February 23, 2005

Based on the Research, Comprehensive Sex Education Is More Effective at Stopping the Spread of HIV Infection, Says APA Committee

Research shows that abstinence-only programs have limited effectiveness and unintended consequences

WASHINGTON—It is estimated that more than half of all new HIV infections occur before the age of 25 and most are acquired through unprotected sexual intercourse. According to the experts on AIDS, many of these new infections occur because young people don't have the knowledge or skills to protect themselves. To address this important health issue, the American Psychological Association (APA) is recommending that comprehensive and empirically supported sex education and HIV prevention programs become widely available to teach youth how to abstain from risky sexual behaviors and learn how they can protect themselves against HIV and other sexually transmitted diseases.

Based on over 15 years of research, the evidence shows that comprehensive sexuality education programs for youth that encourage abstinence, promote appropriate condom use, and teach sexual communication skills reduce HIV-risk behavior and also delay the onset of sexual intercourse.

Research shows that one in five adolescents will have sex before the age of 15 and most who continue to be sexually active do not use condoms consistently. Although some youth acknowledge their fears about HIV/AIDS, many do not perceive themselves to be at risk and lack accurate information about what circumstances put them at risk for HIV infection. According to the CDC, the use of condoms can substantially reduce the risk of HIV.

The APA Committee on Psychology and AIDS is charged with providing policy direction and oversight for activities related to HIV/AIDS. An area of concern, according to the committee members, is that while current Federal policy actively supports widespread implementation of abstinence-only education programs as a way to prevent HIV transmission, there is little scientific evidence that these programs work. Those few studies which report evidence in support of abstinence only and abstinence until marriage programs have very limited generalizability because they did not use appropriate comparison groups and they did not use the type of sampling strategies required to ensure minimum bias in the selection of research subjects. .

"Both comprehensive sex education and abstinence only programs delay the onset of sexual activity. However, only comprehensive sex education is effective in protecting adolescents from pregnancy and sexually transmitted illnesses at first intercourse and during later sexual activity. In contrast, scientifically sound studies of abstinence only programs show an unintended consequence of unprotected sex at first intercourse and during later sexual activity. In this way, abstinence only programs increase the risk of these adolescents for pregnancy and sexually transmitted illnesses, including HIV/AIDS," said psychologist Maureen Lyon, PhD, Chair of the committee that produced the report.

"We have found that comprehensive sexuality education programs, those that provide information, encourage abstinence, promote condom use for those who are sexually active, encourage fewer sexual partners, educate about the importance of early identification and treatment of sexually transmitted diseases and teach sexual communication skills are the most effective in keeping sexually active adolescents disease free," said psychologist Mary Jane Rotheram, PhD, of the University of California, Los Angeles and one of the major contributors to the committee's report.

The research on adolescents' sexual behavior shows that comprehensive sexuality education programs that discuss the appropriate use of condoms do not accelerate sexual experiences. On the contrary, evidence suggests that such programs actually increase the number of adolescents who abstain from sex and also delay the onset of first sexual intercourse. Furthermore, these programs decrease the likelihood of unprotected sex and increase condom use among those having sex for the first time.

According to the findings in the report, APA has developed the following recommendations:

  • Programs to prevent HIV and sexually transmitted diseases among youth should provide clear definitions of the behaviors targeted for change, address a range of sexual behaviors, be available to all adolescents (including youth of color, gay and lesbian adolescents, adolescents exploring same-sex relationships, drug users, adolescent offenders, school dropouts, runaways, mentally ill, homeless and migrant adolescents), and focus on maximizing a range of positive and lasting health outcomes.
  • Only those programs whose efficacy and effectiveness have been well-established through sound scientific methods should be supported for widespread implementation.
  • New programs to prevent HIV and sexually transmitted diseases among youth should be tested against those programs with proven effectiveness.

APA Committee on Psychology and AIDS: Geri Donenberg, PhD, University of Illinois at Chicago; Bianca Guzman, PhD, C.H.O.I.C.E.S.; Karen Ingersoll, PhD, Chair, Medical College of Virginia; Maureen Ellen Lyon, PhD, ABPP, Children's National Medical Center; David Martin, PhD, Harbor-UCLA Medical Center; Mary Jane Rotheram, PhD, University of California, Los Angeles; Jeffrey T. Parsons, PhD, Hunter College; Javier Salazar, CAEAR Coalition Foundation.

Reporters Only: Mary Jane Rotheram, PhD can be by phone at (310) 794-8280 and Maureen Ellen Lyon, PhD can be reached by phone at (703) 346-2873.

The American Psychological Association (APA), in Washington, DC, is the largest scientific and professional organization representing psychology in the United States and is the world's largest association of psychologists. APA's membership includes more than 150,000 researchers, educators, clinicians, consultants and students. Through its divisions in 53 subfields of psychology and affiliations with 60 state, territorial and Canadian provincial associations, APA works to advance psychology as a science, as a profession and as a means of promoting health, education and human welfare.