Related to changing sexual behaviors as a solution. I have read several articles in the last week that do however, from a very conservative viewpoint, wish to alter American's and teenagers sexual behaviors. My observations are two things about this that have a history of not working. The first is prohibition of ANYTHING. I don't care what you pick, alcohol, prostitution, illegal drugs etc. it has never worked. You can make it illegal, you can stigmatize those that engage in it, but at the end of the day you can't eliminate it.

So using OCF tobacco policy as an example, we are proponents of "harm reduction" vs. prohibition. Essentially this means acceptance of the behavior, but offering alternatives that in some way reduce the harm. Clearly in tobacco use this would be replacement of the addictive portion of the product, nicotine with a strong enough supplement to have an equal effect to what was currently being used. The gums and patches do not, and OCF is an advocate for a controlled availability of nicotine inhalers and nasal sprays as higher dose delivery systems that do little harm, but reduce the incidence of inhaled combustion products from burning tobacco. It's not a perfect solution, people are still addicted and some will have higher blood pressure (not more than tobacco use but more than a non smoker), but cancer incidence particularly lung and oral will go down.

Since there is some argument about what constitutes "good" harm reduction, here are a couple of examples. In heroin use, we have FREE methadone to anyone that wants it without too many questions associated with getting it. They are still addicts, but the element of crime to generate capital to buy their habit is eliminated. Some harm reduction (particularly to others, some less revenues going into organized crime) but not a perfect solution. The key is there is no introduction of any new harm in the process. Another good harm reduction strategy are needle exchange programs. They do not stop people from being addicts, but they do stop the spread of HIV, hepatitis and other deadly diseases through their use.

Right now the idea of harm reduction in sex is limited to condom use (partially helpful in HPV, certainly helpful in the AIDS paradigm) and education (whatever is left after our current politics eliminate most of it from our schools for reasons I won't go into here). After that there are no real behavior changes that we can really count on - anyone that remembers their early years when hormones were raging and the opposite sex took a disproportionate amount of your thought process, understands why. Really what we have now is a chance to help the next generation through vaccination, and early discovery of disease stages in HPV+ oral cancers to reduce treatment related morbidity and death.