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Published in Print: April 18, 2007, as Abstinence-Only Programs Don’t Work, Study Finds

Abstinence Programs Don’t Work, Largest Study to Date Concludes

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Students who participated in sexual-abstinence education programs partially funded by the federal government were just as likely to have sex, and had the same number of sexual partners, as those who did not take part in the programs, a federally mandated report said today.

Both groups of youths—those who participated in abstinence education, and those who participated in other health education programs available in their areas—had a median age of first intercourse of 14 years and 9 months.

However, those students who participated in the abstinence programs were just as likely to use contraception as those who did not. Some critics of abstinence education programs have argued that they reduce rates of contraception usage.

“We didn’t see any effects, either good or bad,” from abstinence education, said Christopher Trenholm, the lead researcher for the study, conducted by Mathematica Policy Research Inc. of Princeton, N.J.

Bush administration officials cautioned against drawing sweeping conclusions from the study. They said the four programs reviewed—among several hundred across the nation—were some of the first established after Congress overhauled the nation’s welfare laws in 1996.

Officials said one lesson they learned from the study is that the abstinence message should be reinforced in subsequent years to truly affect behavior.

“This report confirms that these interventions are not like vaccines. You can’t expect one dose in middle school, or a small dose, to be protective all throughout the youth’s high school career,” Harry Wilson, the commissioner of the Family and Youth Services Bureau at the Administration for Children and Families in the U.S. Department of Health and Human Services, said in an interview with the Associated Press.

For its study, released April 13, Mathematica looked at students in four abstinence programs as well as peers from the same communities who did not participate in the abstinence programs. The 2,057 youths came from Miami and Milwaukee and the rural communities of Powhatan, Va., and Clarksdale, Miss.

The students who participated in abstinence education did so for one to three years. Their average age was 11 to 12 when they entered the programs in 1999.

Mathematica did a follow-up survey in late 2005 and early 2006. By that time, the average age of the participants was about 16½. Researchers found that about half of the abstinence students and about half from the control group reported that they had remained abstinent.

Political Climate

Congress uses three different programs to finance abstinence education. The largest, the Community Based Abstinence Education grant program, provides money directly to public and private groups through the Community-Based Abstinence Education grant program. President Bush’s proposed budget for fiscal 2008 would set aside $137 million for that program, currently funded at $109 million.

The second-largest pot of money, $50 million, goes through the states, which match that funding with $3 for every $4 they get from the federal government. The programs teach that sex outside marriage is likely to be psychologically and physically harmful. Eight states have declined to take part in the grant program. ("States Turn Down Abstinence-Only Grants," March 28, 2007.)

The programs must follow eight specific guidelines, including teaching that abstinence “is the only certain way to avoid out-of-wedlock pregnancy, sexually transmitted diseases, and other associated health problems” and that “a mutually faithful, monogamous relationship in the context of marriage is the expected standard of sexual activity.”

The Mathematica findings could have serious implications as Congress considers renewing this summer the state block-grant program for abstinence education, known as Title V of the 1996 welfare reform law.

Democratic lawmakers have introduced legislation to promote comprehensive sex education instead of abstinence-only curricula. They want to send money to schools that stress abstinence while also instructing students about the health benefits and side effects of using contraceptives.

Abstinence-only educators were in Washington this month, in fact, trying to keep Congress from cutting back their programs. The abstinence groups have opened their own trade association near the Capitol and have hired a public relations firm with a long list of Republican and conservative clients.

Valerie Huber, the executive director of the National Abstinence Education Association, said the group’s formation is not a response to the Democrats’ takeover of Congress.

“It really has nothing to do at all with any current political climate, just the evolution of the field of abstinence education,” she said.

“They’ve had smooth sailing for seven years,” said James Wagoner, the president of Advocates for Youth, an organization that promotes comprehensive sex education programs, which teach about contraception. “Their hiring of this firm shows that they know the honeymoon with Congress is over.”

Wade Horn, who oversaw the two largest abstinence-education programs at the U.S. Department of Health and Human Services until he stepped down April 6, predicted Congress will give states more flexibility in determining how Title V money is to be spent.

“I think it’s going to evolve, but I don’t think it’s going to go away,” he said. “I’ve seen some bills introduced by Democrats that suggest they want a separate fund dedicated to comprehensive sex education, but my sense is that it won’t be at the expense of abstinence education. I think it’s a matter of both, not one or the other.”

Democratic Sen. Frank R. Lautenberg of New Jersey sponsored the legislation cited by Mr. Horn. He said he does not believe abstinence education is working. His goal is to make both types of programs available, and he believes schools gradually will shift their focus to the comprehensive sex education programs.

Questions on Accuracy

In a report released late last year, the Government Accountability Office, the congressional watchdog agency, said HHS was not reviewing abstinence-education programs for scientific accuracy. ("Abstinence Programs Lack Factual Reviews, GAO Study Concludes," Nov. 29, 2006.)

The GAO also assessed efforts to evaluate the effectiveness of abstinence-education programs, and found much of the research did not meet basic requirements of scientific rigor, such as using a control group or measuring biological outcomes, as opposed to attitudes and intentions.

The department’s written response to the report said all grant recipients are required, as part of their applications, to indicate they are using materials that are grounded in scientific data. In addition, it noted, studies on the effectiveness of abstinence education were under way, including the Mathematica report.

A separate legal opinion from the general counsel of the GAO said abstinence programs must include “medically accurate” information about condoms or risk violating federal law. The federal department responded that the programs are not required to talk about condom usage, but must present accurate information about condoms when they do so. ("GAO Opinion Renews Debate on Abstinence-Only Programs," Nov. 1, 2006.)

The federal health agency released a document that clarified some of the rules states must follow when accepting any federal abstinence grant money. The memorandum to applicants stressed that each of the eight rules must be equally covered, the applicants “must not” promote condom or other contraceptive use, and applicants also must not promote or encourage the use of any type of contraceptives outside of marriage or refer to abstinence as a form of contraception.

Mathematica has conducted two other federally funded studies into abstinence-education policy. The most recent, released in June 2005, said the program had positive results, but that researchers could not yet tell if participants were actually having sex less often than other youths.

The research group examined four programs that were funded under the State Abstinence Education Grant program. As a part of that grant program, Congress also authorized the research into the programs’ effectiveness.

The 2005 report studied 2,310 youths in Clarksdale, Miss.; Miami; Milwaukee; and Powhatan, Va. and who had received abstinence-education programming, compared with those who had received other forms of sex education, including comprehensive sex education. The programs usually started in the late elementary school and middle school grades.

The study did not determine whether students who received abstinence education actually had less sex than students in the control group. However, students in abstinence programs generally had a more favorable view toward abstinence, and awareness of the negative consequences of premarital and teenage sex, it found.

An earlier report, released in April 2002, looked at early implementation of the state grant program. At that time, Mathematica researchers determined that the programs offered “more than a single message of abstinence.” Other messages included building self-esteem, developing values, and resisting peer pressure. Most students also reported feeling positive about the programs themselves.

Education Week Staff Writer Christina A. Samuels contributed to this story.

Vol. 26, Issue 33, Pages 1,8

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