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Sex-ed sells

National | The press trumpets a "safe sex" education study, despite a researcher's apparent conflict of interest and data that suggest less than meets the eye

Issue: "Don't have a cow," Aug. 11, 2001

Consider this scenario: A nationally known researcher publishes a scientific study touting programs that the government pays his employer to market. Wouldn't this constitute a conflict-of-interest story worthy of national media attention? Not if the researcher works for the safe-sex cartel.

This summer the National Campaign to Prevent Teenage Pregnancy-an advocacy group endorsed by former President Bill Clinton-published a report claiming that abstinence education showed no proof of effectiveness. But "comprehensive" sex education (i.e., programs that pay lip service to abstinence while advocating condoms) reduces both teen pregnancy and sexual activity, said the report. The Campaign based its assertion on a four-year study called "Emerging Answers: Research Findings on Programs to Reduce Teen Pregnancy."

Written by Douglas Kirby, a Campaign board member and a senior researcher for the California-based ETR Associates, the study lauded eight "comprehensive" sex-education programs, including three community-outreach projects and five sex-education curricula, as showing "strong evidence of success." Depending on the definition of "success," that means delayed teenage sexual activity, increased condom use, or reduced pregnancy rates.

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Although Mr. Kirby's report reviewed only three abstinence programs and acknowledged that "the jury is still out" on abstinence education, national media were quick to convict. The New York Times confidently asserted that "abstinence-only" education has "no impact on young people's behavior," while USA Today called for more federally funded safe-sex education. But neither newspaper mentioned Mr. Kirby's conflicts.

As the nation's largest nonprofit, health-education clearing house, ETR (an acronym for Education, Training, Research) conducts scientific studies and produces brochures and manuals on health topics ranging from pelvic exams to Internet dating. In addition to annually distributing some 8 million publications to schools, corporations, and medical clinics, ETR also serves as a powerful marketing tool for the U.S. government.

Each year, the U.S. Centers for Disease Control and Prevention (CDC) publishes a list of health-education programs that it calls "Programs That Work." The CDC offers incentives to public schools to use the programs, including a free teacher-training session. WORLD discovered that ETR not only receives money to package the CDC-endorsed programs and provide training sessions; it also has been paid to provide research to weigh their "effectiveness."

That suggests a direct conflict of interest since the sex-education curricula that Mr. Kirby's study advocates are "Programs That Work." ETR sells three of them-"Reducing the Risk," "Safer Choices," and "Becoming a Responsible Teen." So not only does Mr. Kirby tout his own company's products as the best in the country; he also promotes curricula that

his employer develops for the federal government. It's Big Brother turned

mass marketer.

Here's how the marketing works: Through "corporate agreement grants," the CDC pays ETR to transform "Programs That Work" into curricula and train public schools how to use them. According to ETR training director Linda Fawcett, ETR has also received funding from the CDC to evaluate some "Programs That Work," including "Reducing the Risk" and "Safer Choices." Mr. Kirby denied his co-worker's assertion that ETR received government funding to evaluate any programs other than "Safer Choices," arguing that "I have very openly stated both in the presentations and in 'Emerging Answers' that some of the materials are published by ETR. I have certainly not covered up anything." Evaluators are selected by "competitive procurement," explained Lloyd Kolbe, director of the CDC's adolescent and school health division. "We wouldn't disallow an organization to compete … based on their being successful in developing … 'Programs That Work.'"

But conflict-of-interest issues aren't the only thing the national media missed. They also ignored data that cast doubt on the "safe-sex" message. They failed to report that out of 250 programs examined in Mr. Kirby's study, only 3 percent-eight programs-showed significant success. So instead of dismissing abstinence education on the basis of three programs, the media could have reported that the majority of safe-sex curricula studied produced insignificant results.

"Programs find success in reducing teenage pregnancy," announced The New York Times headline. But the Times neglected to mention that none of the sex-education curricula advocated by Mr. Kirby's study decreased teenage pregnancy rates or sexually transmitted diseases (STDs). The curricula "reduced sexual risk-taking; but they did not provide evidence they reduced teen pregnancy," said the report. This from a report published by a campaign "to Prevent Teen Pregnancy."

"Most of these programs did not even measure or accomplish the most important outcomes they were designed for, yet the media have suggested that we now have the answer, and that is that we must teach contraceptives with abstinence to be effective," said Dr. Joe McIlhaney, who serves on the National Campaign's research committee and directs the Austin-based Medical Institute for Sexual Health. "I don't believe the data support that conclusion."

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