Abstinence-only programs don’t work

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On Thursday, March 9, advocates of abstinence-only-until-marriage programs will gather behind closed doors with Congressional staff in Washington, DC, to argue for increased funding for this type of approach — which they’ve newly labeled “sexual risk avoidance” (SRA). And like the abstinence-only programs they support, we expect their claims to be short on science and basic facts.

Materials being circulated by ASCEND, an abstinence-only-until-marriage advocacy group, falsely claim that sex education doesn’t work — despite a robust scientific literature showing that sex education programs not only improve young people’s knowledge of reproductive and sexual health, relationships, and other topics, but actually lead to healthier behaviors, such as delaying sex, and using condoms and birth control when they do have sex.

{mosads}What Congressional staff will likely not hear from proponents of abstinence-only-until-marriage programs is that unintended pregnancy among teens in the United States is now at its lowest levels in recorded history. This progress was not made by chance or by withholding accurate, lifesaving information from young people.


In 2010, the Office of Adolescent Health established the federal Teen Pregnancy Prevention Program, which supports a variety of evidence-based programs, including youth development and sex education, that have been proven to help young people avoid unintended pregnancy and STIs, including HIV. Not only have these programs been rigorously evaluated and proven to help adolescents make healthy decisions, they also enjoy broad public support.

A recent poll by the National Campaign to Prevent Teen and Unplanned Pregnancy shows that 85 percent of U.S. adults support this approach and 79 percent of adults (including 73 percent of Republicans and 81 percent of Democrats) believe teens should receive more information about abstinence as well as birth control and sexually transmitted infection (STI) protection, rather than either/or.

ASCEND has conducted their own survey using extremely misleading wording which, not surprisingly, led to lower support for programs like those funded through TPPP. This is what they will share with policymakers to back up their arguments. For example, their question about current federal funding was: “Currently, the majority of federal sex education funding goes toward an approach that tells teens it is ok to be sexually active, as long as contraception is used.

Other approaches emphasize giving teens skills to wait for sex. How do you believe tax revenue should be allocated for sex education?” This question presents a false dichotomy. It is patently false to describe federally-funded sex education programs in this way. Learning about abstinence and delaying sex are important parts of any effective sex education program. The federally funded programs under TPPP include several that have proven successful in helping teens abstain from sex or use protection when they do have sex.

There are several problems with the abstinence-only-until-marriage, or “sexual risk avoidance” (SRA), approach. First, almost no abstinence-only program which has undergone rigorous evaluation has been shown to have any effect on young people’s behavior. Rather, programs that provide young people with information about both abstinence and birth control have a better track record of helping young people to delay sexual behavior.

Further, withholding critical, possibly life saving information about STIs and HIV from young people puts their health and futures at risk. The Society for Adolescent Health and Medicine’s position paper on abstinence-only programs notes that: “Efforts to promote abstinence should be provided within health education programs that provide adolescents with complete and accurate information about sexual health, including information about concepts of healthy sexuality, sexual orientation and tolerance, personal responsibility, risks of HIV and other STIs and unwanted pregnancy, access to reproductive healthcare, and benefits and risks of condoms and other contraceptive methods.”

Between 1996 and 2010, Congress funneled over $1.5 billion into unproven abstinence-only-until-marriage programs. We’ve seen the effect of these programs in states like Texas, where a recent study revealed that the percentage of districts not teaching sex education increased from 2.3 percent in the 2007-08 school year to more than 25 percent in 2015-16. Another 58 percent of school districts took an abstinence-only approach to sex education in 2015-16. Texas currently has the fifth highest teen pregnancy rate in the country.

When Congress began funding the evidence-based Teen Pregnancy Prevention Program in 2010, it was a critical move and a huge step forward. The evidence shows that when young people get sex ed programs like those funded by the Teen Pregnancy Prevention Program, they delay having sex and use birth control when they do have sex. These are exactly the kind of investments Congress should be making — ones that empower young people with accurate information on healthy relationships, birth control, and HIV and other STIs.

Lawmakers must protect access to evidence-based prevention programs that have been proven to help young people stay safe and healthy. We can all agree that learning about abstinence and delaying sex is an important part of any pregnancy prevention or sex education program; however, it is not the only part. Young people need education that helps them make healthy decisions about their relationships and their futures. We must not go back to failed policies and programs.

Leslie Kantor, PhD, MPH is Vice President of Education at Planned Parenthood Federation of America and a member of the faculty at the Mailman School of Public Health, Columbia University.

The views of contributors are their own and are not the views of The Hill.

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