| January 2, 2008
Advance for Jan. 4, 2008
Do Abstinence Programs Work?
by Mike McManus
For the first time in 14 years, the teen birth rate rose in 2006. After
falling 34 percent from its 1991 peak, teen births increased 3 percent,
according to a new report.
However, the U.S. teen birth rate is the world's highest - triple that
of Canada, France or Germany, and nine times higher than Italy or Japan.
A stunning 63 percent of U.S. adolescents have experienced intercourse
by the end of high school. Every year one in 13 teen girls becomes
pregnant and 4 million teens contract a sexually transmitted disease
(STD). In fact adolescents account for a quarter of new HIV infections,
though they are only a tenth of the population. Isn't that shocking?
This data heightens a 30-year debate over the best way to protect teens.
"Comprehensive sex education" is what most schools offer. It emphasizes
the use of condoms, though talk about abstinence as well. "Abstinence
only" is the new kid on the block, funded with $176 million of federal
Last April a major report by Mathematica Policy Research on four
abstinence programs stated that 2.5 - 5.5 years after each program,
there was "no evidence that abstinence programs implemented in upper
elementary and middle schools are effective in reducing the rate of teen
sexual activity." Compared to students who did not participate, those
in abstinence-only programs began having sex at the same age and had
similar numbers of sexual partners.
That report was a death-knell to abstinence-based programs in some
states. Ohio, Virginia and New York declared they would no longer seek
federal funds for abstinence-based programs, since state matching was
Two research-based national advocates of abstinence programs, however,
strongly disagreed with Mathematica's analysis. The Medical Institute
for Sexual Health noted the study looked at only four of the 900
abstinence programs and three of the four were black children from
single-parent households: "This is an unrepresentative sample."
"Two of the programs focused on upper elementary school students, and
the other two on middle school students," it added. "None of the four
included a high school component."
Dr. Stan Weed of the Institute for Research and Evaluation, which has
evaluated more than 100 abstinence education programs in 30 states,
asserts "the follow-up time frame employed in this study - 2.5 to 5.5
years after the programs end - is too long for any type of sex education
intervention to have a sustained effect on behavior without interim
reinforcement of the program message."
He argues that some abstinence programs work and some don't. "The
important questions are `which ones do, and why.'" For example, he has
just completed a study of an abstinence program in Northern Virginia
near Washington. Seventh grade virgins who took the course were 46% as
likely after a year to initiate sexual intercourse as virgins in a
comparison group who did not take the course.
Three years ago, this column reported an even better result of a program
Weed evaluated in South Carolina. Of virgins who took the course by
Heritage Community Services in the seventh and eighth grades, only 4
percent began sexual activity in those years compared to 16 percent of
those not in the course.
Weed identified four key ingredients of effective abstinence courses:
1. A lot of programs mention abstinence as an ":ideal," but do not make
a case for it. That requires at least 20 hours of teaching to affect
behavior. The training must be repeated annually.
2. Well-designed programs target teen attitudes, values, efficacy and
goals regarding abstinence, sexuality and relationships. Comprehensive
sex ed programs, by contrast, think information about biology and STDs
is what's needed. "However, information does not change behavior. What
matters are values - what is good and bad, right and wrong," says Weed.
3. Successful programs utilize a variety of instructional methods that
include interactive participatory activities, role-playing,
skill-building personal application and commitment. Kids need to be
taught how to say no to their date, and have the confidence to walk away
from the relationship going in the wrong direction. If he says, "Put
out, or get out" she replies, "See ya," and walks out of the car.
4. Finally, "effective programs pay as much attention to the messenger
as to the message," says Weed. "The teacher makes a huge difference." I
sat in on a South Carolina class for black males which was taught by a
married 31-year-old African-American who could speak with authority
about great sex in marriage, where there is no fear of STDs, or of her
That's how to slash teen sexual initiation from 16 percent to 4 percent.
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