Sexual Integrity for Teens:
An Introduction & Overview

WHAT IS SIT?

"Sexual Integrity for Teens" (SIT) is a program developed by the Kentucky Cooperative Extension Service. It revolves around a series of fact sheets. Each fact sheet is accompanied by a teaching guide designed for the individual delivering the program. The guide presents lesson objectives, a list of materials needed to deliver the program, a presentation guide containing suggestions on how to present the material and "master copies" for overheads and other teaching material.

Overall, the following three statements characterize the content of the SIT program:

• SIT is "values-based." As evidenced by the word "integrity" in the title, SIT emphasizes honesty, sincerity, ethics, responsibility and respect for self and others throughout.

• SIT is "comprehensive." If used in it's entirety, SIT covers a wide range of topics related to sexuality. It provides material for teens and their parents. It includes material on emotions and relationships as well as the physical aspects of sexuality. It includes information on the variety of ways sexuality is expressed. While emphasizing abstinence, it also includes material on contraception and avoiding STDs.

• SIT is "flexible." SIT is designed so that the individual delivering it can "pick and choose" from the various segments to create a program designed to meet local needs. Program material can be used with teens, the parents of teens or both.

THE NEED FOR SIT

Looking at research on teen sexuality leaves little doubt that there is a need for programs like SIT. American teens are more sexually active in the 1990s than at any time in the past. Consider the following:

• A well-designed national survey of high school students conducted in 1990 found that 40 percent of ninth graders and 72 percent of twelfth graders had sexual intercourse (3).

• A study of seventh and eighth graders found that 25 percent were sexually active and that those who were sexually active tended to be less knowledgeable about HIV, less afraid of becoming infected with HIV and more likely to engage in risky behaviors than peers who were not sexually active (2).

• A recent survey found that the average sexually active 15-year-old American boy has had intercourse with at least four different partners (16).

• A recent survey of heterosexual students at a large midwestern university found that undergraduate males reported an average of 11.2 lifetime sex partners and that females reported an average of 5.6 different partners (13).

• Approximately 40 percent of sexually active teens have multiple sex partners each year and those with the most partners are least likely to follow "safer sex" guidelines (9).

• Several studies have found that fewer than 10 percent of sexually active teens consistently use condoms (5,8,13,18).

• Approximately 2.5 million U.S. teens contract an STD each year (9).

• More and more adolescents are becoming infected with HIV. Approximately 20 percent of the people with AIDS in the U.S. are in their 20s. Many of them were infected while they were teenagers (12).

• Approximately 10 percent of American teenage girls aged 15 to 19 become pregnant each year with five out of six pregnancies being unintended (19).

• There are approximately one million teen pregnancies each year in the U.S. which result in approximately 500,000 births, 400,000 induced abortions and 100,000 miscarriages or stillbirths (7).

• Approximately 95 percent of teenage boys and 80 percent of girls experiment with masturbation (9).

• Several studies suggest that 40 to 50 percent of teenagers have tried oal-genital contact (6,11,20).

• A national study of eighth through eleventh graders found that 53 percent of them had been touched, grabbed or pinched in a sexual way at school. Thirteen percent of the girls reported being forced by fellow students, teachers or other school employees to engage in sexual conduct beyond kissing (1).

There is no evidence that Kentucky teens are significantly different from their counterparts in other parts of the country. For example:

• A 1990 survey of approximately 5,500 students conducted by the Kentucky Department of Education indicates that 41 percent of ninth graders and 71 percent of twelfth graders have experienced sexual intercourse. Seventeen percent of the sample had engaged in intercourse at Ythe age of 13 or earlier. Eight percent of the students had gotten pregnant or had caused a pregnancy while four percent had contracted a sexually transmitted disease.

• A study of Kentucky sixth through twelfth graders conducted by the University of Kentucky Cooperative Extension Service found that, within the past year, 11 percent of the students had been forced by a teenager they know to do something sexual that they didn't want to do.

Despite overwhelming evidence of teenage sexual activity and a host of resulting problems, most American teens do not receive comprehensive sexuality education in their middle/junior high schools and high schools. In addition, many of their parents are unprepared, unable or unwilling to provide them the information they need. While we still are a long way from agreeing on what should be done, there is evidence that the public is at least becoming aware of the issues, however. When a 1993 survey conducted by the University of Kentucky Survey Research Center asked a random sample of Kentucky adults to indicate the importance of nine specific youth and family issues in their communities, "having sex at a young age" was considered the most important issue. It was rated as being very important by 79 percent of the respondents.

GUIDING VALUES

The SIT program is based upon the following 15 "guiding values" which where first outlined by The Sexuality Information and Education Council of the United States (SIECUS) and used as a basis for it's "Guidelines for Comprehensive Sexuality Education: Kindergarten - 12th grade"(10):

• Sexuality is a natural and healthy part of living.

• All persons are sexual.

• Sexuality includes physical, ethical, spiritual, psychological and emotional dimensions.

• Every person has dignity and self-worth.

• Individuals express their sexuality in varied ways.

• In a pluralistic society like the United States, people should respect and accept the diversity of values and beliefs about sexuality that exist in a community.

• Sexual relationships should never be coercive or exploitative.

• All children should be loved and cared for.

• All sexual decisions have effects and consequences.

• All persons have the right and obligation to make responsible sexual choices.

• Individuals and society benefit when children are able to discuss sexuality with their parents and/or trusted adults.

• Young people explore their sexuality as a natural process of achieving sexual maturity.

• Premature involvement in sexual behaviors poses risks.

• Abstaining from sexual intercourse is the most effective method of preventing pregnancy and STDs/HIV.

• Young people who are involved in sexual relationships need access to information about health care services.

USING SIT

The SIT program is designed to give you flexibility in program delivery. It can be used in a variety of different settings in a variety of different ways. As a program leader, you can pick and choose from the factsheets and lessons to deliver programs on selected aspects of teen sexuality by offering:

• A comprehensive, multiple-session series of presentations,

• An extended day-long or week-end workshop,

• A single, one-shot presentation on a particular issue or topic (e.g., love and dating, HIV/AIDS, sexual harassment),

• A session for parents as well as sessions for teens.

Since the SIT material covers what some consider "sensitive" issues and topics, be sure to consider the following as you plan your program:

• Age. The SIT program is designed for audiences in grade 7 and above.

• Distribution of printed materials. Think about whether or not you want to distribute copies of the fact sheets to teen participants. You may want to simply use them as guides for what you present verbally and not distribute them. This may be particularly appropriate for low reading-level and/or younger audiences. Older teens in high school can benefit from having written material to refer back to, however.

• Need for parental notification/permission. The necessity and desirability of notifying parents or guardians of the content of the SIT program and obtaining their permission for their teen to participate is influenced by a number of factors. If another organization or agency is organizing the program and invites you to present a one-shot session on one of the SIT topics, it's the other organization's program and you probably don't need to worry about parental permission. If another organization or agency is organizing the program and invites you to present a comprehensive, multi-session series of presentations, you may want to discuss the content of the program and desirability of parental permission with the person who invited you. Ultimately, however, it needs to be the other organization's decision since they invited you and are sponsoring and organizing the program. If you are organizing the program and it is a limited to one or two of the SIT topics, base your decision on the content of the topics you are presenting. If the topic is a sensitive one like "Choices for Controlling Births," you may want to notify parents. If, on the other hand, you are presenting a topic like "Love, Dating & You," there isn't a real need to notify parents. If you are organizing and presenting a comprehensive, multi-session series of presentations, the decision on whether or not to notify parents depends on how the program is structured and promoted. If the SIT program is promoted or advertised separately from others and there is a flier, brochure, registration form, etc. that outlines the content of the program, simply having a parent/guardian sign his/her teen's registration should be sufficient. If, on the other hand, you are presenting SIT as part of an on-going class or series of workshops and parents/guardians are not aware that their teens are going to be participating in the SIT program, parental notification/permission is advised.

• Methods of parental notification/permission. If you decide to notify parents/guardians and seek permission for their teens to participate, there are a number of options for doing so.
  1. As mentioned above when discussing programs that are promoted or advertised separately from others, including a description of the content of the program in a brochure, etc. and having a parent/guardian sign his/her teen's registration form is one method of notifying parents.

  2. You can send a letter or note to each teen's parents/guardians along with a form for them to sign and return if they DO NOT WANT their teen to participate. The letter should outline the content of the program and what materials will be used. It should also state who is sponsoring the program and how parents/guardians can contact you if they have any questions. While not absolutely necessary, you may also want to offer parents/guardians an opportunity to review the materials you will be using. This method of parental notification is particularly appropriate when you are offering SIT as part of an on-going class or series of workshops.

  3. You can send a letter or note to each teen's parents/guardians along with a form for them to sign and return if they WANT their teen to participate. This method is identical to the previous one except parents/guardians are signing their teen INTO the program instead of OUT of it. Compared to signing out, this method has the disadvantage of lowing participation in the program since parents without strong feelings one way of the other may not return the form and their teens will not be able to participate. If you feel it is necessary to have a signed permission form for each participating teen, you still may want to use this method, however.

  4. You can conduct a SIT session for parents before you begin working with their teens. You could present the SIT session titled "Talking with Your Teen about Sexuality." In the process, you can talk about the SIT program and go over the material you intend to use as part of it. This method has the advantage of educating the parents/guardians, encouraging them to play a larger role in their teens sexuality education, and making them a part of the SIT program. It also gives parents/guardians an opportunity to get to know you and provides you an opportunity to provide face-to-face answers to their questions.

• Are you the person to present the program? In order to do an effective job, educators presenting sexuality programs need to come to terms with their own sexuality. They need to feel comfortable dealing with the various topics. Your comfort level with the topics included in the SIT program is going to affect how well you present the material to teens. It's natural to feel nervous and anxious before presenting any program the first time. If you simply cannot imagine yourself being comfortable presenting the SIT material, however, seriously consider whether or not you should present either the entire program or portions of it. If you decide you shouldn't, you have a number of options besides dropping SIT altogether. First, you can make "one-shot" presentations on those topics you do feel comfortable with. Second, you can do part of the program and invite others to present those sections you don't feel comfortable with. Third, you can organize the program and invite others to actually present it. Inviting other professionals to present the program has a couple of potential benefits besides the fact that you've avoided doing it yourself. First, you may pick up some important ideas and techniques for presenting the material if you observe someone else presenting it. This may increase your own confidence and comfort level to the point where you'll want to be the presenter in the future. Second, the teens participating in the program can gain important insights by listening to a variety of presenters.

USING SIT WITHIN THE COOPERATIVE EXTENSION SERVICE

In addition to the things anyone conducting the SIT program should consider, there are some unique issues Cooperative Extension personnel conducting the program need to consider. First, consider your local advisory groups. Before promoting and initiating an Extension-sponsored SIT program, discuss the need for the program, what you want to include in it and how you intend to implement it with your advisory group. Their support is crucial to how the program is received in the community and, ultimately, to its success. If you are invited by another organization to present a program using the SIT material, prior consultation with your advisory group isn't mandatory. You will want to keep the group informed of your activities on a periodic basis, however.

Since the Kentucky Cooperative Extension Service has a wide range of programs for a wide variety of audiences, consider how you might integrate the SIT program with others and how you might use the material with audiences Extension currently serves. Examples of ways the program and materials could be used include:

• A supplement to the Partner Assisted Learning (PAL) and Learning About Parenting (LAP) Extension programs,

• In conjunction with Family Resource/Youth Service Center activities (e.g., health fairs),

• School health, home economics, and other classes,

• Community teen clubs (4-H and others),

• Specially planned youth/parent retreats during which a wide range of parent/teen issues may be discussed,

• "Issues Programs,"

• Senior 4-H Conference,

• "Lock-in" programs for teens,

• Collaborating with religious organizations interested in working with teens on sexuality issues,

• Networking with other organizations that work with teens and/or parents on issues related to teen sexuality.

WORKING WITH TEENS

Presenting teens information on sexuality isn't always easy. You may find the following strategies helpful as you work with them (14):

• Avoid making assumptions about the teens' sexual experience. Don't assume the teens you work with are necessarily experienced or inexperienced.

• Model a positive approach to sexuality. Many teens have never had an open and honest discussion about sexuality with an adult. If they sense you're uncomfortable with the information, they will be too.

• Send the message that sexuality is a natural and healthy part of life.

• Incorporate group interaction into your program. Teens can learn as much from each other as they do from adults.

• Involve teens in planning your program and be flexible in responding to the needs of various groups.

• Be prepared to adapt activities for teens with limited verbal skills or short attention spans.

• Avoid being heterosexist. Use language that is inclusive of all youth, regardless of sexual orientation.

• Recognize your own sexual values.

• Help teens explore their own values and understand group and cultural variations.

• Conduct SIT with "sexual integrity."

CONDUCTING SIT WITH "SEXUAL INTEGRITY"

The title "Sexual Integrity for Teens" should have just as much meaning for those of you organizing and conducting the SIT program as it does for the teens in it. If the program is going to be successful, your decisions and actions must be characterized by honesty, sincerity and ethics. This isn't always easy. Many people have strong feelings about teenage sexuality and you may encounter some who will take advantage of the debate over sexuality education to advance their own agendas. The following suggestions may help, however:

• Maintain your professional integrity. Present only research-based information you know to be accurate.

• Avoid using "fear" or "scare tactics" to reenforce the abstinence message. You can make the point that abstaining from sexual intercourse is the most effective way to avoid pregnancy and STDs without resorting to the medical inaccuracies, misinformation and scare tactics that characterize some "abstinence-only" programs and materials. Such an approach is both unethical and ineffective.

• Answer teens' questions directly. If a teen is willing to ask a question, she or he deserves an answer. If you don't know the answer to a question, say so at the time. You should find out the answer and get back to the teen who asked it as soon as possible, however.

• Continue to educate yourself about teenage sexuality. The suggested readings found in SIT is a good place to start.

• Be prepared to confront myths and answer community questions about sexuality education. The following section should help you prepare.

CONFRONTING THE MYTHS

If you're conducting SIT, it's important to understand the misinformation about sexuality education you may encounter. Some of the most common myths include:

• Teaching young people about sexuality makes them more likely to begin having sex at a young age. This is both wrong and naive. All teaching kids about anything does is help them understand it better and become more knowledgeable about it. As pediatrician Victor Strasburger (17) writes, "Does teaching kids about civics make them more likely to become state senators? Does teaching them about geography make them more likely to drop out of school to join an expedition to Antarctica?

• Programs that both encourage postponing sexual intercourse or abstinence and provide information on contraception and STDs send mixed messages that legitimize sexual experimentation. This simply isn't true. The following message is very clear: "Don't have sex when you're young, but if you do, use birth control and practice `safer sex.'" In addition to being clear, it could actually save a teen's life.

• Condoms are ineffective in preventing pregnancy, STDs and HIV. A number of reliable, scientifically valid research studies demonstrate that condoms are highly effective in preventing pregnancy, STDs and HIV (4).

• Abstinence-only programs have been found to reduce intercourse and pregnancy rates. Only three studies on school-based abstinence-only programs have been published in the professional literature. None of them have found any impact on adolescents' initiation of intercourse (15).

• A program like SIT will reduce teenage pregnancy. Regrettably, this too is a myth. There is no easy, "quick fix" for the problem of teenage pregnancy. SIT is a teen "sexuality education" program, not a teen "pregnancy prevention" program. As a sexuality education program, SIT can be an important component of a pregnancy prevention program. It can't be the total program, however. While pregnancy prevention programs must provide teens information on sexuality, successful ones also include efforts to diminish the effect of poverty and inadequate education and provide teens a positive vision of their futures.

AUDIO/VISUAL MATERIALS

Some of the teaching guides which accompany each of the SIT leaflets contain suggestions for using specific videos when presenting the material. A list of those videos and information on how to obtain them is provided. (Click here to see list)

UPDATING SIT

Over time, some SIT material undoubtedly will be revised, additional leaflets added to the program and new audio/visual material will become available. Check back on a regular basis.

GIVE US YOUR REACTION

The authors of SIT would like to know how you feel about the program. What are its strong and weak points? How can it be improved? What isn't covered that you think should be added? Tell us about your experiences using the material. We can be reached at:

Gary L. Hansen, Department of Sociology, 500 Garrigus Building, University of Kentucky, Lexington, KY 40546-0215, Phone: 606-257-7586, FAX: 606-257-1164, E-mail: ghansen@pop.uky.edu

William W. Mallory, Fayette County Cooperative Extension, 1145 Red Mile Place, Lexington, KY 40504-1172, Phone: 606-257-5582, FAX: 606-254-3697, E-mail: wmallory@ca.uky.edu

REFERENCES

1. Associated Press. (1993). "Sexual Harassment Affects Teens." June 3.

2. Brown, L.K., DiClemente, R.J., & Beausoleil, N.I. (1992). "Comparison of human immunodeficiency virus related knowledge, attitudes, intentions, and behaviors among sexually active and abstinent young adolescents." Journal of Adolescent Health, 13, 140.

3. Centers for Disease Control and Prevention. (1992). "Sexual behavior among high school students - United States, 1990." Morbidity and Mortality Weekly Report, 40, 885-888.

4. Centers for Disease Control and Prevention. (1993). Condoms and Their Use in Preventing HIV Infection and Other STDs.

5. DiClemente, R., Boyer, C., & Morales, E. (1988). "Minorities and AIDS: Knowledge, attitudes and misconceptions among black and Latino adolescents." American Journal of Public Health, 78, 55-57.

6. Hass, A. (1979). Teenage Sexuality. New York: Macmillan.

7. Henshaw, S.K., & Van Vort, J. (1989). "Teenage abortion, birth and pregnancy statistics: An update." Family Planning Perspectives, 21, 85-88.

8. Ku, L.C., Sonenstein, F.L., & Pleck, J.H. (1992). "The association of AIDS education and sex education with sexual behavior and condom use among teenage men." Family Planning Perspectives, 24, 100-106.

9. Masters, W.H., Johnson, V.E., & Kolodny, R.C. (1994). Heterosexuality. New York: Harper Collins.

10. National Guidelines Task Force. (1991). Guidelines for Comprehensive Sexuality Education. New York: SIECUS.

11. Newcomer, S.F., & Udry, J.R. (1985). "Oral sex in an adolescent population." Archives of Sexual Behavior, 14, 41-46.

12. Novello, A.C. (1993). Surgeon General's Report to the American Public on HIV Infections and AIDS. U.S. Public Health Service.

13. Reinisch, J.M. et al. (1992). "High-risk sexual behavior among heterosexual undergraduates at a midwestern university." Family Planning Perspectives, 24, 116-121, 145.

14. Rodriquez, M. (1994). "Sexuality education for youth in high-risk situations." SIECUS Report, 22.

15. SIECUS. (1994). "SIECUS fact sheet, comprehensive sexuality education: Adolescents and abstinence." SIECUS Report, 22, 21-22.

16. Sonenstein, F.L., Pleck, J.H., & Ku, L.C. (1991). "Levels of sexual activity among adolescent males in the United States." Family Planning Perspectives, 23, 162-167.

17. Strasburger, V. (1993). Getting Your Kids to Say No in the 90s When You Said Yes in the 60s. New York: Fireside.

18. Strunin, L., & Hingson, R. (1987). "AIDS and adolescents: Knowledge, beliefs, attitudes, and behavior." Pediatrics, 79, 825-828.

19. Trussell, J. (1988). "Teenage pregnancy in the United States." Family Planning Perspectives, 20, 262-272.

20. Young, M. (1980). "Attitudes and behavior of college students related to oral-genital sexuality." Archives of Sexual Behavior, 9, 61-67.