Studies abstinence only programs

Abstinence-only programs tend to promote abstinence behavior through emotion, such as romantic notions of marriage, moralizing, fear of STDs, and by spreading scientifically incorrect information [7] , [20] , [35]. For example a Congressional committee report found evidence of major errors and distortions of public health information in common abstinence-only curricula [36].

As a result, these programs may actually be promoting irresponsible, high-risk teenage behavior by keeping teens uneducated with regard to reproductive knowledge and sound decision-making instead of giving them the tools to make educated decisions regarding their reproductive health [37].

The effect of presenting inadequate or incorrect information to teenagers regarding sex and pregnancy and STD protection is long-lasting as uneducated teens grow into uneducated adults: almost half of all pregnancies in the U. The U. The difference is not due to the onset of sexual activity [1]. Instead, the main factor seems to be sex education, especially with regard to contraception and prevention of STDs [41].

Sex education in Europe is based on the WHO definition of sexuality as a lifelong process, aiming to create self-determined and responsible attitudes and behavior with regard to sexuality, contraception, relationships and life strategies and planning [42]. In general, there is greater and easier access to sexual health information and services for all people including teens in Europe, which is facilitated by a societal openness and comfort in dealing with sexuality [40] , by pragmatic governmental policies [43] , [44] and less influence by special interest groups.

While states with comprehensive sex education have lower teen pregnancy rates, even in these states rates are much higher than seen in Europe [1].

This is likely influenced by the fact that U. For example, as of August 1, , only 20 states mandated sex education, and 32 states mandated HIV education in their schools [45]. An important first step towards lowering the high teen pregnancy rates would be states requiring that comprehensive sex education with abstinence as a desired behavior is taught in all public schools.

Another important step would involve specialized teacher training. As parents, educators or policy makers it should be our goals that 1 teens can make educated reproductive and sexual health decisions, that 2 teen pregnancy and STD rates are reduced to the rates of other developed nations, and that 3 these trends are maintained through the teenage years into adulthood. One possibility for achieving these goals is a close alignment and integration of sex education with the National Science Standards for U.

In addition, the Precaution Adoption Process Model Figure 5 advocated by the National Institutes of Health [48] offers a good basis for communication and discussions between scientists, educators, and sex education researchers, and could serve as a reference for measuring progress in sex education in alignment with the new evidence-based Teen Pregnancy Prevention Initiative.

In addition, it could be used as a communication tool between sex education teachers and their students. It should be our specific goal to move American teens from Stages 1 or 2 unaware or unengaged in the issues of pregnancy and STD prevention to Stages 3—7 informed decision-making by providing them with knowledge, understanding, and sound decision-making skills Figure 5. This model offers a basis for communication and discussions between educators, scientists, sex education researchers, and health professionals, and could serve as a reference for measuring progress in sex education.

In addition, it could be used as a communication tool between sex education teachers and their students [48].

Our analysis adds to the overwhelming evidence indicating that abstinence-only education does not reduce teen pregnancy rates. Advocates for continued abstinence-only education need to ask themselves: If teens don't learn about human reproduction, including safe sexual health practices to prevent unintended pregnancies and STDs, and how to plan their reproductive adult life in school, then when should they learn it, and from whom?

We thank C2ER, the Council for Community and Economic Research, for providing additional adjusted median household income data for those states that were not included in their online data set, and two anonymous reviewers for helpful comments.

Competing Interests: The authors have declared that no competing interests exist. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. National Center for Biotechnology Information , U. PLoS One. Published online Oct Kathrin F. Hall 2. David W. Virginia J. Vitzthum, Editor. Author information Article notes Copyright and License information Disclaimer. Received Mar 8; Accepted Aug Copyright Stanger-Hall, Hall.

This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited.

This article has been cited by other articles in PMC. Abstract The United States ranks first among developed nations in rates of both teenage pregnancy and sexually transmitted diseases.

Introduction The appropriate type of sex education that should be taught in U. Table 1 U. International Data U. Open in a separate window. Rates are listed as numbers per girls 15—19 years old,. Materials and Methods Level of emphasis on abstinence in state laws Data on abstinence education were retrieved from the Education Commission of the States [16]. Teen pregnancy, abortion and birth data Data on teen pregnancy, birth and abortion rates were retrieved for the 48 states from the most recent national reports, which cover data through [11] , [12].

Other factors Data on four possibly confounding factors were included in our analyses. Socio-economics To account for cost-of-living differences across the US, we used the adjusted median household income for for each state from the Council for Community and Economic Research: C2ER [20].

Ethnic composition We determined the proportion of the three major ethnic groups white, black, Hispanic in the teen population 15—19 years old for each state [12] , and assessed whether the teen pregnancy, abortion and birth rates across states were correlated with the ethnic composition of the teen population. Medicaid waivers for family planning Medicaid-funded access to contraceptives and family planning services has been shown to decrease the incidence of unplanned pregnancies, especially among low-income women and teens [13].

Correlations We used non-parametric Spearman correlations to assess relationships between variables, and for normally distributed variables we also used parametric Pearson correlations, but these results showed the same trends and significance levels as the non-parametric correlations.

Results Among the 48 states in this analysis all U. Figure 1. Abstinence education level prescribed in state laws or policies. Figure 2. Mean teen pregnancy, abortion and birth rates by level of prescribed abstinence education. Table 3 Teen pregnancy, abortion and birth rates per girls aged 14—19 by level of abstinence education. Table 4 Socioeconomics and ethnic diversity as potential influences on teen pregnancy, abortion and birth rates in 48 states.

Please note the teen pregnancy, abortion and birth data per reflect the behavior of all teens in each state: they are not limited to the behavior within that particular ethnic teen population see Table 5. Figure 3. Trends in teen pregnancy and birth rates after accounting for socioeconomics, education and ethnic diversity. Ethnic composition For this analysis we focused on the three largest ethnic groups for which data are available: white, black, and Hispanic [12].

From two decades ago to today, nearly 30 percent fewer students are being taught about birth control methods, which the researchers found maddening. Leslie Kantor, a professor at Columbia. Abstinence-only-until-marriage programs leave all young people unprepared and are particularly harmful to young people who are sexually active, who are LGBTQ, or have experienced sexual abuse.

States are prohibited from educating students about contraceptive use or methods, except when used to inform about failure rates.

With their findings, the researchers affirm that policy must be based on empirical models, which do not support the use of current abstinence strategies.

Programs that focus exclusively on abstinence have not been shown to affect teenager sexual behavior, although they are eligible for tens of millions of dollars in federal grants, according to a study released by a nonpartisan group that seeks to reduce teen pregnancies.

The report, which was based on a review of research into teen sexual behavior, was being released Wednesday by the nonpartisan National Campaign to Prevent Teen and Unplanned Pregnancy. The study found that while abstinence-only efforts appear to have little positive impact, more comprehensive sex education programs were having "positive outcomes" including teenagers "delaying the initiation of sex, reducing the frequency of sex, reducing the number of sexual partners and increasing condom or contraceptive use.

Patra Stephan, a spokesperson for the National Abstinence Education Association, said that the group wanted to examine the study but that there is evidence that an emphasis on abstinence, indeed, has positive results. This year, a new study looked more closely at how federal funding and political ideology interact to impact the sexual health of young people.

The results are stunning and further the fact that, despite being supported by billions in federal dollars, abstinence-only programs continue to fail American youth. What is this study all about? To look at the relationship between these variables, the researchers used data from the Centers for Disease Control and Prevention CDC and the Guttmacher Institute to calculate the number of adolescent births — babies born to mothers between ages 15 and 19 — in each state per year.

From there, the researchers calculated a number they called the per pupil expenditure amount by dividing the total dollars spent on each type of funding by the total number of high school students in the state and adjusted for inflation. The researchers guessed that abstinence-only funding would be more effective at reducing adolescent births in conservative states, where the ideology motivating the policy would be more likely to resonate with the population.