women need in order to extricate themselves from an uncomfortable situation filled with social pressures? It looks so easy on Degrassi Junior High: one girl finally gets uncomfortable enough to say "Enough! This is not cool." and then everyone suddenly realizes she is right. If nothing else surely these girls have seen Degrassi Junior High or similar! Clearly it's not that easy, and eventually it sounds like the girls did stand up and stop this, maybe before the syphilis, but not after they'd been well past the point of feeling forced and out of control and like they might be traumatized for their future sexual experiences.
No answers, just questions.
Saturday, January 31, 2009
FAQ: Pediatrics paper
1. What's the connection between virginity pledges and abstinence education? All you know is that these people took pledges; they may not have been in abstinence education at all.
I looked at abstinence pledges taken in 1995 to about April 1996, at the beginning of the pledge movement. The first abstinence pledges were in 1993, True Love Waits (TLW) pledges from the Southern Baptists: a 6 hour curriculum over 6 weeks, and about half of program participants signed the pledge, according to Rev. Hester, and these numbers have not changed over the program's lifetime. School abstinence programs, the Silver Ring Thing (SRT), and other pledge programs did not exist at the time. I'm not aware of any casual virginity pledge programs from the time, but if there were, it seems unlikely that many participants would sign pledges or continue to identify with the pledges long enough to identify themselves as virginity pledgers on a survey. (Over half of the pledgers from the first two years of TLW retracted their pledge within a year after reporting it.)
2. Who's included in the study outcomes?
The same proportion of pledgers and similar non-pledgers got married five years after pledging, but because married couples are at low risk of STDs, I looked at only singles when looking at condom and birth control use. Whether or not married people use condoms and birth control has virtually no impact on public health. Married people were, however, included in every other outcome: oral and anal sex, STD test results, etc.
3. Even the non-pledgers didn't use condoms at perfect rates. Why not?
About 54% of non-pledgers used condoms "most of the time" or "always", versus 42% of non-pledgers. But there are 46% of non-pledgers who are not using condoms "most of the time." When you are dealing with entire populations, one can't expect perfection or even close to it, and yet when you move an indicator for an entire population by even a few percentage points --- increasing the proportion of people who use condoms, take statins, eat enough vegetables --- it can have an enormous impact. Looking at a range of behaviors, the proportion of people who don't make the "most beneficial" choices is really staggering, and the health and economic system just has to learn to work around these choices to encourage the best behavior. Unfortunately there just doesn't seem to be a condom equivalent of automatic enrollment in retirement plans.
4. Delaying sex is good for teens. Doesn't that mean we should have more abstinence education?
See my oped in the Baltimore Sun.
5. I have idea X for a sex education plan. Will it work?
The National Campaign to prevent teen and unplanned pregnancy has a great publication called Emerging Answers that describes sex education programs that work and lists characteristics of successful programs. It's available here.
6. The public health world says that any sex is okay as long as it involves condoms, and seems to assume that teens are "sexually incontinent" and that "chastity's relevance to contemporary culture ranks with that of buggy whips and slide rules.". Isn't teaching teens about birth control like telling them that we expect them to have sex? Shouldn't we teach higher standards?
First, I think the language is terrific: "sexually incontinent" is a punchy phrase and buggy whips and slide rules is vivid and sharp.
On the substance: Delay is clearly best. The public health world finds unequivocally that people with younger sexual initiation are at higher risk for STDs (higher risk for chlamydia and gonorrhea persists to about 17 or 18, high risk for HPV I understand persists into early 20's), less likely to use birth control, more likely to have a large age difference with their partner (sketchy and unsafe), and that two thirds of teens who have had sex say they wish they had waited. Correct and consistent use of condoms protect completely against fluid-transmitted STDs such as chlamydia, gonorrhea, and HIV, but condoms protect against contact-transmitted STDs such as HPV and herpes only to the extent that they cover.
On the other, see my oped in the Baltimore Sun.
7. The study is "liberal ideology disguised as science" (quote of head of Illinois Right to Life): it looks at 16 and 17 year old abstinence pledgers, instead of younger ones who are at the crucial ages to take pledges.
It's ironic that an abstinence proponent is irked at the subject group restrictions because many abstinence proponents are actually the ones responsible for limiting the study's ability to look at younger adolescents. My data comes from a multi-million dollar project funded by Congress, and when this study was being debated in Congress, many social conservatives objected to asking questions about their attitudes towards and knowledge about sex and birth control to adolescents ages 12-14 (e.g., "Would you feel guilty if you had sex?" and about 50 other questions). These questions are crucial factors in understanding why someone pledges, so I had to omit the 12-14 year olds since they were not asked these questions.
I also took out anyone who had had sex, so these kids at an average age of 16 had not yet had sex and few had much sexual experience at all, so the generalization that it's important to get them while they're young doesn't apply to the same extent.
8. Aren't you a liberal youth homosexuality promotion group? (The first comment.)
No.
9. Should this be the death knell for abstinence-only? Should the item be cut from the budget because
it is clearly wasteful?
Cutting the $200 million may be unnecessarily risky: redefining the program as abstinence-plus would preserve the funding. If the program were entirely cut out, it might not be replaced with effective sex ed.
10. Where does it say that programs may measure virginity pledges and don't have to be medically accurate?
From the GAO study on abstinence education.
Less than 5% of the total federal abstinence budget goes to programs required to be accurate: these come from a different funding mechanism than the program that grew so rapidly since its creation in 1996. Also, some states require the curricula to be accurate; if these states are among the 25 states still getting abstinence funding (originally all 50 were applying for this funding), they review the curricula independently.
11.
"Abstinence-only" is an unfair term: it implies that the curricula are simplistic just say no, but our program does more than that.
That's not a question. Addressing the point, though, the 8 part definition of abstinence-only education in the law requires one-sided education: by definition, abstinence programs have the exclusive purpose of showing the benefits of abstaining from sex. Abstinence programs can teach people to plan their lives and negotiate and all kinds of great personal development lessons, and that's great, but they cannot teach people the benefits of using condoms: they can only say where condoms fail. That is, they can say condoms do not protect fully against HPV and herpes (which is true). Because virtually no abstinence programs are required to be medically accurate, they can also say untrue things such as that condoms do not protect against HIV. They cannot say that correctly used condoms protect completely against chlamydia and other fluid-transmitted STDs, or teach how to use condoms correctly.
I looked at abstinence pledges taken in 1995 to about April 1996, at the beginning of the pledge movement. The first abstinence pledges were in 1993, True Love Waits (TLW) pledges from the Southern Baptists: a 6 hour curriculum over 6 weeks, and about half of program participants signed the pledge, according to Rev. Hester, and these numbers have not changed over the program's lifetime. School abstinence programs, the Silver Ring Thing (SRT), and other pledge programs did not exist at the time. I'm not aware of any casual virginity pledge programs from the time, but if there were, it seems unlikely that many participants would sign pledges or continue to identify with the pledges long enough to identify themselves as virginity pledgers on a survey. (Over half of the pledgers from the first two years of TLW retracted their pledge within a year after reporting it.)
2. Who's included in the study outcomes?
The same proportion of pledgers and similar non-pledgers got married five years after pledging, but because married couples are at low risk of STDs, I looked at only singles when looking at condom and birth control use. Whether or not married people use condoms and birth control has virtually no impact on public health. Married people were, however, included in every other outcome: oral and anal sex, STD test results, etc.
3. Even the non-pledgers didn't use condoms at perfect rates. Why not?
About 54% of non-pledgers used condoms "most of the time" or "always", versus 42% of non-pledgers. But there are 46% of non-pledgers who are not using condoms "most of the time." When you are dealing with entire populations, one can't expect perfection or even close to it, and yet when you move an indicator for an entire population by even a few percentage points --- increasing the proportion of people who use condoms, take statins, eat enough vegetables --- it can have an enormous impact. Looking at a range of behaviors, the proportion of people who don't make the "most beneficial" choices is really staggering, and the health and economic system just has to learn to work around these choices to encourage the best behavior. Unfortunately there just doesn't seem to be a condom equivalent of automatic enrollment in retirement plans.
4. Delaying sex is good for teens. Doesn't that mean we should have more abstinence education?
See my oped in the Baltimore Sun.
5. I have idea X for a sex education plan. Will it work?
The National Campaign to prevent teen and unplanned pregnancy has a great publication called Emerging Answers that describes sex education programs that work and lists characteristics of successful programs. It's available here.
6. The public health world says that any sex is okay as long as it involves condoms, and seems to assume that teens are "sexually incontinent" and that "chastity's relevance to contemporary culture ranks with that of buggy whips and slide rules.". Isn't teaching teens about birth control like telling them that we expect them to have sex? Shouldn't we teach higher standards?
First, I think the language is terrific: "sexually incontinent" is a punchy phrase and buggy whips and slide rules is vivid and sharp.
On the substance: Delay is clearly best. The public health world finds unequivocally that people with younger sexual initiation are at higher risk for STDs (higher risk for chlamydia and gonorrhea persists to about 17 or 18, high risk for HPV I understand persists into early 20's), less likely to use birth control, more likely to have a large age difference with their partner (sketchy and unsafe), and that two thirds of teens who have had sex say they wish they had waited. Correct and consistent use of condoms protect completely against fluid-transmitted STDs such as chlamydia, gonorrhea, and HIV, but condoms protect against contact-transmitted STDs such as HPV and herpes only to the extent that they cover.
On the other, see my oped in the Baltimore Sun.
7. The study is "liberal ideology disguised as science" (quote of head of Illinois Right to Life): it looks at 16 and 17 year old abstinence pledgers, instead of younger ones who are at the crucial ages to take pledges.
It's ironic that an abstinence proponent is irked at the subject group restrictions because many abstinence proponents are actually the ones responsible for limiting the study's ability to look at younger adolescents. My data comes from a multi-million dollar project funded by Congress, and when this study was being debated in Congress, many social conservatives objected to asking questions about their attitudes towards and knowledge about sex and birth control to adolescents ages 12-14 (e.g., "Would you feel guilty if you had sex?" and about 50 other questions). These questions are crucial factors in understanding why someone pledges, so I had to omit the 12-14 year olds since they were not asked these questions.
I also took out anyone who had had sex, so these kids at an average age of 16 had not yet had sex and few had much sexual experience at all, so the generalization that it's important to get them while they're young doesn't apply to the same extent.
8. Aren't you a liberal youth homosexuality promotion group? (The first comment.)
No.
9. Should this be the death knell for abstinence-only? Should the item be cut from the budget because
it is clearly wasteful?
Cutting the $200 million may be unnecessarily risky: redefining the program as abstinence-plus would preserve the funding. If the program were entirely cut out, it might not be replaced with effective sex ed.
10. Where does it say that programs may measure virginity pledges and don't have to be medically accurate?
From the GAO study on abstinence education.
Less than 5% of the total federal abstinence budget goes to programs required to be accurate: these come from a different funding mechanism than the program that grew so rapidly since its creation in 1996. Also, some states require the curricula to be accurate; if these states are among the 25 states still getting abstinence funding (originally all 50 were applying for this funding), they review the curricula independently.
11.
"Abstinence-only" is an unfair term: it implies that the curricula are simplistic just say no, but our program does more than that.
That's not a question. Addressing the point, though, the 8 part definition of abstinence-only education in the law requires one-sided education: by definition, abstinence programs have the exclusive purpose of showing the benefits of abstaining from sex. Abstinence programs can teach people to plan their lives and negotiate and all kinds of great personal development lessons, and that's great, but they cannot teach people the benefits of using condoms: they can only say where condoms fail. That is, they can say condoms do not protect fully against HPV and herpes (which is true). Because virtually no abstinence programs are required to be medically accurate, they can also say untrue things such as that condoms do not protect against HIV. They cannot say that correctly used condoms protect completely against chlamydia and other fluid-transmitted STDs, or teach how to use condoms correctly.
Tuesday, January 27, 2009
We're really not all that far apart
Dan Savage's column last week has a passage that could come straight out of a standard abstinence-plus sex education curriculum, with a few word substitutions.
What's particularly funny is the last paragraph with scare quotes around "prevention", seeming to insinuate that some materials intended to promote prevention set norms of earlier sex, precisely the motivation for abstinence-only proponents. Maybe some materials don't stress that restraint is the first choice, as is true for comprehensive/abstinence-plus curricula. If they don't, they should.
We are really not all that far apart. Nearly everyone thinks adolescents just coming to dating should take it slowly, protect their hearts and their health, and wait for a committed relationship. People differ on what constitutes a committed relationship, but irrespective of whether that line is at marriage or a committed relationship (whatever that means), it's the same skills.
Look, JON, any faggot who wants to fuck you in the ass without a condom is the LAST PERSON ON EARTH you should be having sex with—anal or otherwise, condoms or no condoms. Guys who pressure you into having sex without condoms are having or have had unsafe sex with other people, which means that they're either infected already or will be shortly. If you don't want to get infected, your best course of action when a guy pressures you into having sex without condoms—or any kind of sex you're not comfortable with—is to pull up your pants and leave.
And since you're not particularly interested in anal sex right now, JON, I'd urge you to tell the guys you do go home with that you're just not up for getting fucked. An aversion to anal sex when you're young and just out and easily manipulated is something you should hold on to, JON, even cultivate. Skipping anal sex during your great-big-slut, just-coming-out, making-your-mistakes phase will greatly reduce your risk of contracting HIV and a host of other STIs. Then one day, with luck, you'll meet a nice, decent guy, also hot, who wants to take things slow—a guy who isn't a manipulative, selfish, barebacking piece of shit. And when you meet that guy, JON, you can explore anal with someone who cares about you enough to take it slow and wear condoms.
Anal sex, despite the impression created by HIV "prevention" materials you may have encountered, should not be a first-date activity. Reserve your asshole for guys you're serious about, JON, and for guys who are serious about you. The hot motherfucker you're seeing right now isn't worthy. Walk away.
What's particularly funny is the last paragraph with scare quotes around "prevention", seeming to insinuate that some materials intended to promote prevention set norms of earlier sex, precisely the motivation for abstinence-only proponents. Maybe some materials don't stress that restraint is the first choice, as is true for comprehensive/abstinence-plus curricula. If they don't, they should.
We are really not all that far apart. Nearly everyone thinks adolescents just coming to dating should take it slowly, protect their hearts and their health, and wait for a committed relationship. People differ on what constitutes a committed relationship, but irrespective of whether that line is at marriage or a committed relationship (whatever that means), it's the same skills.
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