Study Shows Experimental Abstinence-Only Education Program Delays Sexual Activity

Main Category: Sexual Health / STDs
Also Included In: Pediatrics / Children's Health;  Women's Health / Gynecology;  Pregnancy / Obstetrics
Article Date: 03 Feb 2010 - 3:00 PDT

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An experimental abstinence-only education program without moralistic themes was more effective in delaying sexual activity among teens than three alternative sexual education programs, according to an NIH-funded study published Monday in the Archives of Pediatric and Adolescent Medicine, the AP/Washington Post reports (Tanner, AP/Washington Post, 2/1). The study, conducted from 2001 to 2004, involved 662 black public school students in a city in the Northeastern U.S. The study randomly assigned students -- all in either sixth or seventh grade -- to one of four sex education classes and monitored their levels of sexual activity over the next two years. According to the Post, the new research is the first abstinence-only study designed to produce the highest level of scientific evidence by comparing the program with several alternatives and following participants for an extended time.

The first group in the study used an eight-hour abstinence-only curriculum that included sessions in which instructors taught the students in small groups and asked them about their attitudes toward abstinence and sexually transmitted infections. The instructors also led role-playing and brainstorming exercises intended to correct misconceptions, encourage abstinence and explore ways to resist pressure to have sex. The instructors did not take a moralistic tone, did not disparage condom use and encouraged students to wait to begin sexual activity until they were ready -- but not necessarily to wait until marriage, a message espoused in most current abstinence-only programs.

The second class featured an eight-hour curriculum on safer sex, while the third class -- which lasted either eight or 12 hours -- taught abstinence and safer sex methods. The final class, which served as the control, involved an eight-hour program teaching students other ways to be healthy, such as exercising and eating well.

Two years after the classes, 33% of the students from the abstinence-only program, 52% from the safer-sex course, 42% from the comprehensive program and 47% from the control group had started having sex. Researchers also found that the abstinence-only course had no negative effect on condom use, a criticism of current abstinence-only programs (Stein, Washington Post, 2/2). In addition, researchers found that 8.8% of participants in the comprehensive class had sex with multiple partners, compared with 14.1% from the control group, suggesting that the comprehensive instruction lowered the risk of STIs (Maugh/Roan, Los Angeles Times, 2/2).

Reaction

John Jemmott, the study's leader and a professor at the University of Pennsylvania, said, "I think we've written off abstinence-only education without looking closely at the nature of the evidence," adding, "Our study shows this could be one approach that could be used." Sarah Brown, head of the National Campaign To Prevent Teen and Unplanned Pregnancy, said the study's findings are "game-changing," adding, "For the first time, there is strong evidence that an abstinence-only intervention can help very young teens." Monica Rodriguez, vice president for education and training at the Sexuality Information and Education Council of the United States, said, "One of the things that's exciting about this study is that it says we have a new tool to add to our repertoire."

Some observers pointed out that the abstinence-only curriculum included in the study differed greatly from current abstinence-only programs. "There is no data in this study to support the 'abstain until marriage' programs, which research proved ineffective during the Bush administration," James Wagoner, president of Advocates for Youth, said (Washington Post, 2/2). Rodriguez agreed, saying, "It's unfair to compare this abstinence-only intervention to the typical abstinence-only-until-marriage program that young people in this country have been put through" (AP/Washington Post, 2/1). Abstinence-only critics noted that the experimental program did not take a negative approach to condom use and avoided a moralistic tone to promote abstinence, which distinguished it from many current programs.

Implications for Federal Funding, Limitations

The findings come in the wake of new research showing a rise in the U.S. teen pregnancy rate after years of declines. The Obama administration cut funding for abstinence-only education programs from the federal budget and is instead launching a $114 million teen pregnancy prevention initiative to focus on programs that have been scientifically proven to be effective. Administration officials suggested programs similar to the abstinence-only class used in the study could become eligible for federal funding.

Nicholas Papas, a spokesperson for HHS, said, "No one study determines funding decisions, but the findings from the research paper suggest that this kind of project could be competitive for grants if there's promise that it achieves the goal of teen pregnancy prevention" (Washington Post, 2/2). In an editorial accompanying the study, Frederick Rivara -- the journal's editor -- and Alain Joffe -- an associate editor, wrote "No public policy should be based on the results of one study, nor should policymakers selectively use scientific literature to formulate a policy that meets preconceived ideologies."

Jemmott noted that the classes in the study were taught at schools during weekends and suggested that future research could examine effectiveness when such classes are taught during regular school hours by the students' regular teachers. Rodriguez also said that the results suggest that the program in the study could be effective for younger students but cautioned that it might be less useful for older, more sexually experienced teens (AP/Washington Post, 2/1).

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