From: dgp@atlas.wustl.edu (Don Porter)
Subject: Re: Passing out Condoms  (Was Re: Better Off Than Four Years Ago NOT)
Organization: Washington University, St. Louis Mo.
Date: Tue, 25 Aug 1992 18:42:59 GMT

<BtJpp8.MKM@apollo.hp.com> (Peter Nelson) writes:
>  ... nature does not provide a built-in incentive
>  to stick a needle in your arm (i.e., it doesn't come naturally) but
>  sex is another matter.   I'm not objecting to a "just say no"
>  campaign; I just don't see any evidence that it works in terms
>  of pregnancy and STD's.  Whereas condoms, if used, demonstrably 
                                             ^^^^^^^^
>  reduce the risk of pregnancy and STD transmission.   

This is the key.  Handing out condoms in a classroom in itself does
not achieve safer sex.  A condom lying in a wallet does not prevent
pregnancy.  A condom blown up to be a silly party decoration does not
prevent the spread of disease.  These results of classroom condom
distribution are just a plausible as their actual use.  Just
as nature doesn't provide an inborn drive to stick a needle in your
arm, it also doesn't provide a drive to wrap latex around your penis.

<1992Aug25.143848.25921@crd.ge.com> doel@crd.ge.com writes:
>> To me, it's just common sense that if you give someone a condom &
>> tell them that it will help them avoid disease and pregnancy
>> (i.e. reduce some of the responsibilities that go with the act),
>> that they'll be more inclined to have sex because it's physically
>> pleasurable and the perceived consequenses are fewer.

Yes.  That seems to be the rational way to approach the question:
SEX -- to do it or not to do it?  This raises the question of
whether teens are rational when considering sex.  Are teens 
completely driven by their inborn drives and hormones?  Or are 
they capable of considering and weighing consequences in the
heat of passion?

This question presents a difficulty for those supporting condom
distribution.  They tend to say that teens *will* have sex.  It
is a force of nature like the hurricane which struck Florida.
Rationality and wise choices can not be counted on in the heat of 
the moment.  But if this is true, then what confidence do we have
that in the heat of the moment a teenager will perform the rational
act of putting on a condom?

An alternative to depending on rationality is to try to instill
condom use as a matter of habit.  Before you eat, wash your hands.
Before you have sex, put on a condom.  The trouble here is whether
we want the schools (government) playing such a powerful role in 
private sexual matters.  There is a difference in providing facts
and information about sex and explicitly trying to direct a
particular standard of sexual behavior, particularly when the
institution providing such direction is nominally one of "education".  
There is also the matter of real effectiveness (Did you wash your 
hands before lunch today?).

Another approach, if it is possible, is to aim at reducing the
opportunities for teens to get into the heat of passion.  This
can be accomplished through greater parent and adult supervision.
IMHO, this has been one of the greatest contributors to the 
increased rate of teen sexual activity -- increased opportunity
through increased time spent away from adult supervision (latchkey
kids, etc.).  Economic realities may severely limit how much progress
can be made on this front, though.

>  But the only useful metric here is the rate of STD's and pregnancy.

That is the useful metric in measuring the benefits to be gained,
a potential decrease in these rates.  But we must also consider how to 
measure the costs, monetary and otherwise, of programs of condom
distribution.  Then we must decide if the gains are worth the losses.

Some of these costs are:

1) The money expended providing the condoms and the distribution system.

2) A changed standard of decency regarding what is appropriate to
   discuss in a public arena with a captive audience.  As we 
   accept more and more formerly private topics into our public
   discourse, our public life is coarsened.  Why is the topic
   of candidates' marital fidelity so much in the forefront now?
   Coincidence?

3) An implicit message to teens that condoms are the only way they
   can be saved from the unhealthy effects of their own desires and
   choices -- that they are incapable of making rational, and yes moral, 
   choices to delay sex.  For some teens this just shows a lack of 
   confidence.  However, for some teens who have been raised to believe 
   sex outside of marriage is wrong, this message can even be insulting 
   and offensive.  "Would you also give me gloves so that I don't
   leave behind fingerprints when I rob my neighbor's house?"

4) An intrusion by the state (school) into matters traditionally
   overseen by the family and the church.  A creeping growth
   of the areas of our lives subject to government interference.
   This is a problem in itself, and because of the backlash against
   government and public education it creates in those who oppose
   such programs.  It endangers the sense that our public 
   institutions exist to perform our shared missions, and increases
   the sense that public institutions are weapons to be drafted
   onto one side or another of cultural conflicts.

These are real costs, and need to be considered before parading
forward with programs of dubious effectiveness.  The cost of
the status quo is also great (continued teen pregnancy and 
spread of disease) so we must do something.  But we must not
let our need to do something push us into doing just anything
without weighing the costs and reasonably expected benefits.

>  So let's say that condom use uncourages sex.  Remember that most
>  kids are already having sex by the time they reach the end of their
>  teenage years.   Say 60% of kids have sex but only 10% use condoms.
>  Then we introduce condoms and teach them how and why to use them.
>  Even if this results in 70% of the kids having sex, if 90% of those
>  use condoms you still have fewer kids having unsafe sex.

This is an important calculation.  However, it's based on "let's say"
numbers.  To perform the calculation for real, we need to know
how effective condom education and distribution is in getting
teens to *use* condoms (all the time).  I think 90% seems awful rosy.

Unfortunately, there's no reliable way to measure this.  Teens know they
should use condoms if they're going to have sex.  So if we ask them
if they are using condoms, they will tend to answer yes, whether
that's true or not.  They may even be truthful in that they've used
condoms on at least one occasion, but may not use them all the time.
Short of an intrusive bush and bedroom patrol, I don't think we can get
a reliable sense of effectiveness.

Also, the comparison above compares a condom distribution program
with the status quo.  Even if it is accurate, it only indicates
that such a program is an improvement over what we have now, not
that it is the best program to pursue.

>  Look, I'm interested in reducing teenage pregnancies and the spread
>  of STD's, not in pleasant little drawing room niceties about morality
>  and clean living.  Those things are nice but they are utopian.  

This assumes we can neatly separate human motivations into the moral
and the practical.  I think human beings are more complicated than 
that.

Besides you are certainly interested in more than just reducing
teen pregnancies and STD's.  These can be easily prevented through
a strict program of gender apartheid from ages 10 to 21.  Draconian?
Yes, but if our only concern is pregnancy and disease, it is
certainly effective.  The truth is that we have many other goals
and values.  The values of decency, privacy, and morality cited
by opponent of condom distribution programs are no more utopian
than the values of liberty and community which compel us to
oppose my absurd example.  They should not be lightly dismissed.

|   Don Porter | dgp@saturn.wustl.edu | Washington University in St Louis   |
|  "The effect of liberty to individuals is, that they may do what they     |
|   please; we ought to see what it will please them to do, before we       |
|___risk congratulations." -- Edmund Burke._________________________________|
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