Sex-ed programs with an abstinence-only message may help to delay the start of sexual activity for certain populations of children, a new study suggests.
The researchers looked at the effectiveness of various sex-ed programs for African American middle-school students. They found that, after two years, a program that urged kids to abstain from sex all together reduced the percentage of students who started having sex by about one-third compared with a health course that didn't include sex education (a control group).
Other types of sex-ed programs, such as ones promoting "safe sex" (not abstinence), were not found to significantly delay the start of sex compared with the control group.
The study, which was published in the Archives of Pediatrics & Adolescent Medicine, a journal of the American Medical Association, is the first of its kind to find that abstinence programs can reduce rates of sexual activity among adolescents followed over such a long time.
However, the results do not indicate that abstinence education is necessarily the best way to teach children about the risks of sexual behavior, nor do they suggest that other types of programs should be disregarded, the researchers say.
"The take-home message is that abstinence-only interventions can be used as one of an array of interventions to reduce the risk of sexually transmitted disease and pregnancy within the population," said John B. Jemmott III, a professor of Communication in Psychiatry at the University of Pennsylvania.
In addition, this one study alone should not be used to influence policy, experts say. "The results of this study now must be combined with those from other studies on prevention of sexually transmitted infections and unintended pregnancy and become part of the knowledge base for the formation of public policy on sexuality education," write Frederick P. Rivara of the University of Washington and Alain Joffe of Johns Hopkins University in an accompanying editorial.
Sex-ed debate
Sex education is intended to teach children and young teens about the potential risks of sexual intercourse, including pregnancy and exposure to sexually transmitted diseases, such as HIV. But there has been an ongoing debate about the best method for providing such information.
Some people argue that programs should advocate "abstinence only," while others say sex-ed programs should include information on "safe sex," such as use of condoms and other types of contraception.
The reasoning behind the arguments on both sides, however, is not necessarily accurate, said Jemmott. For instance, some "abstinence" supporters say that teaching children about condom use will encourage them to have sex, a perception that is not backed up by research, Jemmott told LiveScience.
On the other hand, "safe sex" supporters often state that "abstinence" education is harmful because children who receive such education will be less likely to use condoms or other STD-preventing measures. That claim is also not necessarily true, Jemmott said.
While abstinence-only education programs have been widely implemented in the United States, few studies have looked at exactly how effective they are.
Evaluating abstinence
Jemmott and his colleagues enrolled 662 African American students in grades 6 and 7, ranging in age from 10 to 15, from four public middle schools in urban, low-income communities.
The students were randomly assigned to one of five sex-education programs: an eight-hour abstinence-only program; an eight-hour safe-sex program; an eight-hour or a 12-hour comprehensive program that included information on abstinence and contraception use; or an eight-hour health promotion program that discussed health-related issues, such as good dietary practices and exercise habits, but didn’t bring up sexual health — this was the control group.
The students were followed up periodically with questionnaires about their sexual activity, with the final survey taking place two years later. About 84 percent of the initial participants completed the final follow-up.
Results showed that while 48.5 percent of students in the health-promotion group had sex for the first time during the study period, only 33.5 percent of those in the abstinence-only group did so.
The abstinence only program also did not have an effect on whether or not the students in that group used condoms during sex.
The safe-sex and comprehensive interventions didn't significantly postpone the start of sexual activity compared with the control group. However, the comprehensive program was significantly more effective than the control at reducing reports of multiple sexual partners.
Some caveats: the results were based on students' self reports, which may not reflect reality. Also, since the study looked at a specific population of children, the results may not apply to other demographics. And abstinence-only education may have a different outcome in older student groups.
While more research is needed to back-up the results, abstinence should remain part of the sex-ed discussion, Jemmott said. "The longer children postpone having sex, that's a period of time when they can't get pregnant, and they can't get a sexually transmitted disease, so that's a good thing." Also, people who start having sex later in life are more likely to practice responsible sexual behavior such as using condoms, he added.
The study was funded by the National Institute of Mental Health.
