Dr. Mark Alain Déry was at the state Capitol on May 15 waiting on "pins and needles'' for the state House Education Committee to decide on a bill requiring the teaching of sex education in Louisiana public schools. Déry, a physician specializing in HIV/AIDS at the Tulane University School of Medicine, pleaded with the panel to support the measure, testifying that most 18-year-olds with HIV that he has spoken with said they either received no sex education or abstinence-only instruction.
When the measure failed, Déry was consumed by a feeling of emptiness. "I remember walking away from the Capitol, seeing the building getting smaller, and thinking: Yeah, I guess that's it."
Two months later, Déry and two Tulane researchers released the results of a study linking abstinence-only instruction in public schools to the epidemic HIV rates among young African-Americans in Louisiana.
The study includes figures from the Louisiana Department of Health and Hospitals showing that in 2011, 73 percent of newly diagnosed HIV cases and 76 percent of newly diagnosed AIDS cases in Louisiana were among African-Americans, and that the disease is starting to affect younger and more vulnerable populations within the black community.
Louisiana currently ranks No. 1 in the country in terms of HIV incidence among young people between the ages 13 and 24, figures show. Twenty-five percent of new HIV diagnoses fall within this age category.
The study, "Reducing Sexual Health Disparities Among Adolescents: An Economics-Based Case for Sexual Health Education Reform in Louisiana and U.S. Public Schools'' was released in July at the International Aids Conference in Washington, D.C.
Although their findings are correlational, lead researcher Liana Elliot said they still demonstrate a strong association between public education, race, HIV, sexually transmitted diseases and teen pregnancy rates. Variables that did not have an effect were the number of families living in poverty, the amount of sex education grants and the state birth rate, researchers said.
To address the growing HIV epidemic among young people, the researchers propose a comprehensive sexual education model in public schools based on the Clean Water Act. Analogous to a water pump, the model features a closed-loop funding structure, where public schools have to buy a permit in order to use abstinence-only education, so that the money ultimately returns to medical facilities providing care and treatment for HIV/AIDS and teen pregnancy.
Although their study focuses on the effect of sex education, the researchers recognize that other factors that can also help lower teenage HIV and pregnancy rates include improving access to contraceptives and pregnancy kits, ensuring the availability of after-school activities, and reducing overall exposure to drugs and alcohol.
But most importantly, Elliot emphasizes the need to "recontextualize" sex as something natural that poses no danger to society. "The conversation around it needs to change," she says.
Since 1981, the government has promoted abstinence-only education programs through the Adolescent Family Life Act. U.S. Department of Health and Human Services figures show that federal funding for these programs increased from 1996 to 2006. Some of the act's most vocal detractors, like Déry, believe that the sudden outpouring of funds was politically motivated.
Spurred by the decade-long burst of funding, Louisiana was one of the 26 states in the country that stressed abstinence-only education, according to the Guttmacher Institute.
A Congress-sponsored scientific evaluation in 2007 concluded that teaching abstinence is statistically identical to teaching no sexual education at all. On the other hand, a 2010 study in the Archives of Pediatrics and Adolescent Education reported that abstinence-only interventions are effective in preventing sexual involvement among middle schoolers.
Rev. Gene Mills, executive director of the pro-abstinence Louisiana Family Forum, said there are two "irreconcilable" world views at play: one where teenage sex is inevitable, and the other where it is avoidable.
Although Louisiana mandates an abstinence-only curriculum, varying forms of sex education exist in public, private and charter schools. STD and teenage pregnancy prevention programs, like Making Proud Choices, operate in some public schools willing to challenge the state mandate. The Making Proud Choices program promotes the sexual, mental and physical wellbeing of 11- to 13-year-olds, and emphasizes parental engagement for issues around teenage sex and sexuality, according to Chana Doreaux, director of community relations.
Many private schools affiliated with the Catholic church promote an abstinence and celibacy-based curriculum which endorses human dignity, self-respect and chastity for young people, said Jan Daniel Lancaster, superintendent of Catholic Schools in New Orleans.
Charter schools have the liberty of more flexibility in their approach to sexual education than traditional public schools. While publicly funded institutions, they are still exempt from some mandates applied to public schools. Some charter schools, like Lake Area Early College Charter High School in New Orleans, are able to transcend the abstinence-only education model and promote their own form of sex education.
Derrick Lewis, a P.E. and health coach at Lake Area , makes sure that he thoroughly educates his students about every single system of the body so that by the time he gets to the reproductive organs, it seems "just like another day of going through the body," he said.
He teaches his students about sexually-transmitted diseases like HIV and promotes both abstinence and contraception. "He was cool and laid back with it," 10th-grader Kennedy Jefferson, 15, said. "He didn't want to scare us."
Meanwhile, Pat Smith, the Baton Rouge legislator who sponsored the comprehensive sex education bill that failed in the Legislature this year, still holds on to her beliefs. "All we're asking for is to provide accurate and factual information for our children so they can make the right decision," Smith said. "If they make the wrong decision, at least they can't say we didn't give them enough information."