an After abortion

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Tuesday, February 15, 2005

Some people believe with all their heart that the way to reduce abortion is to reduce unwanted pregnancies, and the way to reduce unwanted pregnancies is to provide comprehensive sexual education and free or low-cost contraception.

Reading Gays Debate Radical Steps to Curb Unsafe Sex in the New York Times should, I think, suggest the need for a more reality-based perspective on the ability of education programs to bring about positive changes in sexual behavior:

After all the thousands of AIDS deaths and all the years of "Safe Sex Is Hot Sex" prevention messages, it has come down to this: many gay men who know the rules of engagement in the age of AIDS are not using condoms. As news of a potentially virulent strain of H.I.V. settles in, gay activists and AIDS prevention workers say they are dismayed and angry that the 25-year-old battle against the disease might have to begin all over again.
A leading activist says:

Until people really believe an unstoppable virus is out there, he said, they will continue to indulge in unsafe sexual practices. "People are not going to modify their sexual habits in ways that are difficult or unpleasant until they see their friends dying again," he said. "And to me that's just an unbelievably depressing thought."
A sidebar article on
How to Get Those at Risk to Avoid Risky Sex?
documents how an extremely extensive attempt at education and behavioral modification had very limited success:

If nothing else, the AIDS case that alarmed health officials in New York last week illustrates the enormous difficulty of promoting and sustaining changes in sexual behavior, social scientists say.

A nationwide team of researchers and public health workers recently completed perhaps the most ambitious effort to reduce H.I.V. transmission rates among high-risk gay men. The Explore project, as it is known, followed 4,295 sexually active men in six American cities who were H.I.V. negative when the study started in 1999. Half the men received 10 sessions of one-on-one counseling, intended to drive home the dangers of risky sex and to provide practical strategies for avoiding it. The other half received two visits a year from a health clinic worker who discussed risk reduction.

The results, published last summer, fell short of expectations. After a year, the rate of new H.I.V. infections was 18 percent lower in the group who had counseling, and these men were about 20 percent less likely than the others to have had sex with a partner whose H.I.V. status was unknown. But after two years, the differences between the two groups vanished.

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