11
When the public is informed about condom effectiveness by the CDC and other authorities, terms such as “highly effective,” “very good,” and “significant” are used. While there is no doubt that proper use of condoms prevents some infections to some degree, it would be ethical to remind people this refers only to vaginal intercourse and to provide the actual statistics so they can make informed decisions about their behavior. From what I could gather, “significant” sometimes refers to “statistically significant,” a level of protection many people would consider unacceptable.
12
Ruth M. Jacobs, MD, letter to
The Gazette
, March 28, 2005.
13
She teamed up with Citizens for Responsible Curriculum (CRC) to challenge the video. CRC was also concerned about the lack of warning about the risks of multiple partners, oral sex; the partial protection against herpes, HPV, and other organisms; and subsequently about transgenderism and issues related to homosexuality.
14
Pertaining to HIV, for the receptive individual, compared to receptive vaginal intercourse.
15
Barbara G. Silverman and Thomas P. Gross, “Use and Effectiveness of Condoms During Anal Intercourse: A Review,”
Sexually Transmitted Diseases
24, no.1 (January 1997):11â17.
16
In Holland, concern about condom failure during anal sex was so serious that a new type was designed and marketed specific to this use. It appears that the FDA considered the possibility but was concerned about ethical issues involved in testing a new device.
17
Ruth M. Jacobs, MD, letter to
The Gazette
, March 28, 2005.
18
Jami S. Leichliter, Anjani Chandra, Nicole Lidden, Kevin A. Fenton, and Sevgi O. Aral, “Prevalence and Correlates of Heterosexual Anal and Oral Sex in Adolescents and Adults in the United States,”
The Journal of Infectious Diseases
196, no.12 (15 December 2007): 1852â59.
19
Bradley O. Boekeloo and Donna E. Howard, “Oral Sexual Experience Among Young Adolescents Receiving General Health Examinations,”
American Journal of Health Behavior
26, no.4 (August 2002): 306â14.
20
Stephanie A. Sanders and June Machover Reinisch, “Would You Say You âHad Sex' If . . . ?”
JAMA
281, no.3 (20 January 1999): 275-277; M. Keith Rawlings, Robert J. Graff, Rodrigo Calderon, Shelisa Casey-Bailey, and Mary V. Palsey, “Differences in Perceptions of What Constitutes Having
âHad Sex' in a Population of People Living with HIV/AIDS,”
JAMA
98, no.6 (June 2006): 845â50.
21
The legal action was based on the curriculum's exclusion of ex-gays and its discriminatory religious references. The judge found that it violated the establishment clause.
22
And PFOX (Parents and Friends of Ex-Gays).
23
Getting two minutes before the MCPS Board was not easy. The Board office only accepts calls from interested parties on the Monday before they meet, and only for two, thirty-minute periodsâone for speakers who wish to address issues relating to the day's agenda, and the other for speakers wishing to address other issues. At the time Jacobs was trying to present, the number was usually busy. She succeeded in getting through by using the redial button on two separate phones. See Montgomery County Public Schools, “Public Participation,”
http://www.montgomeryschoolsmd.org/boe/community/participation.shtm
.
24
Usually males are asymptomatic and may only learn of their infection when symptoms develop in a female partner and she is diagnosed.
26
Discussed as a variation of sexual behavior on GoAskAlice and other sites for teens.
27
This is the email my assistant got when she wrote MCPS to ask if their current (as of March 2009) curriculum specifies that:
1. Anal sex is the most dangerous type of intercourse and
2. Condoms may be more likely to fail during non-vaginal use:
Date: Mon, Mar 30, 2009 at 2:49 PM
Subject: sex ed curricula question
Dear Ms. ****:
Thank you for your March 16, 2009, e-mail message to Dr.ââ, superintendent of schools, in which you request information regarding the Montgomery County Public Schools Health Curriculum, specifically: “does the current sex ed curricula specify that anal sex is the most dangerous type of intercourse, i.e., the easiest way to transmit infection?” and, “does the curricula provide the same or a similar warning to that on condom wrappers (regarding the possible breakage of a condom for non-vaginal use)?”
A 45-minute condom use demonstration lesson for Grade 10 health education students is designed to address the following concept and objectives:
Abstinence is the only 100 percent effective way to prevent unwanted pregnancy and sexually transmitted infections. Individuals who engage in sexual activity are responsible for protecting themselves and their partners from unwanted pregnancy and sexually transmitted infections.
Describe how a condom works to help prevent contracting a sexually transmitted disease.
List in order the proper steps for correctly examining a condom, putting on a condom, and removing/disposing of a condom.
Anal sex and condom use warnings are not the focus of the condom demonstration lesson or the Montgomery County Public Schools Curriculum Framework for Pre-K-12 Health Education.
[name redacted], Associate Superintendent for Curriculum and Instructional Programs Montgomery County Public Schools
28
Mark Jacobs, “Due warning in a ârisky' world,”
The Washington Times
, May 8, 2005.
29
Citizens for Community Values, “Workshop Summary: Scientific Evidence on Condom Effectiveness for Sexually Transmitted Disease (STD) Prevention.”
33
HPV-related anal cancer is on the rise and has striking similarities to cervical cancer. It most commonly occurs in the anal transition zone, an area of immature cells very like the cervical transformation zone. Having receptive anal sex causes trauma and repair of the anal transition zone, a process that accelerates the turnover of cells and makes the area more vulnerable to malignant change. Teresa M. Darragh, “Anal Cytology for Anal Cancer Screening: Is It Time Yet?” Diagnostic
Cytopathology
30, no.6 (May 2004): 371â73. This is the reason some physicians are performing anal Pap tests on men who have sex with men. Also, a 2008 Robinson article indicates that the sexual revolution is a major contributor to HPV-related cancers. See D. Robinson, et al, “An analysis of temporal and generational trends in the incidence of anal and other HPV-related cancers in Southeast England,”
British Journal of Cancer
100, no.3 (January 2009): 527â31.
36
Stephen Joseph, MD, personal communication, December 1, 2005.
39
Remember, Planned Parenthood says, “Parents know that the best foundation for their children's success is a good education. When it comes to sexual health, Planned Parenthood provides what parents want for their childrenâmedically accurate, comprehensive, and age-appropriate information to guide them through a lifetime of choices.” From Planned Parenthood, “About Us,”
http://www.plannedparenthood.org/about-us/about-us-90.htm
. Also, “Planned Parenthood is proud of its vital role in providing young people with honest sexuality and relationship information in classrooms and online.”
43
Heather Corinna,
S.E.X: The All-You-Need-to-Know progressive sexuality guide to get you through High School and College
(New York: Marlowe and Co., 2007), 156.
47
Norman Sohn, Michael Weinstein, and Joel Gonchar, “Social Injuries of the Rectum,”
American Journal of Surgery
134, no.5 (November 1977): 611â12.
49
Heather Corinna,
S.E.X.
, 147.
50
Miriam Grossman,
Unprotected: A Campus Psychiatrist Reveals How Political Correctness Endangers Every Student
(New York: Sentinel, 2006), 68â70.
53
Luis Carlos Junqueira and Jose Carneiro,
Basic Histology: Text and Atlas
, 10th ed. (New York: McGraw-Hill, 2003).
54
Peter Greenhead, Peter Hayes, Patricia S. Watts, Ken G. Laing, George E. Griffin, and Robin J. Shattock, “Parameters of Human Immunodeficiency Virus Infection of Human Cervical Tissue and Inhibition by Vaginal Virucides,”
Journal of Virology
74, no.12 (June 2000): 5577â86.
55
B. Voeller and D. J. Anderson, letter to the
Journal of the American Medical Association
267 (October 2003): 1917â18. (from Brody,
Sex at Risk
, 216)
56
A. Moriyama, K. Shimoya, I. Ogata, T. Kimura, T. Nakamura, H. Wada, K. Ohashi, C. Azuma, F. Saji and Y. Murata, “Secretory leukocyte protease inhibitor (SLPI) concentrations in cervical mucus of women with normal menstrual cycle,”
Molecular Human Reproduction
5, no.7 (July 1999): 656â61.
57
Lot de Witte, Alexey Nabatov, Marjorie Pion, et al, “Langerin is a natural barrier to HIV-1 transmission by Langerhans cells,”
Nature Medicine
, 13, no. 3 (2007): 367-371.
58
S. J. Robboy, M. Prade and G. Cunha, in Steven S. Sternberg, ed.,
Histology for Pathologists
, (North Holland, New York: Raven Press, 1992), 881â92.
59
Peter Greenhead et al, “Parameters of Human Immunodeficiency,”
Journal of Virology
74, no.12 (June 2000): 5577â86. The cervix may be more vulnerable, especially the transformation zone.
61
M cells were actually first identified by Dr. Kenzaburo Kumagai of Osaka Tuberculosis Institute in 1922. See Robert L. Owen, “Uptake and transport of intestinal macromolecules and microorganisms by M cells in Peyer's patchesâa personal and historical perspective,”
Seminars in Immunology
11, no.3 (June 1999): 157â63.
62
A. D. O'Leary and E. C. Sweeney, “Lymphoglandular Complexes of the Colon: Structure and Distribution,”
Histopathology
10 (1986): 267â83.
63
Marian R. Neutra, Nicholas J. Mantis, Andreas Frey, and Paul J. Giannasca, “The composition and function of M cell apical membranes: Implications for microbial pathogenesis,”
Seminars in Immunology
11, no.3 (June 1999): 171â81; Harvey Miller, Jianbing Zhang, Rhonda KuoLee, Girishchandra B. Patel, and Wangxue Chen, “Intestinal M Cells: The fallible sentinels?”
World Journal of Gastroenterology
13, no.10 (14 March 2007):1477â86.
64
Robert L. Owen, “Uptake and transport,”
Seminars in Immunology
.
65
J. P. Kraehenbuhl and M. R. Neutra, “Mollecular and cellular basis of immune protection of mucosal surfaces,”
Physiological Review
72, no.4 (1 October 1992): 853â79.
66
This has been demonstrated in vitro but not in vivo.
67
William B. Whitman, David C. Coleman, and William J. Wiebe, “Prokaryotes: The unseen majority,”
Proceedings of the National Academy of Sciences USA
95, no.12 (9 June 1998): 6578â83.
68
Harvey Miller et al “Intestinal M cells: The fallible sentinels?”
World Journal of Gastroenterology.
69
Sinead C. Corr, Cormac C.G.M. Gahan, and Colin Hill, “M-Cells: origin, morphology and role in mucosal immunity and microbial pathogenesis,”
FEMS Immunology and Medical Microbiology
52, no.1 (January 2008): 2â12.