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What's different now? The '90s presented a mixed picture of teen sexual health. There was a solid 20% decline in the teen birth rate, and according to a CDC report released last week, sexual activity decreased 15%. But the incidence of certain sexually transmitted diseases rose among adolescents. A quarter of all new HIV cases today occur in those ages 21 and younger. And doctors are reporting more frequent diagnoses of herpes and the human papillomavirus, or HPV, which is linked to cervical cancer and is thought to infect more than 15% of sexually active teens. The last figure is the one gnawing at some doctors. Though the particulars of HPV remain something of a medical mystery, we have learned at least one frightening thing about the disease: HPV is spread through skin-to-skin contact of genitals and their surrounding areas, so condoms do not always protect against it. Which means, as Sulak is fond of saying, there is no such thing as safe sex.
That Sulak should be leading this charge is a little surprising. She is a highly respected contraceptive expert who has devoted the past decade to researching the birth-control pill. She came to her latest cause seven years ago when she was asked to help choose a sex-ed program for her son's middle school. The curriculums she examined were steeped in ideology and medical errors. So she designed one, drawing extensively on data from the National Institutes of Health and the CDC. "All we've done is state facts," she says, "and you can't argue with facts."
But the way those facts are framed is drawing fire from both sides. Some hard-line conservatives, who see sex ed as the one culture war in which they have had consistent successes, contend Sulak doesn't do enough to promote the sanctity of marriage, a condition of receiving federal abstinence funding. Nor are they particularly pleased by the prospect of young children spending part of their school days looking at cervixes. Says Leslee Unruh, president of the National Abstinence Clearinghouse: "I've raised five abstinent children without showing one of them diseased genitals."
For their part, advocates of comprehensive sex ed worry about sins of omission. Worth the Wait is silent on masturbation and homosexuality and, in keeping with federal guidelines, mentions condoms only to point out their myriad imperfections. "Manipulating facts about condoms is using a scare tactic to try and get kids not to be sexually active," says Tamara Kreinin, president of the Sexuality Information and Education Council of the U.S. "And the fact that physicians are now doing this gives it an added level of credibility." Dr. David Kaplan, a professor of pediatrics at the University of Colorado School of Medicine, shares her concern: "It's infuriating not to give kids information so that they can protect themselves."