Not enough evidence to support 'abstinence-only'

VOLUME 30, NUMBER 11 December 1999

Psychologists say the government is paying for sex-ed programs that haven't been proven effective.

By Lisa Rabasca
Monitor staff

There's no compelling evidence to prove abstinence-only education reduces sexual activity in teen-agers, say psychologists. Yet the federal government is spending $250 million to teach students that abstinence is the only way to protect themselves against pregnancy, sexually transmitted diseases and HIV infection.

Congress gave abstinence-only education its blessing in 1996 when it agreed to fund these programs from 1998 to 2002. But many psychologists say promoting abstinence from sex rather than safer-sex procedures is an unrealistic message because it ignores the reality that four out of five teen-agers are sexually active by age 18.

Only a handful of studies have measured the effect abstinence-only programs have on teens' sexual behaviors. None have found a consistent and significant impact on delaying intercourse, says Douglas Kirby, PhD.

"It's likely that some abstinence-only programs work and some don't," says Kirby, a senior research scientist at ETR Associates, a nonprofit organization in Santa Cruz, Calif., that promotes health education and research. "It's an important task to identify which programs do work."

Until those programs are identified, many psychologists say there's no reason for Congress to exclude other types of sexuality education.

What's out there

Sex education in the United States falls into three categories:

Abstinence-only programs, which teach students that sexual activity outside of marriage is likely to have harmful psychological and physical effects.

Abstinence-based education, also referred to as comprehensive sexuality education, which urges students to wait until marriage to have sex, but also educates them on condoms and other methods of contraception that protect against pregnancy, HIV infection and sexually transmitted diseases (STDs).

Safer-sex programs, which offer no guidance on delaying sexual activity, but teach students how to use condoms and other methods of contraception.

Two dozen published studies have shown that safer-sex and abstinence-based programs reduce teens' risky sexual behaviors. But few studies have been done on abstinence-only programs, and most of those that have been conducted had several methodological limitations, such as measuring short-term behaviors or having small sample sizes, psychologists and others say. None of them found that these programs delayed sexual activity or changed other sexual behaviors, says Kirby.

New Hampshire and California are the only two states that don't accept federal funding for abstinence-only education. The other 48 states have used federal money to award nearly 700 new abstinence-only grants to community-based organizations and education agencies across the country, according to the Sexuality Information and Education Council of the United States.

Meanwhile, abstinence-only education programs vary widely. Although their common message advises to abstain from sex until marriage, some programs run 15 to 20 sessions and include parent groups, while others last only one or two sessions.

Few include skill-building interventions, says Kirby. Instead, most don't discuss the protection provided by condoms and teach students that the only way to avoid pregnancy, STDs or HIV is by not having sex.

"The main message of many abstinence-only programs is sex outside the marriage is wrong" says Kirby. "But research has taught us we need to do more than that to make the program effective."

The decision about which sexuality-education program to use rests with individual school boards. In many communities, only a minority of adults support abstinence-only education but this minority is often more organized and vocal and their actions often sway the school board, says Kirby.

Study planned--a bit too late

This fall, Congress began funding a $6 million study to evaluate the effectiveness of abstinence-only education. The study will look at about a dozen abstinence-only programs that use different curricula and will have a control group.

"Ultimately, what we want to know is whether the students abstained from sex," says Rebecca Maynard, of Mathematica Policy Research, Inc., which is conducting the study.

The results are expected to influence whether Congress continues to fund abstinence-only education. But, Maynard says, the decision about whether to reauthorize the program will be determined before Congress gets the report in August 2001.

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