Public policy implications in abstinence-only programs

The following editorial memo was released today by Advocates for Youth:

The Study: Efficacy of a Theory-Based Abstinence-Only Intervention,  John B. Jemmott III, PhD; Loretta S. Jemmott, PhD, RN; Geoffrey T. Fong, PhD Arch Pediatr Adolesc ed.  2010; 164(2):152-159.

Background: Study focused on young African American preteens in an urban area:  This is a legitimate public health study and it did show that a certain type of abstinence only program can help some very young adolescents (average age 12) delay sexual initiation for up to 24 months.

The study provides no data in support of the failed abstinence-only-until-marriage programs of the Bush era:  The abstinence-only intervention in this study would not have been eligible for federal funding during the Bush years because it did not fit the restrictive, ideological requirements of those abstinence-only-until-marriage programs. The program goal was to help early teens avoid sex until they are ready—a totally different objective than the Bush-era programs which were proven ineffective by the long-term Mathematica study (which showed "no impact on teen behavior"). In the Jemmotts' own words: "It was not designed to meet federal criteria for abstinence-only programs. For instance, the target behavior was abstaining from vaginal, anal, and oral intercourse until a time later in life when the adolescent is more prepared to handle the consequences of sex. The intervention did not contain inaccurate information, portray sex in a negative light, or use a moralistic tone. The training and curriculum manual explicitly instructed the facilitators not to disparage the efficacy of condoms or allow the view that condoms are ineffective to go uncorrected."

Public Policy Implications: Five Points to Keep in Mind

• Almost one-quarter of the young people in the study were already sexually active when the study began.  An abstinence-only program provides no information about condoms and contraception to help sexually active youth protect their health and safety.
  

• Previous research on virginity pledges (Bearman and Bruckner), demonstrated that initial delays in sexual activity wore off in the later teen years. Note: Half of all teens are sexually active by the age of 17 and 70 percent of youth have had sexual intercourse by age 19.
  

• There is good research showing that many comprehensive sex education programs are effective at helping young people delay sexual initiation as well as at using contraception/condoms when they do become sexually active.  If the U.S. has limited resources, shouldn't we invest in programs that can deliver both outcomes and that serve the greatest number of youth?
  

• Thirty years of public health studies have clearly determined that the provision of information about condoms and contraception does not increase sexual activity among teens or lower the age of sexual initiation—again putting into question why the U.S. would want to withhold such information from young people.
  

• The Obama administration is on the right track in funding only science-based programs with evidence of effectiveness.  The administration should also consider how scarce resources are invested and recognize the rights of all young people to complete, accurate and honest information about sexual health.