The YEAH! Network uses research, advocacy, and community education and collaboration to influence policy and practice in adolescent sexual health. By articulating a common agenda among diverse local, state, and national stakeholders, we are working to create an informed, empowered, and engaged response to teen pregnancy and sexual health disparities in Hampden County.

Wednesday, March 3, 2010

Response to success of Abstinence-only curriculum

A response posted by Cristin O'Grady:    

Efficacy of a Theory-based Abstinence-Only Intervention over 24 Months: A randomized Controlled Trial with Young Adolescents was published in the February 2010 edition of the Archives of Pediatric Adolescent Medicine.  The article has gained notoriety because it is the first study that reports that an abstinence-only intervention can be an effective method of delaying sexual initiation. There are several critical points that must be considered when evaluating the author’s finding that the abstinence-only curriculum was effective.

           First, the study uses a different definition of  “abstinence-only” than we commonly are accustomed to in the United States.  There are 8 tenets of any federally approved abstinence-only education plan, the main principle being abstinence-only until marriage.  In contrast, in the abstinence-only intervention evaluated in the study “the target behavior was abstaining…until a time later in life when the adolescent is more prepared to handle the consequences of sex.” Further, the curriculum “did not contain inaccurate information, portray sex in a negative light, or use a moralistic tone.” The curriculum did not attempt to portray abstinence as a morally correct behavior but rather as a healthy decision for a young person to make.  Further, the curriculum recognizes that “waiting for marriage” is not the only healthy, safe way to discuss sex.  In letting go of the moral overtones that tend to dominate abstinence-only education, the decision to have sex becomes less about what one’s church says or one’s community says and more about individual health, safety and autonomy – which might be easier for the ego-driven young person to understand and accept. 

           The curriculum was implemented with a very specific group: 6th and 7th grade African Americans in an economically deprived area of the East coast.  The sample size was quite small, and the participants had to be willing to participate in a weekend health education class. The vast majority of participants in the study had not had sex, a situation that would certainly be different in high school.  As the authors state,  “theory based abstinence-only interventions might be effective with young adolescents but ineffective with older people or people in committed relationships.”  Further, participation in a weekend health intervention may indicate that, as a group, those in the study might be more motivated towards healthy behaviors than the general population. 

            Finally, and perhaps most importantly, the abstinence-only program involved teaching life skills, negotiation skills, and career planning. When children and young adults are taught about sexual decision-making in this context, they learn to evaluate their sexual decisions in the context of life goals.  The ability to make such an evaluation gives much greater meaning to personal decisions made about sex, and provides the individual with more internal motivation to abstain. 

            While none of these issues serve to discredit the results of the study in any way, they do provide a lens through which to view the results and understand how to apply them. This study is just a first step in understanding how an abstinence-only education program with no moral-agenda can be effective.  The study should not serve as an excuse to stop talking about sex with young people, but rather evidence of a way in which sex can be discussed that actually helps young people to make their own healthy decisions. 

Other responses to the article:  

Quick Response to Study of Abstinence Education  - NY Times

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