Expert Panel Rejects Abstinence-Only Sex Ed
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Task Force Finds That Abstinence-Only Programs Don't Reduce Teen Pregnancy
By
Daniel J. DeNoon
WebMD Health News
Reviewed By
Brunilda Nazario, MD
Nov. 6, 2009 -- There's no evidence that abstinence-only sexual education
programs cut teens' risk of sexually transmitted disease, HIV, or pregnancy, a
task force of public health experts finds.
But the panel finds that sex ed that includes information about condoms and delaying sexual initiation does work by:
- Reducing the number of teens who have sex.
- Reducing the frequency of sexual activity in teens who have sex.
- Reducing the number of sex partners in teens who have sex.
- Reducing sexually transmitted infections.
- Increasing use of condoms and other methods of birth control.
The panel is the 12-member Task Force on Community Preventive Services,
chaired by Jonathan Fielding, MD, MPH, MBA, the public health director of Los
Angeles County. It recommends various public-health interventions based on an
extensive analysis of all available data. Panel members are appointed by the
CDC.
The task force evaluated 62 studies and 83 study arms that evaluated various
"comprehensive risk reduction" sex-ed strategies -- that is, strategies for
both abstinence and risk reduction. The task force also evaluated 21 studies
and 23 study arms that evaluated various abstinence-only sex-ed strategies.
The CDC will publish the findings in a scientific journal in about a year's
time. But the task force today released its bottom-line recommendations:
-
On risk-reduction strategies: "The task force recommends group-based
comprehensive risk reduction delivered to adolescents to promote behaviors that
prevent or reduce the risk of pregnancy, HIV, and other sexually transmitted
infections."
-
On abstinence-only strategies: "The task force concludes that there
is insufficient evidence to determine the effectiveness of group-based
abstinence education delivered to adolescents to prevent pregnancy, HIV, and
other sexually transmitted diseases."
"The finding of insufficient evidence [for abstinence-based sex ed] really
means that based on the evidence available, the task force could not come to
any conclusions," Randy Elder, PhD,
the CDC's scientific director of systematic reviews, tells WebMD. "It is really
a big question mark, with the implication being we need more research in
this area before we can make any determination whether this intervention does
or doesn't work."
This hasn't prevented an objection by two members of the review team that
presented evidence in favor of abstinence-only sex ed to the task force.
The task-force recommendations "fail to acknowledge the effectiveness of
abstinence education programs at reducing teen sexual activity and make
comparative effectiveness claims about comprehensive risk reduction versus
abstinence education that are based on weakly supported assumptions," claim
Irene Ericksen, a research analyst for The Institute for Research &
Evaluation, a Salt Lake City nonprofit organization that has reported favorably
on abstinence-only programs; and Danielle Ruedt, MPH, with the Georgia
Governor's Office of Children and Families.
Ericksen and Ruedt have released a nine-page rebuttal of the task force
findings.
"The task force fully considered all the points they raised based on the
entire body of evidence, rather than those relatively minor points addressed in
the press release," Elder says.
SOURCES: The Community Guide web site: "Prevention of HIV/AIDS, other STIs and Pregnancy: Group-based Abstinence Education Interventions for Adolescents."
Institute for Research & Evaluation web site: "A Minority Report: Fundamental Concerns about the CDC Meta-analysis of Group-based Interventions
to Prevent Adolescent Pregnancy, HIV, and Other STIs."
News release, Institute for Research & Evaluation.
Randy Elder, PhD, scientific director of systematic reviews, CDC, Atlanta.
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