28 March 2005

The Risks of Abstinence Education

Everyone from politicians to the American Association for Pediatrics is hailing abstinence education as the greatest way of lowering teen HIV and pregnancy rates. I wanted an unbiased view of whether or not abstinence really works, so I did my own survey.


In the United States of American, there is a current trend towards teaching abstinence in lieu of sexual education. The Christian Right, along with a few other groups (such as the American Association for Pediatrics), has applauded this form of education for several decades. Recently, more “liberal” or “left” organizations have also started pushing for “abstinence-plus education”. While abstinence has been taught in many districts over the decades, including parts of Canada, the issue has only recently returned to public debate, following American federal and state-level public policy. In 2002 the president of the United States of America introduced grants for school districts that agreed to teach only abstinence, and put aside mention of condoms and STDs. He made speeches, boasting of the effectiveness of teaching abstinence. Lower pregnancy rates and lower STDs and HIV infection rates were cited. This new attention to abstinence made me curious… Was abstinence really the solution? Was teaching abstinence really lowering the HIV and STD transmission rates among youth? I decided to survey youth and find out.

The different types of sexual education I examined fell into three categories. For the purpose of this paper, “comprehensive sexual education” refers to high school students learning about sexuality and safer-sex, which includes the use of condoms as barriers for STDs and HIV/AIDS, as well as condoms as a preventative measure against pregnancies. “Abstinence-only” education refers to the teaching that the only option for youth is to wait until marriage for sex. This option usually, but not always, mentions pregnancy as a deterrent, but seldom mentions STDs or HIV/AIDS. Additionally, abstinence is mentioned as the only 100% effective way to prevent unintended pregnancy, STDs, or HIV/AIDS. Condoms are not mentioned, as marital sex is seen to be wanted, safe, and loving, with the goal of procreation. Medically based information about condoms and other forms of contraception and birth control are not mentioned. “Abstinence-plus education” teaches youth that they should wait until marriage for sex. However, if they are to have pre-marital sex, and this is not encouraged, they should be aware that there are some risks. Like abstinence-only, pregnancy is usually sited as the major deterrent, though some educators mention other risks such as STDs and HIV/AIDS. Condoms may or may not be mentioned.

For the purpose of measuring the effectiveness of the different types of education, I conducted an online survey. In less than a week’s time, I had 300 people fill out the survey. The study asked that people anonymously give basic information about themselves (gender, sexual identity) and information about the type of education they received (age and grade when they received sexual education; type of sexual education; whether or not condoms, pregnancy, STDs, and/or HIV/AIDS were mentioned), as well as follow-up questions (the age they first had sex, if they had had sex; whether or not they practiced safer-sex by using condoms during their first time; and if they had any consequences from their first time having intercourse, such as pregnancy, STDs, and/or HIV).

AIDS Action, an American national advocacy group, writes that, “According to the Presidential Advisory Council on HIV/AIDS, a significant challenge in preventing HIV transmission among teens is the increasing number of abstinence-only sex education programs in schools.“ However the president is not listening to his own council. $273 million of the US’s 2005 budget was allotted to promoting abstinence-only education, as was one third of the $15 billion global AIDS-relief package. Grants were made available by both the Department of Health and Human Services and the new White House Office of Faith-Based and Community Initiatives to schools and school boards willing to implement abstinence-only education. The press release from the Department of Health and Human Services stated, “Abstinence education interventions are designed to reduce the number of adolescents who engage in premarital sexual activity and, consequently, the number of pregnancies and sexually transmitted diseases among unmarried teens.”

The total amount of money given out via these grants since its conception in 2001 is over $31 million. At the same time that the money available for abstinence-only education continues to increase, public schools are facing continual budget cuts and restrictions. The result is that school boards are applying for this grant money, as they are able to use it not only in the implementation of abstinence-only teaching, but in any related subject. The grant money is seen as a band-aid for budget cuts.

The state of Illinois, for example, received a grant for $2.8 million in 2004. However, a recent study, commissioned by Planned Parenthood and the Illinois Caucus for Adolescent Health found that their youth are being taught with “materials that offer teens incomplete or inaccurate information.” Further, the study found that, “Middle and high school teachers averaged 12 hours of sex-education instruction in all, and 60 percent of health teachers did not cover birth control, sexual orientation or abortion. About 15 percent did not teach the basics of conception, pregnancy and childbirth.” Additionally, the survey noted that 89% of the teachers in Illinois taught about abstinence.

According to the proponents of abstinence-only education, the benefits are clear. Continuing with the recent results from Illinois, we see that the pregnancy rate amongst youth has decreased by 13% over the last 5 years in that state. And the federal government continues to state that abstinence-only education is working, claiming that the HIV/AIDS infection rates are dropping amongst youth. Yet it is estimated that youth in America continue to contract HIV at a rate of 2 youth per hour.

So is abstinence the solution? Is it really working? In examining the findings of my survey, I noticed several trends. These trends indicate varying degrees of effectiveness of all education methods, but also show that abstinence education is not the solution.

First of all, the youth responded with the age and grade that they first received sex education, as well as the age they were when they first had sex. By comparing the two, I have noticed that there is a direct correlation between the age when youth fist receive their education and their use of safer-sex practices. When youth do not receive their education until the end of their high school careers, they have often already started having sexual relationships. Of the 74 participants who replied that they were in the eleventh or twelfth grades when they first received their education, 43 of them, or 58.1% had already had sex by the time they received their education. And of those 43, more than half did not practice safer-sex. This resulted in two pregnancies, five STD infections, and two HIV infections. When the numbers of youth who receive abstinence-only education is isolate from the youth who received comprehensive sexual education in grades eleven and twelve, the trends are even higher: fewer of those participants responded that they used condoms compared to their peers who received comprehensive sexual education.

Another noticeable problem was with the youth who received comprehensive sexual education in lower grades, at younger ages. Perhaps because their teachers did not feel comfortable, or did find it appropriate, the youth who received comprehensive sexual education in the fifth through seventh grades were less frequently informed about the risk of pregnancy, STD infection, or HIV/AIDS, than students who received the same style of education in later grades. The result was that of those youth who both received comprehensive sexual education in a lower grade, with the information missing or incomplete, and chose to have sex at a young age (15-years old or younger), there was a higher rate of not practicing safer-sex than their older peers who received the same style of education.

I feel that the most notable problem, based on the results of the survey, is related to abstinence-only and abstinence-plus education. Of the 72 respondents who received abstinence-only education, 41 received their education in the eleventh or twelfth grades. Of those 41, 33 youth did not practice safer-sex. That’s an astounding 80.5%. Those 33 youth reported four pregnancies, thirteen STD infections, and five new HIV infections. Only one of those 31 youth reported being taught about STDs, three were taught about HIV/AIDS, and one reported being taught about both STDs and HIV/AIDS. Of the 91 participants who reported that they were taught abstinence-plus education, 25 were in the eleventh or twelfth grades when they were first taught. Of these 25, 13 youth, or 52%, did not practice safer-sex. Those 13 youth reported one pregnancy, three STD infections, and one HIV infection. Only three of those youth had been taught about HIV/AIDS, while four were taught about both STDs and HIV/AIDS. Compared to the fact that all of the youth who were taught by the abstinence-only or abstinence-plus styles were warned of the risk of pregnancy, it is despicable that so few were warned of the risks STDs and HIV/AIDS. The blame lies in the fact that of all of the abstinence-only students, 72 students, none were taught about condom usage. Of the 93 students of abstinence-plus, 28% were not taught about condoms. Combining the two abstinence styles, that’s 59.4% (96 out of 165) youth who were taught that abstinence was the only method of safer-sex. This compares to only 6.5% (9 out of 138) youth who were taught comprehensive sexual education and were not informed about condoms. Further, contrasting to their abstinence taught peers, that 6.5% were all under the age of 13 when they received their education, while the abstinence taught students who were not taught about condoms spanned all ages, up to 18-years old. This is of relevance as my study does not ask when or if the students had subsequent education. Thus while there was a chance that the 11-13-year olds might have been taught at a later age to use condoms, the older students had less of a chance of receiving further education.

It is also interesting to examine specifically the gay male youth who responded to the survey. Of the 83 gay males who participated, 24 were taught abstinence-only, 30 were taught abstinence-plus, and 29 were taught sexual education. Of the 24 abstinence-only students, 20 (83.3%) responded that they did not practice safer-sex. We can then see that all 24 of this males had not been taught about condoms, while only two had HIV/AIDS taught in their classes and two more had STDs and HIV/AIDS taught. These boys responded that nine had contracted an STD, while another seven became infected with HIV their first time having sex. Of the 30 abstinence-plus students, 12 (40%) did not practice safer-sex. While 86.6% of these 30 students were taught about condoms, only 30% were taught about HIV/AIDS, while an additional 40% were taught about both STDs and HIV/AIDS. This statistic is particularly interesting as the participants who responded that they did not practice safer-sex were either not taught about condoms or had already had sex by the time they were taught. Additionally, they all responded that sexualities aside from heterosexuality were never mentioned in their education. It can be extrapolated they were taught to be safe by abstaining from sex, but if they were to have sex, condoms would be a good measure against pregnancy (for those taught about condoms). Since these participants all identify as gay, using a condom to prevent pregnancy would not be of relevance to them. And as they were not taught about safer-sex measures for non-heterosexual sex, they would not have known that condoms could be useful as protection against STDs and HIV/AIDS. As a result, of the twelve who had sex without a condom, three contracted an STD, while one became infected with HIV. The two abstinence styles can then be compared to the 29 gay males who were taught a more comprehensive sexual education. All of these 29 were taught about condoms. And of the 29, only one practiced unsafe sex; this respondent reported having unprotected sex before he received his first sexual education.

Based on my research, and readings, I believe that the current government-sponsored abstinence-only education has to be strongly discouraged. The youth are not abstaining until marriage. They are having pre-marital sex, and participating in unsafe sex as they have not been taught about the use of condoms. That is, if they have waited until after they receive their education before having sex.

Abstinence-plus education could be effective if a few changes were made to the teachings, to make it more comprehensive. First, students must be taught at a younger age, before they start having sex. Teaching about sex after a youth has already started is not effective. Secondly, while emphasizing abstinence is acceptable as a starting point, safer-sex and the risks of unprotected sex must be taught as well as not all of the youth are going to abstain from sex until they are married. Finally, sexualities beside heterosexuality must not only be acknowledged, but must be included in teachings about sex risks and safer-sex practices. Like abstinence-plus teachings, sexual education needs to become more comprehensive to become more effective. While most students who are taught sexual education already learn about condoms, safer-sex, and STDs and HIV/AIDS, all youth need to learn about all factors and about sexualities aside from heterosexuality at a younger age. Only by being proactive in teaching about sex, instead of teaching deterrence only, can we hope to decrease the unsafe sex practices among youth, thus lowering the rates of STD and HIV transmission, as well as teen pregnancies.