Just Say Maybe to Abstinence ED

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Like the “just say no” anti-drug advertisements that first lady Nancy Reagan made famous a generation ago, abstinence-only sex education programs have become an increasingly popular punching bag for liberal commentators and many youth advocates.

And with good reason. Despite $1.5 billion in federal funding for abstinence education programs from 1997 through 2009, not one carefully controlled random-assignment study of abstinence education showed a significant long-term impact in delaying sexual activity or preventing unsafe sex practices among teens.

Until now. A new study is challenging conventional wisdom and sparking renewed debate about abstinence and sex education.

Surprising results

A research team led by University of Pennsylvania psychologist John Jemmott randomly assigned 662 African-American sixth- and seventh-graders in Philadelphia to one of four regimens: an eight-hour abstinence-focused program; an eight-hour safe-sex program promoting condom use; an eight- or 12-hour comprehensive sex education curriculum aimed at both delaying sex and promoting condom use; or a control group receiving health instruction unrelated to sexuality.

Among those who had not had sexual intercourse before entering the study – about three-fourths of the study population – the abstinence program group proved the least likely to initiate sex. Less than one-third (32.6 percent) of previously inactive youths in the abstinence group had sex during the 24-month study period, compared with 46.6 percent of control group youths. The abstinence education group was also the least likely to report sexual intercourse in the final three months of the 24-month follow-up period.

Those receiving comprehensive sex education reported a slightly lower rate of sexual activity than the control group, while those in the safe sex group were more likely than the controls to initiate sex.

The results flew in the face of substantial prior research suggesting that abstinence-only approaches don’t work, and that comprehensive, theory-driven approaches to sex education are far more effective. Last year, an American Medical Association panel found “scant evidence” to support the effectiveness of abstinence-only education because “the overwhelming number of programs that have been reviewed fail to keep youth abstinent until marriage, or to significantly delay the onset of sexual activity.”

Unlike the methodologically suspect evaluations touted in the past by some conservative-leaning abstinence-education advocates, the new Jemmott study has not been challenged by leading social scientists or youth policy experts – even liberals.

James Wagoner, president of Washington-based Advocates for Youth – which has derided abstinence-only education programs as “not effective” – lauded the study as “good science.”

The National Campaign to Prevent Teen and Unplanned Pregnancy, which had also criticized abstinence education for lack of evidence, called the study “game-changing.”

A different approach

Ironically, the finding emerged one year after Congress and the Obama administration eliminated funding in the 2010 federal budget for three longstanding abstinence-only grant programs. Several abstinence proponents – including Maggie Gallagher at the National Organization for Marriage, Valerie Huber of the National Abstinence Education Association and Christine Kim at the Heritage Foundation, the conservative think tank – touted the new study as proof that those budget cuts were ill-advised.

However, their criticisms ignore a crucial detail: The abstinence curriculum used in the Jemmott study contrasted sharply with the approaches commonly used in abstinence-only-until-marriage and virginity pledge programs. All three federally funded programs that previously supported abstinence education – which together allocated $176 million to state and local programs in 2008 – were reserved for abstinence programs adhering to eight moralistic principles. One required that the sole purpose of instruction be to extol the virtues of abstinence – i.e., no lessons on contraception or avoiding sexually transmitted diseases. Another required that the curriculum promote “abstinence from sexual activity outside marriage as the expected standard for all school children.”

For the Jemmott study, abstinence instructors eschewed such moralism. Rather than preaching that youths should delay sex until marriage or disparaging condom use, the curriculum asked them to weigh for themselves the pros and cons of sexual activity at their young ages. The goal was to empower youth to avoid sex until they were more prepared to handle its consequences (not necessarily until marriage), and to help them develop skills to avoid social pressure to become sexually active. While information about condoms and other contraceptives was not included in the lesson plans, teachers provided accurate information about these topics when questioned by students.

The curriculum “was not designed to meet federal criteria for abstinence-only programs,” the study noted, and it would not have been eligible for federal abstinence-only grants. As the liberal Guttmacher Institute stated, the Jemmott study “adds important new information to the question of ‘what works’ in sex education, but it essentially leaves intact the significant body of evidence showing that abstinence-only-until-marriage programming that met previous federal guidelines is ineffective.”

Policy implications

Even with these caveats, the study represents a seismic shift in the scholarly debate over what works in delaying the onset of sexual activity and preventing pregnancy and sexually transmitted disease. Jemmott himself has expressed surprise at the findings. “We’ve written off abstinence-only education without looking closely at the nature of the evidence,” he told National Public Radio. “Our study shows this could be one approach that could be used.”

Left unanswered is precisely what part the theory-driven brand of abstinence education validated by the Jemmott study should play in sex education and pregnancy/STD prevention efforts.

More research will be required to replicate the Jemmott study and see if its encouraging outcomes can be confirmed for African-American middle school children, then tested among different populations.

Even if subsequent research confirms the Jemmott results, the overwhelming weight of evidence still supports a central role for sex education that combines abstinence messages with accurate information about condoms to prevent pregnancy and sexually transmitted infections once youth become sexually active.