They finally work! Such have been the praises resounding in headliners on a recent study regarding the efficacy of an abstinence-only approach to sex. With this Archives of Pediatric and Adolescent Medicine study reporting that an abstinence-only intervention reduced sexual initiation, many are making the claim that sex education classes focusing on encouraging abstinence may now, hands-down, be the way to go.
Yet should we be so quick to declare abstinence-only as the best approach to sexuality education? After all, this is only one study, and it certainly has its shortcomings, like its...
Size. This study is small, involving only 662 African American sixth and seventh graders.
Age group. The mean age was 12.2, with most students 14 by the end of the study. While this age group is more sexually active than we're willing to acknowledge, the real challenge - and problems - of delaying sexual initiation lie mostly with high schoolers. Would this intervention have been equally effective with older teens?
Methodology. Young adolescents aren't exactly known for being truthful with adults about their sexual liaisons. This study was self-report, thus running the risk of youth stating what they think they're supposed to report versus what's really going on in their lives.
Muddling matters a bit more is how the results are being reported. This randomized controlled trial involved students receiving an eight-hour abstinence-only intervention aimed at reducing sexual intercourse; OR and eight-hour safer sex-only intervention hoping to increase condom use; OR an eight-hour and 12-hour comprehensive intervention seeking to address sexual intercourse and condom use; OR an eight-hour health promotion control intervention (that had nothing to do with sexual behaviors).
Findings are largely based on students in the abstinence-only, safer sex-only, and eight-hour and 12-hour approach being compared to the control group, which received no sex education at all. So abstinence-only reduced sexual initiation when compared to the control group. It also had fewer students reporting having had sex in the last three months during the follow-up period when compared to the control group.
The eight-hour and 12-hour comprehensive interventions reduced reports of multiple partners when compared to the control group. Yet no other differences between interventions and controls were significant. Furthermore, this study does not offer a critical comparison of abstinence-only and comprehensive sex education.
Sex educators will be the first to say that abstinence is a critical and necessary part of comprehensive sex education efforts, an option that needs to be highlighted and supported when it comes to postponing adolescent sexual involvement. Research has shown that sex ed efforts of any kind pay off when students are given focused messages and the opportunity to practice related skills in various scenarios.
As research has shown over the years, different approaches work for different populations. This intervention was effective for one outcome with one particular group of students - and not necessarily because it was abstinence-focused.
Let's not forget that it's seemingly based on sound theory and utilizes effective elements for behavior change amongst adolescents. It also took a sex positive approach, with students being given the forum in small groups to talk about their views on abstinence and their knowledge of HIV and other sexually transmitted infections. They further got to participate in role-playing, suggest ways to resist the pressure to have sex, and brainstorm accurate answers to sex and sexual health misconceptions.
It also probably helped that the intervention took place on Saturdays, allowing for much more sex ed than your average student receives in a classroom period or two (which is quite typical). Finally, it didn't take the moralistic tone and approach of the well-known "abstinence-until-marriage" programs the government has been funding for over 25 years. It's those little things that can make all of the difference -- abstinence-focused approach or not.