Abstinence message is less effective than teaching about safer sex

Safer-sex interventions work best to prevent sexually experienced youth from contracting HIV through sex, says one of the first large-scale studies to compare a safer-sex intervention with an abstinence intervention.

The study, published in the Journal of the American Medical Association (Vol. 279, No. 19, p. 1529?1536), enrolled 659 African-American adolescents into one of three interventions. An abstinence intervention emphasized delaying sexual intercourse or reducing its frequency; a safer-sex intervention stressed condom use; and a control intervention discussed health issues unrelated to sexual behavior. Researchers designed both the abstinence and safer-sex interventions to be culturally sensitive and based them on cognitive-behavioral theories and basic behavioral research.

Safer-sex intervention participants reported higher frequency of condom use than either of the other intervention groups at three-, six- and 12-month follow ups. And, among adolescents who reported sexual experience at the start of the study, those in the safer-sex intervention reported less sexual intercourse at six- and 12-month follow up than those in either of the other interventions.

Adolescents in the abstinence intervention were more likely to abstain from sex three months after the intervention but not a year later, the researchers found.

'Both abstinence and safer-sex interventions can reduce HIV sexual risk behaviors, but safer-sex interventions may be especially effective with sexually experienced adolescents and may have longer-lasting effects,' conclude the study authors, psychologists John Jemmott, III, PhD, Loretta Sweet Jemmott, PhD, and Geoffrey T. Fong, PhD.

An editorial that accompanied the article criticized a provision of the Welfare Reform Act that earmarked $50 million annually for five years to states for the provision of abstinence-only programs.

?B. Azar