New Study on Abstinence-Only Sex Education Released

The Archives of Pediatrics and Adolescent Medicine released a new study in February on the efficacy of different types of sex education for middle school students, and found an abstinence-only curriculum to be the most effective in delaying the onset of sexual activity.  The study, “Efficacy of a Theory-Based Abstinence-Only Intervention Over 24 Months,” is the first ever to show an abstinence-only program to be effective and has sent ripples through both sides of the ongoing sex education debate. 

Most notable about this study is the kind of abstinence-only program used.  Instead of being crafted to meet Bush-era federal funding guidelines, which required programs to be intentionally disparaging of all forms of contraception and any premarital sex and forbade them from teaching about safe sex, this abstinence-only program is not moralistic, does not portray sex or contraception in a negative light, and promotes abstinence “until a later time in life” instead of until marriage.

The study measured the efficacy of different types of interventions in delaying the onset of sexual activity and increasing the use of condoms.  The abstinence-only program was one of five intervention programs, the others being a safer sex-only program, two different comprehensive sex education programs, and a general health-promotion program, which served as a control group.  Four programs were each eight hours in length and delivered over two sessions; one of the comprehensive programs was twelve hours and three sessions long. 

Follow-up interviews with participants in the five programs revealed that two years after the intervention programs,

• all programs saw a marked increase in sexual activity;
• among students who had not had sex before the intervention, 33.5 percent in the abstinence-only group were likely to have had sex after two years, compared to 48.5 percent for the other four groups, with no significant difference among these groups;
• participants in both comprehensive groups were significantly less likely to have multiple partners than participants in the control group; and
• all groups saw an increase in condom use, with no significant differences in condom use across the five groups.

These findings are promising for advocacy groups – such as National Campaign to Prevent Teen Pregnancy - which seek to advance age-appropriate, evidence-based sex education, but the prevailing limitations of abstinence-only education raise serious questions as well, as outlined by SIECUS in its review of the study.  Of particular concern is that, among the participants in the study, with an average age of 12 years old, 23.4 percent - including 20.3 percent in the abstinence-only intervention group – were already having sex.  Nationally only 6 percent of teens report having sex before age 13, and the average age of first sex across the country is 17.  Withholding critical information about contraception and safe sex from teens who are already sexually active only puts them at further risk.

Cautious about the implications of their findings, the authors of the study state that “the results of this trial should not be taken to mean that all abstinence-only interventions are efficacious … or that other approaches should be abandoned.”  They recognize that the very targeted nature of the prevention program, created specifically for sixth- and seventh-grade African Americans in an urban setting, limits the generalizability of the results.  Whether this program would work for older teens, or teens of other races in other areas of the country, is “unclear.”  A follow-up editorial in Archives of Pediatrics and Adolescent Medicine further cautions that “no public policy should be based on the results of one study.”

Federal funding for abstinence-only sex education began under the Clinton administration and gained notoriety under Pres. George W. Bush, during whose second term teen pregnancy rates rose for the first time in over fifteen years.   President Obama’s proposed 2010 fiscal year budget shifted funding priorities, and the budget that passed eliminated abstinence-only funding, rededicating $110 million to evidence-based sex education programs, of which there are many.  The proposed budget for the 2011 fiscal year increases that amount to $129 million. While the Archives of Pediatrics and Adolescent Medicine study contributes in some ways to an understanding of “what works” in sex education, its findings about early teen sex and condom use confirm that there is still a long way to go. 

For more information, contact Wendy Pollack, director, Women’s Law and Policy Project, Sargent Shriver National Center on Poverty Law, at 312.368.3303 or wendypollack@povertylaw.org.

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