Thursday, January 05, 2006

Review of Abstinence-Only Education

An article in the current issue of the Journal of Adolescent Health (found via Feministing) looks at abstinence-only education programs in the United States. This is a review article, meaning that the authors have not done any original clinical studies or experiments, but are providing an overview of what is known on a topic. The piece looks at how abstinence is defined under federal guidelines, physical/psychological health outcomes of adolescent sexual behaviors, current federal policy and local programs, reviews of abstinence-only education, the effectiveness of abstinence in preventing pregnancy and STIs, and other related topics. The authors review the evidence on each of these topics, but add the following commentary to the end of article:

Although abstinence from sexual intercourse represents a healthy behavioral choice for adolescents, policies or programs offering “abstinence only” or “abstinence until marriage” as a single option for adolescents are scientifically and ethically flawed. Although abstinence from vaginal and anal intercourse is theoretically fully protective against pregnancy and disease, in actual practice, abstinence-only programs often fail to prevent these outcomes. Although federal support of abstinence-only programs has grown rapidly since 1996, existing evaluations of such programs either do not meet standards for scientific evaluation or lack evidence of efficacy in delaying initiation of sexual intercourse.

Although health care is founded on ethical notions of informed consent and free choice, federal abstinence-only programs are inherently coercive, withholding information needed to make informed choices and promoting questionable and inaccurate opinions. Federal funding language promotes a specific moral viewpoint, not a public health approach. Abstinence-only programs are inconsistent with commonly accepted notions of human rights.

In many communities, AOE has been replacing comprehensive sexuality education. Federally funded AOE programs censor lifesaving information about prevention of pregnancy, HIV and other STIs, and provide incomplete or misleading misinformation about contraception. The federal government’s emphasis on abstinence-only approaches may also be harming other public health efforts such as family planning programs and HIV prevention efforts—domestically and globally. Federally funded abstinence-until-marriage programs discriminate against GLBTQ 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 adolescents. “Abstinence-only” as a basis for health policy and programs should be abandoned.
A concluding paragraph stating the authors' conclusions and thoughts about their implications is very common in the medical literature. What is unusual is reading a scholarly article in a reputable medical journal and feeling as though you are being slapped in the face with the authors' political agendas. It seems striking that this should be the reader's reaction - after all, sexual and reproductive health are medical issues, not political ones. There can be two readings of this particular article. As a scholarly piece, it can read as a summary of known fact that seems to support comprehensive sex education rather than abstience-only, making the authors' concluding points a perfectly reasonably "implications" section of a standard research article. As a political piece, it is a strong editorial statement in opposition to the abstience-only agenda being pushed by certain policy-makers. Because the audience for this journal may be limited, it will be interesting to see what reaction this article provokes, if any.

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MeSH Tags:Sexual Abstience; Sex Education

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