US research could be important in protecting teens against pregnancy and STDs, writes ROB STEINin Washington
SEX EDUCATION classes that focus on encouraging children to remain abstinent can convince a significant proportion to delay sexual activity, researchers reported this week.
The landmark study in the US could have major implications for the protection of young people against unwanted pregnancies and sexually transmitted diseases (STDs).
In the first carefully designed study to evaluate the controversial approach to sex education, researchers found only about a third of 6th and 7th graders (average age 11-13 years) who went through sessions focused on abstinence started having sex in the next two years. In contrast, almost half of students who got other classes, including those that included details on contraception, became sexually active.
“I think we’ve written off abstinence-only education without looking closely at the nature of the evidence,” says John B Jemmott III, a professor at the University of Pennsylvania, who led the federally funded study. “Our study shows this could be one approach that could be used.”
The research, published in the Archives of Pediatric Adolescent Medicine, comes amid intense debate over how to reduce sexual activity, pregnancies, births and STDs among children and teenagers. After declining for more than a decade, births, pregnancies and STDs among US teens have begun to rise again.
The new study involved 662 African-American students who were randomly assigned to go through one of five programmes: an eight-hour curriculum that encouraged them to delay having sex; an eight-hour programme focused on teaching safe sex; an eight- or 12-hour programme that did both; or an eight-hour programme focused on teaching the youngsters other ways to be healthy, such as eating well and exercising.
Over the next two years, 33.5 per cent of the students who went through the abstinence programme started having sex, compared to 52 per cent who were just taught safe sex. About 42 per cent of the students who went through the comprehensive programme started having sex, and about 48.5 per cent of those who just learned about other ways to be healthy. The abstinence programme had no negative effects on condom use, which has been a major criticism of the abstinence approach.
The Obama administration has cut more than $150 million (€107.5 million) in federal funding targeted at abstinence programmes, which are relatively new and have little rigorous evidence supporting their effectiveness. Instead, it is launching a new $114 million pregnancy prevention initiative that will fund only programmes that have been shown scientifically to work. On Monday, the administration proposed expanding that programme to $183 million next year. The move came after intensifying questions about the effectiveness of abstinence programmes.
“This new study is game-changing,” says Sarah Brown, who leads the National Campaign to Prevent Teen and Unplanned Pregnancy. “For the first time, there is strong evidence that an abstinence-only intervention can help very young teens delay sex and reduce their recent sexual activity as well.” The new study is the first to evaluate an abstinence programme using a “controlled” design comparing it directly to alternative strategies – considered the highest level of scientific evidence.
“This takes away the main pillar of opposition to abstinence education,” says Robert Rector, a senior research fellow at the Heritage Foundation who wrote the criteria for federal funding of abstinence programmes. “I’ve always known that abstinence programmes have gotten a bad rap.” Even long-time critics of the approach praised the new study, saying it provided strong evidence that such programmes can work and may deserve state support.
Based on the findings, Obama administration officials said programmes like the one evaluated in the study could be eligible for federal funding.
“No one study determines funding decisions, but the findings from the research paper suggest that this kind of project could be competitive for grants if there’s promise that it achieves the goal of teen pregnancy prevention,” says health and human services department spokesman Nicholas Pappas.
Several critics of the abstinence-only approach argued that the curriculum tested was not representative of most abstinence programmes. It did not take on a moralistic tone, as many abstinence programmes do. Most notably, the sessions encouraged children to delay sex until they were ready, not necessarily until they were married; did not portray sex outside of marriage as never appropriate, and did not disparage condoms.
“There is no data in this study to support the ‘abstain-until marriage’ programmes, which research proved ineffective during the Bush administration,” says James Wagoner, president of Advocates for Youth. But abstinence supporters disputed this, saying the new programme was essentially the same as other good abstinence programmes.
“For our critics to use ‘marriage’ as the thing that sets the programme in this study apart from federally funded programmes is an exaggeration, and smacks of an effort to dismiss abstinence education rather than understanding what it is,” says Valerie Huber of the National Abstinence Education Association.
“The take-home message is that we need a variety of interventions to address an epidemic like HIV, sexually transmitted diseases and pregnancy,” says Jemmott. “There are populations that really want an abstinence intervention. They are against telling children about condoms. This study suggests abstinence programmes can be part of the mix of programmes that we offer.” – (Washington Post service)