AMA House of Delegates

AMA meeting: Comprehensive sex ed said to have most impact

A report says abstinence should be one part -- but not the only one -- of teaching kids about sexual activity.

By — Posted June 29, 2009

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Chicago Sex education that provides information about abstinence, condom use and other contraceptive methods is the most effective way to reduce the growing number of teenagers who contract a sexually transmitted infection or become pregnant.

So federal funding should flow to comprehensive programs proven to address these public health issues, according to a Council on Science and Public Health report adopted at the AMA Annual Meeting.

The studies reviewed found "no delay of initiating sexual activity, no reduction in the number of sexual partners and no increase in abstinence" from abstinence-only programs, said Stuart Gitlow, MD, MPH, who presented the council's report.

Data from the Centers for Disease Control and Prevention show the birth rate among teens age 15 to 19 rose to 41.9 per 1,000 live births in 2006 from 40.5 in 2005. This rate had been declining for the previous 14 years. Other studies have found about a fourth of teen girls had at least one STD.

"What we're talking about is comprehensive programs which, of course, include abstinence, but we can't just stick our heads in the sand and expect them to do the right thing. We have to provide them with all of the information they need to make responsible, adult decisions," said Barry Sheppard, MD, a thoracic surgeon and alternate delegate for the California Medical Assn.

Some delegates argued that abstinence-only education was being subjected to tougher standards than other sex education programs and had not been given enough of a chance to make an impact.

"What works in California may not work in Mississippi," said Freda Bush, MD, an ob-gyn and alternate delegate for the Mississippi State Medical Assn. "We need to work together to find and fund what works to help protect America's children."

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Meeting notes: Public health

Issue: Some organizations are lobbying to have obesity declared a disability, but this designation could interfere with physician counseling on the subject.
Proposed action: Oppose such efforts. [Adopted]

Issue: Concerns have been raised about the safety of conducted electrical devices being used by law enforcement officials and others.
Proposed action: Law enforcement departments and other agencies should design and implement guidelines, training and accountability on the use of these devices. These bodies should also have standard approaches to medical evaluation, management and postexposure monitoring. Additional independent research is needed to better understand the risks and benefits of these devices. [Adopted]

Issue: Male breast cancer is uncommon but tends to be diagnosed at late stages. Awareness of this possibility is low.
Proposed action: Recognize that breast cancer affects men as well as women, some men are at increased risk and heightened surveillance may be appropriate for a minority of men. Support Medicare and insurance coverage for screening and testing services for those at increased risk. [Adopted]

Issue: Hormones have been promoted to prevent aging, but there are many open questions as to the risks and benefits of taking those substances for that purpose.
Proposed action: Disseminate the Council on Science and Public Health report that found scientific evidence was lacking and, in some cases, long-term use may cause harm. Take the position that those who promote these treatments have a responsibility to support claims with well-designed, randomized placebo-controlled trials. [Adopted]

Issue: Americans' overall health continues to decline because of preventable conditions, many linked to overweight and obesity.
Proposed action: Make improving Americans' eating and exercise habits a priority, propose draft legislation that would establish innovative programs to encourage people to adopt healthier habits and work with partner organizations to educate patients on how to improve diet and increase physical activity. [Adopted]

Issue: The obesity epidemic is growing, but people do not have easy access to the nutritional information they need to eat healthily in restaurants.
Proposed action: Create a method for displaying calorie and other relevant information on restaurant menus and menu boards for all food and beverage items. [Reaffirm existing policy on nutrition labeling]

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