Abstinence-only education policies and programs: A position paper of the Society for Adolescent Medicine
ABSTRACT Abstinence from sexual intercourse represents a healthy choice for teenagers, as teenagers face considerable risk to their reproductive health from unintended pregnancy and sexually transmitted infections (STIs) including infection with the human immunodeficiency virus (HIV). Remaining abstinent, at least through high school, is strongly supported by parents and even by adolescents themselves. However, few Americans remain abstinent until marriage, many do not or cannot marry, and most initiate sexual intercourse and other sexual behaviors as adolescents. Abstinence as a behavioral goal is not the same as abstinence-only education programs. Abstinence from sexual intercourse, while theoretically fully protective, often fails to protect against pregnancy and disease in actual practice because abstinence is not maintained. Providing "abstinence only" or "abstinence until marriage" messages as a sole option for teenagers is flawed from scientific and medical ethics viewpoints. Efforts to promote abstinence should be based on sound science. Although federal support of abstinence-only programs has grown rapidly since 1996, the evaluations of such programs find little evidence of efficacy in delaying initiation of sexual intercourse. Conversely, efforts to promote abstinence, when offered as part of comprehensive reproductive health promotion programs that provide information about contraceptive options and protection from STIs have successfully delayed initiation of sexual intercourse. Moreover, abstinence-only programs are ethically problematic, being inherently coercive and often providing misinformation and withholding information needed to make informed choices. In many communities, abstinence-only education (AOE) has been replacing comprehensive sexuality education. In some communities, AOE has become the basis for suppression of free speech in schools. Abstinence-only education programs provide incomplete and/or misleading information about contraceptives, or none at all, and are often insensitive to sexually active teenagers. Federally funded abstinence-until-marriage programs discriminate against gay, lesbian, bisexual, transgender and questioning youth, as federal law limits the definition of marriage to heterosexual couples. Schools and health care providers should encourage abstinence as an important option for teenagers. "Abstinence-only" as a basis for health policy and programs should be abandoned.
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ABSTRACT: Though African-American youth in the South are at high risk for HIV infection, abstinence until marriage education continues to be the only option in some public schools. Using community-based participatory research methods, we conducted 11 focus groups with African-American adults and youth in a rural community in North Carolina with high rates of HIV infection with marked racial disparities. Focus group discussions explored participant views on contributors to the elevated rates of HIV and resources available to reduce transmission. Participants consistently identified the public schools' sex education policies and practices as major barriers toward preventing HIV infection among youth in their community. Ideas for decreasing youth's risk of HIV included public schools providing access to health services and sex education. Policymakers, school administrators, and other stakeholders should consider the public school setting as a place to provide HIV prevention education for youth in rural areas.AIDS education and prevention: official publication of the International Society for AIDS Education 02/2012; 24(1):41-53. DOI:10.1521/aeap.2012.24.1.41 · 1.51 Impact Factor
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ABSTRACT: Recent research has shown that 82% of adolescent pregnancies are unintended. Social marketing has potential to reduce unintended adolescent pregnancy but its effectiveness in this area has not been thoroughly evaluated. This arti-cle reviews the literature on social marketing and assesses its potential to reduce unintended adolescent pregnancy. We identified five communication principles as relevant to adolescent reproductive health messaging: Countermarketing, making credible and likeable "arguments" for behavior change, use of theory-based models, social modeling and behav-ioral alternatives, and risk communication when the behavioral choices are clear. We examine studies of social marketing on other health risk behaviors and a case study of a recent campaign to promote parent-child communication about wait-ing to have sex. Findings suggest that to reduce unintended pregnancy and improve reproductive health outcomes among adolescents, there is a need for targeted prevention messages and social marketing approaches.The Open Communication Journal 12/2007; 1(1). DOI:10.2174/1874916X00701010001
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ABSTRACT: Ongoing and often rancorous policy arguments at the federal, state, and local school-district levels address the relative merits of different types of sex education. The conflicts between proponents of programs that exclusively teach abstinence-only-until-marriage versus programs that include instruction regarding contraception and protection from sexually transmitted diseases (STDs) are often characterized by strong emotional arguments. In this heated