Student Opinions of Condom Distribution at a Denver, Colorado, High School

Article excerpt

Sexually transmitted diseases (STDs) and HIV are serious potential consequences of unprotected intercourse among sexually active adolescents. Distribution of condoms in schools has been recommended as a potential method of preventing STDs, HIV, and unintended pregnancy for sexually active teen-agers. One in four adolescents contracts a STD while in high school[1] and 86% of all STDs occur among adolescents and young adults ages 1529.[2] Prevalence studies show that between 8% and 40% of teen-age females have chlamydia,[3] and between 15% and 38% of sexually active urban teens have human papilloma virus.[4, 5] The gonorrhea infection rate has increased 170% between 1960-1988 among those ages 15-19, while it has decreased in almost all other age groups.[3, 6, 7] Syphilis among adolescents decreased until the past few years when the incidence exploded by 46% to 16.6 per 100,000 adolescents, the highest percentage in 40 years.[8] Adolescents may be predisposed to contracting STDs as is suggested by the findings that both pelvic inflammatory disease and infection with chlamydia are more prevalent in teen-agers than in older populations with similar exposure to STDs.[3, 9]

The most worrisome STD statistic is the increasing rate of HIV. Although only 691 AIDS cases had been identified in 1991 among teen-agers (ages 13-19),[10] between 1990-1992, the Centers for Disease Control and Prevention reported a 77% increase in AIDS cases among those ages 13-24.[11] AIDS cases in 1992 among adults ages 20-29 (totaling 39,849) accounted for 20% of the total AIDS population.[11] Although few published studies address HIV prevalence in the high school population, among 16,800 college students ages 18-24 from 19 different universities, 0.8 per 1,000 presently are HIV seropositive.[12] Among 1.1 million military applicants younger than age 20, 0.34 per 1,000 are HIV seropositive.[13] Among 137,200 Job Corps applicants ages 16-21, 3.6 per 1,000 are seropositive.[14] All three studies demonstrated an increased incidence of seropositivity among older individuals, males, and origination from the northeastern United States.

Since the median incubation period of HIV prior to clinical AIDS is 11 years, it is likely that initial infection occurs during adolescence.[15] Sixty-five percent of those ages 13-19 with HIV became infected by sexual intercourse or intravenous drug use.[15] An even greater prevalence of HIV exists among high-risk groups, such as runaway teen-agers. In one teen-age runaway shelter in New York City, 5% of teens were diagnosed with HIV.[16] Notably, another study showed that being HIV seropositive does not always diminish subsequent unprotected sexual activity. This study found that 41% of females and 33% of males acquired a new STD after HIV was diagnosed.[17] Yet, if used consistently, condoms have been found to be a reliable barrier in preventing HIV transmission.[18]

Most teen-agers (75% to 86%) have their first sexual intercourse between ages 15-20.[19,20] Of high school students, 39.6% in ninth grade, 47.6% in 10th grade, 57.3% in 11th grade, and 71.9% in 12th grade claim they have had sexual intercourse.[21] In a sample of impoverished urban minority youth, 80% of those age 15 and 12% of those age nine are sexually active.[22] Among all sexually active teen-agers, 31% of students never use condoms during sexual activity, and only 37% use condoms all the time,[23] while 21% of females ages 15-19 use no method of contraception.[24]

SURVEY ADMINISTRATION

In October 1992, a survey was conducted in a Denver, Colorado, urban high school to assess students' attitudes toward condom distribution in schools (Figure 1). Seventy-five percent of the high school's 1,330 students simultaneously and anonymously completed the survey during a homeroom class. The multiple-choice questionnaire asked whether the student did or did not want condoms distributed at the school, what their reasons were for supporting or opposing condom distribution, and how they thought distribution would change the frequency of sexual activity. …