SEX education in public schools has always been a sensitive issue. Since the advent of AIDS education, the level of urgency and controversy surrounding the topic has increased dramatically.
"The AIDS epidemic has caused a willingness on the part of school systems and parents to be more explicit with young people rather than less," says Debra Haffner, executive director of the Sex Information and Education Council of the United States in Washington, D.C.
In the early '80s, schools began outlining policies for responding to students and employees who had AIDS, says Brenda Greene, manager of AIDS education at the National School Boards Association in Alexandria, Va. "Gradually it has evolved into the need to educate for prevention."
In 1986, Surgeon General C. Everett Koop called on public schools nationwide to implement AIDS education "at the lowest grade possible."
Rhode Island passed the first mandate for AIDS education in February 1987. Today, 34 states require AIDS education, and 14 states encourage it.
Despite the contentiousness of the debate over AIDS education, everyone seems to agree on the goal: to prevent behavior doctors say spreads AIDS. Yet, in many cases, deciding on the best way to meet that goal isn't proving easy.
Nowhere is the debate more volatile than in New York City. Last year the city's Board of Education approved free distribution of condoms in high schools. About two dozen school districts across the US have followed New York's lead.
A more recent controversy in New York surrounds abstinence-based AIDS education. Throughout the US, parents, teachers, and AIDS educators are arguing about how much emphasis should be placed on abstaining from sexual intercourse as the only sure prevention of AIDS.
In April, the New York Board of Education approved a resolution requiring that all AIDS education in the city's schools emphasize sexual abstinence more than other prevention methods, such as the use of condoms.
All instruction relating to AIDS prevention "must stress that abstinence is the most appropriate premarital protection against AIDS," states the resolution.
Any community or health group wanting to come into classrooms for AIDS education is required to sign a form pledging adherence to the resolution.
State regulations, passed in 1991, already require all teachers to stress abstinence in AIDS-prevention instruction, says Christopher Carpenter, a spokesman for the state Department of Education in Albany, N.Y.
The current controversy surrounds the boundaries of discussion for outside AIDS educators who come into New York City classrooms.
More than 40 of some 200 AIDS-education groups in New York have refused to sign the abstinence pledge. Many AIDS educators argue that it is unrealistic to talk to students about abstaining from sexual intercourse. Stressing abstinence further alienates adults from teens, they say.
"Sexuality education and HIV education is hard enough to accomplish without measuring your words and making sure that within a single class you are talking more about abstinence than other things," Ms. Greene says. "Particularly if you are going to allow kids to ask questions and really try to meet the needs of the kids who are there."
"The fact is that sexual intercourse is normative behavior in the United States for adolescents," Ms. Haffner says.
Seventy-two percent of high school seniors say they are sexually active, according to a study released this year by the Centers for Disease Control in Atlanta.
"Of course we want to talk to young people about abstinence," Haffner says. "We need to tell them that abstinence is the only 100 percent effective method [of preventing HIV infection]."
But, she argues, "it is immoral to say to the young people of America, `Just say no or die.' That's what I think an abstinence-only program is teaching."
Joanne Gough, founder of Parents for the Restoration of Values in Education, supports abstinence-based programs. "It's not a Nancy Reagan, `Just Say No,' cutesy thing," says this mother of a high schooler on Staten Island.
But Bill Batson, executive director of Teens as Community Resources in Boston, calls talk of abstinence a "smokescreen." "People that want to talk about abstinence are really saying they don't want to talk about sex at all," he says.
Mrs. Gough disagrees, pointing out that most abstinence programs include lessons on refusal skills and how to deal with peer pressure.
Gough became concerned about the AIDS curriculum currently used in New York high schools after attending a peer leadership training program with her son last year. "Some of the basic assumptions bothered me," she says. "There was only one message for the kids: It was purely safe sex. I only heard the word abstinence once, and it was ridiculed."
The assumption among the adults leading this program was that teenage sexuality is normal behavior, Gough says. "It was the expected thing." She argues that "we're giving our kids a failure script," since they usually live up to expectations.
"From a public-health point of view, when I saw that the condom was the centerpiece of prevention, I said, `Wait a minute,' " remembers Gough, who is a trained nurse. "There was no discussion of risk factors or condom failures. None of that."
After spending a summer researching AIDS curricula in New York and other states, Gough concluded that the schools are giving students "too much too soon. It ends up being more harmful than helpful," she says.
GOUGH was appointed to her local AIDS advisory council last year and began reviewing the new K-6 AIDS-education curriculum being developed for New York City schools. The revised elementary curriculum will be implemented in schools this year.
Although she didn't have any trouble with the material intended for kindergarten to third grade, Gough objected to the explicit nature of material for fourth graders. Some of that information was shifted to the sixth-grade level.
Despite such changes, "there's no way to protect kids from the concept of sexuality," Mr. Batson says. "They see it all around them."
"I don't think we're helping them by adding to it," counters Gough.
Polls regularly show that an overwhelming majority of parents want AIDS education in public schools. Ninety-four percent of parents support AIDS education, according to a poll by the Harvard Program on Public Opinion and Health Care. Eighty percent favor teaching students about the preventive uses of condoms, the poll found.
Student concern about AIDS is also high. "I think it's the No. 1 concern after alcohol and drugs," says Jeffrey Nesmith, a sophomore at West Roxbury High School in Boston. "It's everybody's responsibility to teach about AIDS, because everybody needs to know," he says. "Since school is a place to learn, you should definitely hear about it there."
Daniel Caban, a junior at Boston Latin School, says he and other students get much of their information about AIDS from television. Last year, the school invited some people who had AIDS to talk with students. "The real teachers were the people who have AIDS," he says. "That really got people's attention. They didn't look any different than us."