Helping the Young to Be Sexually Responsible

“We’re in the worst place in the cycle,” Judith Senderowitz said of teen-agers, their sexuality and American culture. “We allow images and influences about sex, but bringing in talk of responsibility is taboo to many people.”

Senderowitz is executive director of the Washington-based Center for Population Options, a nonprofit organization that seeks to prevent pregnancy and sexually transmitted disease among teen-agers.

She was in town last week for a two-day conference on teen-agers and AIDS, staged by CPO at the Universal Sheraton. She also met with staff of the organization’s Studio City office, which works to have sexual issues treated frankly by the entertainment industry.

Senderowitz said in an interview that the threat of AIDS among adolescents is much greater than the public thinks. This is because teen-agers generally do not take the precautions that, with the blitz of information on AIDS, have gained acceptance among older people.

The CPO funded a study of AIDS attitudes in three East Coast groups of teen-agers, two made up of high school students and the third of dropouts. Senderowitz said the dropouts were largely unaware of the AIDS epidemic, and the two educated groups “were very negative on condom use or abstinence even though they knew the risks.”

At the end of February, the U.S. Public Health Service reported that only 352 of the nation’s 88,096 cases of AIDS were among teen-agers. But Senderowitz and others point out that the disease’s latency period, once thought to be just a few years, now is estimated at five to 10 years. With people in their 20s accounting for 21% of AIDS cases, it is evident that many contract the human immunodeficiency virus in their teens.

Dr. Karen Hein, head of the adolescent AIDS program at Albert Einstein College of Medicine in New York, said 14% of the 16- to 19-year-olds who were admitted last year to a New York shelter tested positive for the HIV virus.

Hein was opening speaker of the conference, attended by about 350 people from youth-service agencies. About one-third were from California.

She told the audience that the rate is high because many of the teen-agers tested were runaways who have worked as prostitutes or been intravenous drug users. But Hein said that fact is no comfort for the mainstream population, because runaways often rejoin their families or find stable lives elsewhere. They then can serve as a conduit to adolescents who otherwise would not be exposed.

Hein drew a few gasps by saying that discovering a cure for AIDS will not free the adolescent population from the disease.

“Having a cure won’t make any difference,” she said. “We have cures for syphilis and gonorrhea, but they’re still rampant among teens.”

Behavior Change

Unless teen-agers change their sexual behavior, she said, AIDS will become a permanent, even if treatable, threat in the age group.

She and others believe that a feeling of invincibility and immortality common to young people makes them lack caution. Because of the long HIV latency period, they do not see friends or acquaintences becoming sick. Meanwhile, they are discovering their sexuality and are apt to experiment.

Wanda Wigfall-Williams, head of CPO’s anti-AIDS programs, said in an interview: “It is quite common to have same-sex partners when you’re young, although we don’t talk about it. Many of these people don’t end up being homosexual.”

Hein said that more than one-fourth of the teen-agers seen at an adolescent clinic in New York reported having had anal intercourse. Some had been male prostitutes; some said they were experimenting; some females said they were practicing birth control.

Risk to Females

Hein said that teen-age women are significantly at risk from AIDS.

“The epidemic of heterosexual transmission that everyone said won’t happen is happening in adolescent women,” she said.

While 9% of the adults with AIDS are female, among adolescents with AIDS the figure is 18%. This, researchers believe, is because condom use among teen-agers is very low. The CPO says that among sexually active women 15 to 19, only one-fourth use contraception regularly, and only one-fifth of those choose condoms as their birth control method.

Senderowitz said she remembers reading a newspaper interview with two 16-year- old fathers.

“They weren’t fathers by choice,” she said. “They’d much rather it hadn’t happened. The interviewer asked why they hadn’t used condoms and each of them said, ‘Because she wasn’t that kind of girl.’ ”

The boys meant that pulling out a condom would be like pulling out pornography--something you don’t do with a nice girl. In a culture that loves to depict sex, this sort of attitude brings about high rates of teen-age pregnancy and venereal disease, she said.

A reason for the attitude, Senderowitz said, is widespread repression in families of talk about sexuality. She cited results of surveys done at high school medical clinics.

“When kids rank what they want to learn about, it’s always contraception, homosexuality, masturbation and abortion--the very things they can’t talk about.”

CPO prepares curricula for use by high schools, health clinics and youth-service agencies. One of them calls for students to go to a store and purchase condoms. It also has them act out a scene of “negotiating sex,” where a girl tells a boy she will have sex only if he uses protection. The curriculum is in use across the country, including Pasadena and Los Angeles, officials said, although users may omit portions of it if they wish.

“Being able to talk about the problem gives them more power,” Senderowitz said. “If a young woman has talked about sex, she has more power to say, ‘If you don’t have a condom I’m not interested.’ But if she’s never used the word ‘condom,’ she’s not going to say it.”

Hein believes that parents should encourage their children to pursue activities other than intercourse. “Let us promote outercourse, those activities without risk: touching, being touched, masturbation, massages,” she said.

The CPO is a great believer in the power of media to influence sexual behavior. The group’s Studio City office, called the media project, works to have sexual issues depicted frankly, especially on television. Ironically, the AIDS crisis has helped, said media director Marlene Goland.

“This past season almost every prime-time show has dealt with these issues in a positive way,” she said.

Reviews Scripts

Goland’s office reviews scripts for producers and writers, suggests story ideas, holds educational conferences and hands out the annual Nancy Susan Reynolds Awards for sexually responsible programming. Winners last year were “Cagney and Lacey,” “Designing Women,” “An Enemy Among Us” and “The Wonder Years.”

“Kids model after characters and images they see on television,” Goland said. “There are mixed messages going out to teens on sex. They’re told it’s exciting and very attractive, yet there is a puritanical attitude about discussing sexual responsibility.”

“Roe vs. Wade,” the NBC movie that aired Monday about the landmark abortion case, is the sort of program CPO applauds. But with anti-abortion groups very much in the public eye, potential sponsors backed away from the show and NBC had a hard time selling advertising.

‘Climate of Fear’

Goland said a “climate of fear” is growing among advertisers about sexual themes, and that CPO probably will “put together educational programs for sponsors, to let them know that the general public doesn’t object to this kind of programming, and in fact wants to see it.”

The Center for Population Options was formed in 1980 to combat teen-age pregnancy and has seen its mission grow to include other adolescent health concerns. Officials said it evolved from a group called the Population Institute, which combatted overpopulation internationally. The CPO has 30 employees and an annual budget of $2.3 million, nearly all of it coming from foundations.