Abstinence-Only Sex Education Not Good Enough

PHILADELPHIA, Nov. 6 -- Most Americans support teaching youngsters more than just abstinence in school-based sex education, according to a national survey.

Across political and religious ideologies, abstinence-only programs received the least support and most opposition from the 1,096 survey respondents said Amy Bleakley, Ph.D., M.P.H., of the University of Pennsylvania here, and colleagues.

At the same time, they added, 82% of the respondents backed sex education that also teaches other methods of preventing pregnancy and sexually transmitted diseases, the researchers wrote in the November issue of Archives of Pediatrics & Adolescent Medicine.

"Abstinence-only programs, while a priority of the federal government, are supported by neither a majority of the public nor the scientific community," they said.

Abstinence-only sex education emphasizes delaying sexual activity until marriage and precludes mention of birth control and protection, such as condoms, unless it is to mention their failure rates and other limitations, the authors noted. This approach does not have strong evidence for effectively delaying sex or reducing teen pregnancy according to a recent review, but is the only one that is federally funded, they added.

Abstinence-plus, or comprehensive, programs offer information on contraception and protection against sexually transmitted disease as well as emphasize abstinence, said Dr. Bleakley and colleagues. Systematic reviews have suggested these programs may delay sexual debut, reduce frequency of sex and unprotected sex, and decrease the number of sexual partners.

The researchers compared support for abstinence-only, comprehensive, and condom use instruction in a randomly selected, nationally representative sample of adults ages 18 to 83 (mean 46.8). The survey found:

• 82% supported abstinence-plus programs while 68% supported condom instruction and 36% supported abstinence-only programs.
• 10% opposed comprehensive programs compared with 21% for condom instruction and 50.7% for abstinence only.

A similar pattern emerged in attitudes toward the three types of programs. The findings were:

• 54.5% of respondents did not agree that abstinence-only programs were effective in preventing unplanned pregnancies compared to 39.1% that did.
• 80.4% agreed that a combination of abstinence and other methods were effective in preventing unplanned pregnancies compared to 15.0% that disagreed.
• 56.9% did not believe that condom instruction encourages students to have sex while 37% did.

Support for abstinence-plus programs and condom instruction was high across political ideologies. Among the 35.% of respondents who identified themselves as conservative, 39.5% as moderate, and 25% liberal, the researchers reported:

• Abstinence-plus got the most support (70% conservatives, 86.4% moderate, 91.6% liberal) and least opposition (19%, 5.3% and 3.7%, respectively).
• Conservatives supported condom instruction more frequently than abstinence-only sex education (51.2% versus 47%) and opposed both at approximately the same rate (39.9% versus 37.5%).
• Most liberals and moderates opposed abstinence-only education (67% and 50.4%) than condom instruction (9.1% and 13.4%).

"Our results indicate that U.S. adults, regardless of political ideology, favor a more balanced approach to sex education compared with the abstinence only programs funded by the federal government," Dr. Bleakley and colleagues wrote.

Likewise, abstinence plus received the most backing of the options from survey respondents across levels of religious service attendance. Support for comprehensive sex education ranged from 87.4% among those who said they never attended services to 60.3% among those who attended more than once a week. The majority across the board also supported condom instruction except the 52.6% of those who attended services more than once a week.

This study is not the first to report that the American public wants sex education to include instruction on abstinence, condoms and other methods of contraception, according to an editorial by Douglas Kirby, Ph.D., of ETR Associates in Scotts Valley, Calif., a non-for-profit company that provides health and sex education programs and products. He cited surveys dating to 1943 that the majority of adults approved of school-based sex education and that comprehensive programs have been supported for decades.

The researchers concluded, "With such high support for comprehensive sex education among the public from liberals, conservatives, and moderates alike, political leaders could capitalize on this rare occasion to enact public policy that is supported by both sound scientific evidence as well as public opinion."