Sex-until-after-marriage programs in the United States have been ineffective study shows

By Dr. Ananya Mandal, MDAug 22 2017

Two research papers have been released that show that the abstinence-only-until-marriage (AOUM) programs and policies in the United States are ineffective by and large and have not been successful in reducing risky sexual behaviors or early initiation of sex. Studies have reported that these are programs that successfully withhold medically accurate information not to mention infringe on adolescent human rights and reinforce gender stereotypes. The findings are published in the Journal of Adolescent Health.

Health professionals mainly look after young people, including the Society for Adolescent Health and Medicine have expressed their dissatisfaction with the AOUM programs and have rejected them. The authors of this new study had published a review in 2006 in the Journal of Adolescent Health stating the inefficacy of this program. They have shown that a wholesome sex education works in a much more effective manner in terms of reducing risky sexual behavior, delaying sexual initiation, reducing number of sexual partners and frequency of sex, increasing use of condoms and other forms of contraception etc. Overall a comprehensive sex education has been shown to reduce teenage pregnancies, frequency of unprotected sex and sexually transmitted infections (STIs). In fact armed with accurate knowledge has helped teenagers remain abstinent while abstinence-only programs have failed to do so.

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Co-author John Santelli, professor of Population and Family Health at the Mailman School of Public Health, has said that these programs have been shown to be ineffective in most of the available scientific research. He noted that these programs do not “prepare young people to avoid unwanted pregnancies or sexually transmitted diseases”.

Definition of abstinence refers to abstaining from all “sexual activity,” which “refers to any type of genital contact or sexual stimulation between two persons, including, but not limited to sexual intercourse”.

For this new study the team looked at multiple sources that included the scientific evidence and research and other review articles that focused on the efficacy of AOUM programs and the information from human rights organizations since 2006. Publications of advocacy groups that influenced policy makers were also included in the analysis. They noted that due to the increasing age when people get married and the decreasing age when young people begin to have sex, the gap between the age at first sex and first marriage is 8.7 years for women and 11.7 years for men in the US.

Results from this survey showed that these AOUM policies have significantly and detrimentally affected sex education programs, HIV prevention programs and also family planning education and awareness programs. This has not only happened in the US but also worldwide. For example;

• Between 2002 and 2014, sex education and HIV prevention awareness suffered a huge set back. The researchers found that the percentage of schools that taught students about human sexuality declined from 67 percent to 48 percent and those about HIV prevention reduced from 64 percent to 41 percent. These are alarming trends that violate adolescent human rights by not providing them with adequate medical information.
• Birth control and family planning information was given to 81 percent and 87 percent of teenage boys and girls respectively in 1995. This reduced to 55 percent and 60 percent of young men and women respectively as seen in 2011-2013 surveys.

Dr. Leslie Kantor, assistant professor of Population and Family Health at the Mailman School of Public Health and vice president of Education at Planned Parenthood Federation of America, said it is a fundamental right of the youngsters to receive sex education that gives them the “information and skills” that could ensure their healthy and safe lives. These are critical information that when withheld is a violation of their rights. These AUOM programs have left the young people unprepared. These are particularly dangerous for sexually active teenagers, those that belong to LGBTQ, or those that face child or adolescent sexual abuse she said.

The first AOUM program came into being in 1981 via the Adolescent Family Life Act. This provided funds to community- and faith-based organizations in order to promote “chastity” and “self-discipline”. The Community-Based Abstinence Education (CBAE) program came into being in 2000. Federal funding for these programs rose from fiscal year (FY) 1996 until FY 2006. By 2010 the funding declined. The funding rose again in FY 2012 and again in FY 2016. Current funds for the AUOM programs are $85 million per year and between 1982 and 2017, the Congress has spent over $2 billion on in house abstinence-only programs. The U.S. has spent $1.4 billion on AUOM programs for foreign aid for HIV prevention. These current guidelines state that states would not be able to use these massive fund allotments for educating youth about available contraceptive methods except to emphasize upon them the rates of failures of these methods and thus promote abstinence.

Santelli stated that these current programs are not based on science, principles of human rights and public health principles and thus should be “abandoned”.