To understand the various factors of sexually transmitted disease (STD) in adolescent teens and young adults, Hannah Brückner and Peter Bearman highlighted the importance of evaluating the interventions that have been designed to restrict the spread of STDs. One of the fundamental interventions are the programs that inspire premarital chastity through virginity pledges, which is supported by numerous organizations and programs. Virginity pledges had first started to become a rising trend in 1993 through “True Love Waits,” which had initiated a movement to encourage teens to pledge abstinence until marriage (Brückner and Bearman, 2005). Two years later, an estimate of twelve percent of all adolescents in the United States had taken virginity pledges in response to the movement, which portrayed society’s positive reaction towards it.
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Research revealed a positive correlation between the virginity pledges and the significant delay of the standard age for one’s first sexual intercourse (Bearman and Brückner, 2001, as cited in Brückner and Bearman, 2005). However, the outcome of the pledge had mainly been shaped by social context and structure of society and the number of individuals that had taken the pledge (Brückner and Bearman, 2005). Many adolescents and young adults were able to shape the social structure of the community by spreading the movement and influencing other individuals of society to partake in the movement. By having a growing number of individuals partake in the virginity pledge movement and with positive support from the community, the virginity pledge movement had enhanced the idea of abstinence until marriage as a social norm of society (Brückner and Bearman, 2005).
Due to the concept of virginity pledges, many may believe that those who partake in virginity pledges are less likely to contract STDs than others. Some of the reasons behind this assumption may include later initiation of sexual activity, fewer sexual partners, and the higher chance of having sexual intercourse in the context of a marital relationship (Brückner and Bearman, 2005). In contrast, it can be counter-argued that pledgers may have a higher likelihood of being exposed to sexual diseases because of the lower probability of using condoms in their sexual activities (Bearman and Brückner, 2001, as cited in Brückner and Bearman, 2005). This would lead sexually active pledgers to have a greater motive to hide their active sex life because of the crucial meaning the pledge has in society (Brückner and Bearman, 2005). However, by hiding their sexual activity from even health professionals, sexually active pledgers may not be able to receive direly needed services or information (Brückner and Bearman, 2005). With this in mind, Brückner and Bearman follow-up their research with various data and results concerning the relationship between virginity pledges and the self-reported STD-related health care application (Brückner and Bearman, 2005).
Data and Methods
For their research, Brückner and Bearman relied on the data from the National Longitudinal Study of Adolescent Health (Brückner and Bearman, 2005). From it, the authors used the data of three different waves of interviews/tests, which analyzed the correlation between teen virginity pledges and STD status of adolescents. Brückner and Bearman specifically focused on the third wave because it allowed them to consider the long-term consequences of teen virginity pledging and STD acquisition of young adults (Brückner and Bearman, 2005).
In the third wave, there had been 15,170 individuals (73% of wave one respondents) participating in the research (Brückner and Bearman, 2005). Of the 15,170 individuals, 92% had agreed to give urine samples, and the other eight percent refused to participate (Brückner and Bearman, 2005). The collected urine samples had then been tested for several different types of STDs: Chlamydia (CH), Gonorrhea (GC), Trichomoniasis (TR), and Human Papilloma Virus (HPV) (Add Health Biomarker Team, 2004, as cited in Brückner and Bearman, 2005).
During the process of collecting and analyzing urine samples, a strict protocol had been followed for an accurate analysis and to dispose of contaminated samples. While compiling the analysis reports, the researchers made sure to adjust the data to comply for the oversampling of individuals and nonresponses (Brückner and Bearman, 2005). The researchers of the study were then able to conclude that pledgers did not show any difference from non-pledgers (Brückner and Bearman, 2005). At the same time, they found that a portion of female participants were reported to change their pledge status throughout the three waves (Brückner and Bearman, 2005). Also, male participants were more likely to participate in all three waves than others if they had cooperated in the first two waves of this study (Brückner and Bearman, 2005). Nonetheless, pledging and participation in the third wave were negatively correlated with age.
These analysis reports were based on several sources of examination. It was derived from cross-tabulating pledges with the various outcomes and behavioral measures (Brückner and Bearman, 2005). In addition, the researchers used standard procedures provided in STATA to trim off standard errors found in the data (Stata Corp, 2003; Chantala and Tabo, 2004, as cited in Brückner and Bearman, 2005). Kaplan-Meier estimates of the survivor function and Wald tests were also used to test the variances between the observed and expected estimates of failures in each subject group (Brückner and Bearman, 2005).
Through the three waves, pledge status of adolescents and young adults had been collected (Brückner and Bearman, 2005). In the first two waves, respondents were asked if they had taken a public or written pledge to remain a virgin until marriage. In the third wave, respondents were asked if they had signed a pledge to abstain from sex until marriage. Based on the answers that they received, researchers were able to distinguish the respondents into three different groups. The first group was made up of the non-pledgers, that consisted of 80% of the total respondents (Brückner and Bearman, 2005). The second group was comprised of the consistent pledgers (seven percent of the total respondents), and the final group had the inconsistent pledgers (13% of the total respondents) (Brückner and Bearman, 2005).
With these three groups, Brückner and Bearman examined for STDs using data from the urine sample analyses from the third wave (Brückner and Bearman, 2005). GC, CH, TR were grouped under a single category to increase the sample size because of their low prevalence rates. On the other hand, HPV was categorized separately because of its high prevalence rates and large sample population. Overall, they came to a hypothesis that inconsistent pledgers would be less exposed to STDs than non-pledgers, but still have a higher probability than the consistent pledgers (Brückner and Bearman, 2005).
In addition to the pledge status, the researchers had acquired extra information on the participants’ sexual and health behavior. They had asked respondents for the timing of their first sexual vaginal intercourse, the timing of their pledging, the number of sexual partners they had, condom usage in sexual intercourses, and the number of years they were exposed to sexual activity (Brückner and Bearman, 2005). The respondents were also asked to answer questions concerning their experiences with STDs, STD diagnosis, doctor visits, and STD testing (Brückner and Bearman, 2005). With these various survey questions, the researchers were able to measure the prevalence of STDs in each of the three groups.
Results
From the survey questions that the participants responded to, the researchers were able to compile a list of data and divide them into four major categories. The first category was STD acquisition, based on bio-marker rates. The researchers found that the African-American population had rates that were about eight times higher than that of the White population (Brückner and Bearman, 2005). Other minority groups had rates two to five times that of the White population for TR, GC, and CH infection (Brückner and Bearman, 2005). Because race/ethnicity and pledging were correlated with STD infection, the authors considered there to be a relationship between the effect of pledging on different racial/ethnicity groups. However, there were no significant differences in STD rates between pledge groups and non-pledge groups, and between races and ethnicities, except for Whites.
The second category is sexual debut and marriage. In this category, the researchers found that the majority of non-pledgers experience their first vaginal intercourse at the ages of 17-18 (Brückner and Bearman, 2005). On the other hand, the majority of pledgers reach their sexual debut at the age of 24 (Brückner and Bearman, 2005). Male and female pledgers were found to be more likely to marry earlier than their non-pledging counterparts. However, despite this information, many pledgers were still found to conduct premarital sex.
The next category that the authors discuss is condom usage and the substitution of vaginal sex. They found that pledgers are significantly less likely to use condoms for their first sexual intercourse than non-pledgers (Brückner and Bearman, 2001, as cited in Brückner and Bearman, 2005). In addition, they found that anal and oral sex were prevalent behaviors in this population (Brückner and Bearman, 2005). A portion of the pledgers partook in oral and anal sex because virginity is often linked solely to vaginal sex. Even in these various types of sexual intercourses, condom usage was found to be very low. Overall, data results show low condom usage and over-representation of pledgers (Brückner and Bearman, 2005).
The final category discusses additional STD risk factors that are thought to be associated with STD acquisition. The risk factor that is emphasized is the risk of the number of sexual partners. Researchers found that pledgers have fewer partners than non-pledgers (Brückner and Bearman, 2005). However, Brückner and Bearman state that it is possible for the pledgers’ partners to have had more numerous partners themselves. Thus leaving the pledgers at a high risk of STDs. But according to the data they received, the authors state that there is no correlation between the higher-than-expected pledge STD rate with high-risk partners (Brückner and Bearman, 2005).
Discussion
Brückner and Bearman concluded that there is no significant difference in STD infection rates between virginity pledgers and non-pledgers (Brückner and Bearman, 2005). Even though the pledgers had a delayed first sex, less exposure, fewer partners, and lower numbers of sexual partners, research revealed that there was almost no difference between pledgers and non-pledgers, with an exception to the White participants (Brückner and Bearman, 2005). Many supporters of virginity pledges strongly assert that premarital abstinence and post-marital sex are crucial in avoiding STDs. However, this claim clashes with the reality of the sexual behaviors of adolescent teens and young adults. Pledging is not effective in preventing STD acquisition in young adults (Brückner and Bearman, 2005).
Despite the abstinence pledges, many pledgers are reported to still engage in premarital sex. Reports show that the pledgers who do partake in premarital sex have a lower frequency of condom usage at first intercourse, and others who do not report sexual intercourse are likely to substitute vaginal sex with anal and oral sex (Brückner and Bearman, 2005). Furthermore, female pledgers are shown to have the same rates of STDs as female non-pledgers (Brückner and Bearman, 2005).
Past studies have shown that many teens and young adults underestimate their risks of STDs and have inaccurate beliefs about STD protection (Kaiser Family Foundation, 2004, as cited in Brückner and Bearman, 2005). By referring to this data, the authors point out that organizations that promote virginity pledges programs are hostile to other programs that try to inform sexually active adolescents of safe sex (Brückner and Bearman, 2005). Thus, it leads to a higher probability of adolescents of being infected with STDs because pledgers are less likely to be tested and treated for STDs by doctors. Ultimately, Brückner and Bearman suggest that the impact of sex education is not adequate to predict the health impact of STD rates (Brückner and Bearman, 2005).
References
Bearman, P., & Brückner, H. (2005). After the promise: The STD consequences of adolescent virginity pledges. Journal of Adolescent Health, 36(4), 271-278. doi:10.1016/j.jadohealth.2005.01.005
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