HIVとともに 「性の健康」を学ぶ / Sex Ed for the Stroller Set

HIVとともに　「性の健康」を学ぶ
思春期前に正しい知識

小学生の娘たちに性感染症について話した熊谷さん科学的に話せる雰囲気を
　　　
　ＨＩＶ（エイズウイルス）などの性感染症について、子どもたちに上手に教えるには、どうしたらいいのだろうか。

　我が子が思春期にさしかかると、性にかかわることは親子で話しにくいものだ。自らも小６の息子を持つ東京都立駒込病院感染症科の看護師、堀成美さんは「インターネットや雑誌、友達から、ゆがんだ性情報が入ってくる前に、正しい知識を伝えたいものです」と、思春期以前の「情報先着主義」を唱える。

　千葉県浦安市の開業助産師、川口真理子さんも同じ考えだ。同市が小学生や幼稚園児の親を対象に、公民館で開いている「家庭教育学級」で、「幼児期からの性の健康教育」を親たちに勧めている。

　男女４人の子どもを持つ同市の熊谷玲子さん（３６）は、３年前に初めて川口さんの講演を聴き、「目からウロコが落ちた」と言う。

　最近は小学生でも、性について見聞きすることが多くなったが、正しい知識を持っているようには思えない。「学校の先生の話では、小３ぐらいの子がもう『先生ってセックスしたんだ、へえ～不潔』とか言うらしいんです」

　早速、川口さんが講演の中で紹介した性教育の絵本を借りて帰り、当時小３と小１だった娘たちと一緒に読んだ。「セックスのことは何となく知っていたけど、エッチなことだと思っていた。お母さんの話で初めて、ちゃんとしたことなんだと分かった」と、現在小６の長女は振り返る。

　性について理解し、また科学的な話もわかる学年になったことをふまえ、熊谷さんは最近、性感染症について娘たちと話した。

　ＨＩＶやクラミジア、尖圭（せんけい）コンジローマ、性器ヘルペスなど一通りの性感染症と、それぞれの症状や予防法が詳しく書かれたホームページを見つけ、娘たちと一緒に読んだ。長女は、輸血でＨＩＶに感染した子どもについての本は読んだことがあったが、「セックスでうつることは知らなかった」と言う。

　性について、子どもたちは興味本位で知りたがることが多いが、病気のことを含め、現実の危険性をはっきり見せることも必要だ。

　３人の子を持つ神奈川県の母親（４８）は、子ども向け健康教育の教材として作られた「性感染症」（少年写真新聞社）という本を買ってきた。患部の写真なども載っていて、当時小中学生だった子どもたちは、「気持ち悪い～」と言いながらも、熱心に見ていたという。

　川口さんは、「性感染症について、親がすべて知っていなくても、子どもと一緒に調べればいいんです。大事なのは、性の健康について親子で科学的に話せる雰囲気を作っておくこと。そうすれば、思春期になって何か困ったことが起きた時に、子どもが親に助けを求めることもできるでしょう」と話している。

（2005年11月23日 読売新聞）

予防教室　親も“開眼”


保健所が開いたシンポジウムの討論に、多くの保護者が熱心に耳を傾けた（千葉県勝浦市で）「感染防ぐ道具はコンドームだけ。でも１００％ではありません」
　性感染症が若者の間に広がりつつある。命にかかわることもあるＨＩＶ（エイズウイルス）感染もその一つだ。思春期の子を持つ親は心配が尽きないが、実は、親世代である中年以上の感染者も少なくない。

　「性の健康」についての知識は幼児からお年寄りまで、みんなに必要だと気づき、一生を通じて学ぼうという動きも出てきた。子どもとともに学び始めた親たちを取材した。

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　「性感染症には、薬で治せる病気と、治せない病気があります。エイズのように放っておいたら死に至る病気もあるんですよ」「防ぐ道具はコンドームだけ。でも１００％ではありません。セックスをするようになったら、自分の健康を守るために、医療機関で定期的に調べる必要があります」

　冷房の利いたパソコン教室に集まった６０人の中学３年生に、どよめきが広がった。

　千葉県御宿町の町立御宿中学校で、今年９月に行われたモデル授業「思春期教室」。東京都立駒込病院感染症科の看護師、堀成美さんが講師を務めた。同病院はエイズ治療の拠点病院で、８００人のＨＩＶ感染者／エイズ患者が通院している。

　この日は保護者にも参観を呼びかけ、約１０人が参加した。一人の女子生徒の母親は「子どもたちを守るためには、科学的な知識が必要だと思う。踏み込んだところまで教えてもらえて、親としては助かりました」と話した。

　同町や勝浦市など千葉県南東部の６市町を受け持つ県の夷隅（いすみ）保健所が、このモデル授業を企画した。同保健所地域保健福祉課の高梨葉子さんは「若者の性の健康は、学校だけで守れるものではない。保護者をはじめ地域全体で取り組む必要があるが、ほとんどの保護者は若者の性の実態を知らないし、学校で行われている性教育にも無関心なんです」と嘆く。

　高３女子４割　性交経験あり

　全国高等学校ＰＴＡ連合会の昨年度の調査によると、高校３年女子の３８・６％がセックスを経験していた。厚生労働省研究班は、１８歳女性の１５人に１人がクラミジアに感染していると推計している。

　「クラミジアに感染するということは、当然ＨＩＶにも感染する可能性がある。ＨＩＶは潜伏期間が長いので、気が付かないうちに感染が広がる危険がある」と、研究班班長の熊本悦明・札幌医大名誉教授は心配する。

　保健体育の教科書に性感染症は載っているが、実際にどう教えるかは、学校や教師によってまちまちだ。御宿中の場合も「性交のことは、学校では取り上げにくい。第二次性徴や妊娠・出産は教えても、性感染症や望まない妊娠については、ほとんど手をつけてこなかった」と養護教諭の高梨智子さんは話す。

　夷隅保健所は「性の健康」教育に保護者を巻き込むため、昨年、今年と２年続けて、学校、保護者、行政関係者が一堂に会する「思春期の性に関するシンポジウム」を開催した。

　前述の母親は、モデル授業を参観し、親の役割にも気付いたという。「具体的な予防法を専門家に聞いて終わりではなく、『お互いの心と体を思いやる』『愛＝セックスと思わないようにする』など精神面のフォローを、親や教師がしなければ。それをして初めて、本当の意味で性の健康教育といえるのではないでしょうか」

　感染者・患者１万人超

　国内で昨年新たに報告されたＨＩＶ感染者とエイズ患者の数は計１１６５人で、史上初めて１０００人を超えた。日本で初めてエイズ患者が確認された１９８５年以来の累計は１万人を突破している。

　年代別では、感染者、患者とも３０代が最も多いが、１０代後半でＨＩＶ感染が分かった人も１１人、２０代前半では９０人に上った。２０代前半で既にエイズを発症した患者も９人いた。一方、４０代、５０代、６０歳以上の各年代でも、それぞれ数十人以上の感染者、患者が出ており、若い世代だけの問題ではないことが分かる。

（2005年11月22日 読売新聞）


The New York Times
November 17, 2005
Sex Ed for the Stroller Set
By JODI KANTOR

THIS September 3-year-old Halley Vollmar of Bellmore, N.Y., was having her annual checkup when her pediatrician paused. "I'm going to check your peepee now," he warned, and tugged down her underwear. But Halley protested. "Mommy, why he call my vagina a peepee?" she scolded, telling the startled physician he was a "silly doctor" before allowing him to proceed.

Last week Kristin Hansen, Halley's mother, recounted the story to several other women with a satisfied laugh. The gathering in Wantagh, N.Y., was something of a reunion. Over the summer the mothers had convened weekly for lessons in how to educate their toddlers about sex, a program they found so necessary they are already planning to reconvene next year.

Halley may be surprisingly articulate about her private parts, but she is in excellent company. Like many other parents and educators, the mothers chatting over lemonade and coffee cake in Susan Vartoukian's toy-strewn home maintain that sex education - once and mostly still an awkward fixture of the pubescent years - should begin early. And when they say early, they mean it: preferably from birth, or if not that, from toilet training age. "Parents don't have the luxury of silence anymore," said Nanette Ecker, a sex educator at the Nassau County chapter of Planned Parenthood, who led the group.

For most adults, knowledge of intercourse came as a distinct moment of revelation: an "aha" moment in the schoolyard or the living room when the mysterious connection between body parts and babies was made suddenly and shockingly clear. But now children who are practically babies themselves are learning how babies are made.

According to this approach, toddlers should learn words like "vulva" at the same time they learn "ears" and "toes," benign-sounding myths about storks and seeds constitute harmful misinformation, and any child who can ask about how he or she was created is old enough for a truthful answer.

"People have been told by experts that there's a right age" to learn about intercourse, said Dr. Justin Richardson, a assistant professor of psychiatry at Cornell and Columbia medical schools and an author of "Everything You Never Wanted Your Kids to Know About Sex (But Were Afraid They'd Ask)," one of a number of recently published guides that advocates early tutelage.

"If you're talking about how babies are made, there's no age at which it is harmful to learn that the penis goes into the vagina," he said. "Yes, it's true that exposing a child to sexual stimulation is harmful. But telling a kid how babies are made is very different."

The general cultural environment has become so vulgar, the early-approach advocates say, that sex education has become a race: parents must reach children before other forces - from misinformed playground confidantes to pubescent-looking models posed in their skivvies - do. "We need to get there first," said Deborah M. Roffman, a sex educator and the author of "But How'd I Get in There in the First Place? Talking to Your Young Child About Sex."

If not, these advocates warn, children will gather their impressions anywhere and everywhere: from prime-time television jokes about threesomes, Internet pop-up ads for penis enlargement pills or even more explicit Web sites. When the Rev. Debra Haffner's son typed "Katrina images" into Google's search box for a school project, he ended up staring at photographs that had nothing to do with the hurricane, said Ms. Haffner, a Unitarian Universalist minister and the author of "From Diapers to Dating."

"When parents say to me, 'But my child is too young, I want to keep them safe and innocent for as long as I can,' I say, 'Do you take them grocery shopping?' " Ms. Haffner said, referring to the naughty poses and headlines featured on magazines at the checkout counter.

Early sex education is a small and hard-to-measure movement, but it's a growing one, with advocates like Ms. Roffman, Ms. Haffner and Dr. Richardson writing books and conducting seminars for parents, preschool teachers and day care providers. Many chapters of Planned Parenthood offer workshops on the topic and so do some evangelical Christian churches.

"The classic approach in religious circles has been, shield their innocence for as long as you can, until they're 13, then give them The Talk," said Stanton L. Jones, a professor of psychology and the provost of Wheaton College in Illinois. Dr. Stanton and his wife, Brenna Jones, wrote "The Story of Me," a sex education book for 3-to-5-year-olds. (The book emphasizes God's contribution and traditional gender roles, and says less about intercourse than many of its secular equivalents).

Lately the Joneses "have found a lot of acceptance" for starting sex education early, Mr. Jones said; pastors teach their approach at conferences on family life, and the book is sold by the conservative evangelical group Focus on the Family.

Robie H. Harris, a leading author of sex education books for children, started on the topic in 1994 with "It's Perfectly Normal" for preteenagers. (There are now 400,000 copies in print in the United States and more than a million worldwide.) Since then she has found herself addressing progressively younger audiences: first with "It's So Amazing," geared to 7-year-olds and up, and now "It's Not the Stork," due this summer, and intended for children as young as 4. In 2008 she is to publish a volume aimed at 2½-year-olds. Her steady downward demographic shift, she said, is purely in response to parental demand. "Everyplace I would speak, I would hear, 'I don't know how to talk about this,' " Ms. Harris said.

On the whole, early sex education has attracted little organized resistance. While Ms. Harris's "It's Perfectly Normal" often appears on the American Library Association's annual list of most frequently challenged books - critics object to its references to homosexuality, contraception and masturbation - her work for younger children has drawn less attention. Perhaps this is because early sex education is a matter of parental choice or because the materials tend to concentrate on basic biology and safety.

Rather, the resistance comes from parents who cannot imagine initiating a conversation about sex with children who cannot read a book or ride a bicycle, and haven't yet displayed any curiosity about the matter. Rachel Wolman of Chevy Chase, Md., said she "would definitely not" sit her 3-year-old daughter down "for a birds-and-bees discussion."

"I'm guessing that kids wise up pretty quick by the time they get to 5," she added, "but even at that point, I'm not prepared to have a sit-down to run through how things work."

Jaymi Offir, a mother in Caldwell, N.J., said that introducing the topic to her daughter, Zoe, nearly 4, "would only confuse her."

"Being proactive at sex ed would be more appropriate for 9- or 10-year-olds," she said.

But even if parents of kindergarten-age children aren't prepared to discuss intercourse, early-childhood sex educators urge parents to abandon the usual litany of babyish names for private parts: the rather insulting "weenie" for boys, the murky "down there" for girls and so on. (A 1997 study in the journal Gender and Psychoanalysis showed that fewer girls are taught names for their genitals than boys, and that while girls learn the names of male genitals, the reverse is often not the case.)

When showing children their eyes and noses, "we don't say 'blink blink' or 'blow blow,'" said Ms. Ecker of Planned Parenthood.

Instead some toddlers are learning startlingly specific, biologically correct terms that even adults tend to confuse. "It's Not the Stork" includes a drawing of the vas deferens (the tubes that carry sperm); many educators emphasize the difference between the vagina (the tract that connects the uterus to the outside of the body) and the vulva (a collective term for all of the external female genital organs).

Early childhood sex educators also caution parents about never - no matter how mortifying the question - lying to children. Or feeding them benign-sounding half truths. Or even distracting them. "Kids have a right to have this information," Ms. Harris said. "If we ignore it, then the myths and fears start coming in."

The solution, they agree, is to give correct but simple answers. Parents have a tendency to blurt out more than what's needed: answering a question about nipples, say, with a flustered, halting lecture on sexual pleasure.

"If a child holds up a tampon and says, 'What's this?' " said Bill Taverner, the director of education for Planned Parenthood of Greater Northern New Jersey, "the best answer may just be, 'that's a tampon.' Having a name for something is sometimes enough."

The early education approach has exaggerated the already wide disparities in what various kids know, and some arrive at school so fluent that they fluster their teachers. (Though some public elementary schools do teach sex education, especially HIV awareness, it's a scattered affair, varying enormously not only by state but by district and even classroom.)

Take Mr. Taverner's son Rob, whose first-grade teacher refused to hang on the bulletin board a drawing on which the child had scrawled, "Sex is when two married people join the egg and the sperm."

Even parents who have embraced this kind of frankness seem somewhat taken aback by it. Back in Wantagh, Diana Lee shook her head over the difference between the rich sexual education her daughter, Alexandra, already had, and the skimpy one she received as a child.

"I was surprised I had to tell her so much at 3 years old," she said. "I'm still waiting for The Talk," she added of her own parents' silence on the matter.

"It's a fun time at dinner now," Ms. Vartoukian, the host of the Wantagh gathering, said, gesturing at her two small boys. "We have The Talk every single night."