Call for sexual health policy to be driven by science instead of politics

Apr 6 2004

NCSD, ASHA, and NFPRHA issued the call for science-based sexual health policy in response to today’s hearing on human papillomavirus (HPV) and cervical cancer by the House Government Reform Subcommittee on Criminal Justice, Drug Policy, and Human Resources.  HPV is a highly prevalent sexually transmitted infection that in most instances is asymptomatic and transient.  In some cases certain strains of HPV can lead to cervical cancer.  Available scientific evidence suggests that the effectiveness of condoms in preventing HPV is unknown.  However, condom use has been associated with lower rates of HPV-associated diseases, including cervical cancer.

“There are some who argue that because condoms are not 100% effective in preventing all sexually transmitted diseases, public health professionals should not encourage their use,” said Theresa Raphael, Executive Director of NCSD.  “This is the wrong message.  For those that are sexually active, condoms are the best way to reduce the risk of contracting a host of sexually transmitted diseases, including HIV.  Scaring sexually active individuals away from using condoms will not reduce the prevalence of HPV.  Instead it will put millions of Americans at risk of contracting a range of preventable STDs.”

According to a January CDC report, the best way to prevent HPV infection is to refrain from all genital contact with another individual.  The report also states that the current scientific evidence is not sufficient to recommend condoms as a primary prevention strategy for the prevention of HPV.  The report also notes, however, that there is evidence that condom use may actually reduce the risk of cervical cancer itself.  Possible explanations for the protective effect of condoms against cancer may be that condom use reduces the quantity of HPV transmitted, the likelihood of re-exposure to HPV, or the exposure to a co-factor for cervical cancer, such as chlamydia or genital herpes.

“Cervical cancer is preventable, treatable, and curable,” said James R. Allen, MD, MPH, President and CEO of ASHA.  “Since the invention of the Pap test, cervical cancer incidence has dropped by nearly 75%.  If we want to beat cervical cancer, we must focus on making sure all women have access to cervical cancer screening and follow-up care instead of turning cervical cancer into an excuse to disparage condoms.”

Undermining public confidence in condoms jeopardizes public health.  A new study presented at the National STD Prevention Conference shows that of 12,000 adolescents that took virginity pledges, nearly 9 out of 10 had sex before marriage.  More importantly, the study shows that even though adolescents who took virginity pledges tended to have fewer sexual partners than those who did not vow to remain abstinent, both groups had nearly the same rate of STDs.  Researchers found that this was due in part to the “pledgers’” failure to use condoms once they did become sexually active.

“What this proves is what we have known for some time – that adolescents need to be encouraged to remain abstinent, but they also need to know how to protect themselves when they do eventually have sex,” said NFPRHA President and CEO Judith M. DeSarno.  “These messages are not mutually exclusive.  If we want to protect young people, we need to prepare them by giving them the facts about contraception and STD prevention.  Withholding information or providing biased information that reflects a given moral or political agenda does not allow young people to make informed choices.”

NCSD represents the directors of public health sexually transmitted disease prevention programs in states, large cities/counties and territories of the United States, and advocates for effective policies, strategies, and sufficient resources to fight the spread of sexually transmitted diseases.

ASHA has been dedicated to improving the health of individuals, families, and communities, with a focus on preventing sexually transmitted diseases and their harmful consequences since 1914.

NFPRHA, founded in 1971, is a non-profit membership organization established to assure access to voluntary, comprehensive and culturally sensitive family planning and reproductive health care services and to support reproductive freedom for all. NFPRHA advocates on behalf of Title X family planning agencies that serve more than 4 million women in over 4,600 clinics across the United States.