New research published in Pediatrics found that 20% of 9 th graders surveyed have engaged in oral sex. Conducted by Dr. Bonnie Halpern-Felsher, Professor of Pediatrics at University of California , San Francisco (UCSF) and her colleagues, the study involved an ethnically diverse sample of 580 California students ages 14 and 15. The teens completed a questionnaire that inquired about their sexual activity, attitudes, and perceptions of risk.1
Among the respondents, oral sex was more prevalent than vaginal sex and was perceived both as more socially acceptable and as less risky with respect to sexually transmitted diseases (STDs). In addition to the 20% of students who had already participated in oral sex (compared to 14% who had participated in vaginal sex), 32% responded that they intended to have oral sex in the next six months.2
Oral sex is in fact significantly less risky than vaginal or anal intercourse for transmitting HIV and other STDs, and the majority of students acknowledged this difference. However, researchers were concerned that some students inaccurately believed that there is no risk of transmitting STDs through oral sex.3
According to the researchers, this gap in teen knowledge must be addressed with "information and guidance about potential health risks and risk-reducing strategies such as barrier protection (eg, condoms, dental dams), as well as stressing the importance of talking to one's sexual partners about their sexual history, including noncoital experiences."4 They also recommend that sexuality educators begin providing these messages before high school because adolescents are having oral sex before they reach the 9 th grade.
This article adds to the growing research documenting the reality of teen sexual activity. The Youth Risk Behavior Survey (YRBS), administered nationally by the Centers for Disease Control and Prevention, reports that 45% of female high school students and 48% of male high school students have ever had sexual intercourse. 5 The YRBS does not clearly define "sexual intercourse" nor does it ask questions about sexual activity other than vaginal intercourse. This new UCSF research focusing on oral sex reveals that younger students are engaging in other forms of sexual activity in significant numbers.
Despite these numbers, the Bush administration has not heeded the recommendations of public health and pediatric researchers who suggest comprehensive approaches to sexuality education. Instead, the President's Fiscal Year 2006 Budget allocates $206 million for unproven abstinence-only-until-marriage programs that are prohibited from mentioning condoms and contraception unless discussing their failure rates.
Some of these abstinence-only-until-marriage programs have also been associated with higher rates of oral sex. A recent study of young people that took virginity pledges, a common component of such programs, found that they had the same rate of STDs as their peers who did not pledge and that they were more likely to engage in risky behavior including unprotected oral and anal sex.6 Researchers concluded that some pledgers engaged in alternative sexual behaviors in order to preserve their "virginity." Participants in the UCSF study also believed that oral sex was less threatening to their moral, ethical, and religious beliefs compared to vaginal sex.7
This research allows policymakers and public health professionals a more complete picture of teen sexual activity. Nationally, teen pregnancy rates have been decreasing, but as this study points out pregnancy rates do not accurately capture the full spectrum of sexual activity or STD risk that young people experience. The study also suggests that youth making complex decisions surrounding these issues can be best supported by comprehensive sexuality education programs that include information about abstinence as well as contraception and other risk-reduction strategies.
1 Bonnie L Halpern-Felsher, et al., "Oral Versus Vaginal Sex Among Adolescents: Perceptions, Attitudes, and Behavior," Pediatrics 115.4 (April 2005): 845-851.
2 Ibid, 845.
3 Ibid, 849.
4 Ibid. 850.
5 Jo Anne Grunbaum, et al., "Youth Risk Behavior Surveillance- United States , 2003," Surveillance Summaries, Morbidity and Mortality Weekly Report 53.SS-2 (21 May 2004): 1-95, accessed 28 January 2005, < http://www.cdc.gov/nccdphp/dash/yrbs/ >.
6 Hannah Brückner and Peter S. Bearman, "After the Promise: the STD Consequences of Adolescent Virginity Pledges," Journal of Adolescent Health 36 (2005): 271-278.
7 Halpern-Felsher, et al., 849.