Abstinence Programs Don't Cut HIV Risk
Researchers Say the Education Programs Have No Effect on Teen HIV Rates
Aug. 2, 2007 -- Programs that stress sexual abstinence have had no impact on
HIV infection rates in the U.S., according to a new research review. But an
abstinence education expert says the study is flawed.
Investigators analyzed findings from 13 studies comparing abstinence-only
education to other forms of sexual education or no sexual education at all.
Some 16,000 preteens and teens in the U.S. participated in the self-reported
"We found no evidence at all that these abstinence-only programs
resulted in lower HIV infection rates for any targeted subgroup,"
researcher Paul Montgomery, DPhil, of the University of Oxford's Center for
Evidence-Based Medicine, tells WebMD.
There was also little evidence indicating a positive impact on risky sexual
behaviors, pregnancy rates, or the transmission of other sexually transmitted
diseases (STDs), Montgomery says.
The researchers concluded that the tax dollars now being used to fund
abstinence-only programs could be better spent on sex education programs that
include both the abstinence message and promotion of condom use and other
Abstinence Program Funding
Last month, Congress voted to extend an abstinence-only education program
that provides $50 million annually in block grants, but such programs are
facing increasing opposition from states, which must match the federal
The New York Times recently reported that 14 states have either
rejected abstinence education or passed laws to greatly limit such
An additional $141 million in federal funding for abstinence-only programs
is expected to win approval when Congress returns from its August recess. The
Community-Based Abstinence Education (CBAE) program is administered through the
U.S. Department of Health and Human Services.
Kristen Underhill of the Center for Evidence-Based Medicine tells WebMD that
an additional $1 billion annually is spent on abstinence-only education
through a larger aid program targeting the spread of HIV in Africa and other
Underhill says the debate surrounding these programs has been largely
"We would encourage a stronger look at the empirical evidence assessing
the effectiveness of these programs," she says. "This should play a
much larger role in the discussion. There are other programs that have been
shown to be more effective in reducing risky sexual behaviors."
Specifically, programs that promote not only abstinence but also the use of
condoms and limiting sexual partners have been shown to lower HIV risk, says
University of Washington pathology professor Nancy Kiviat, MD.
"These interventions do make a difference, especially among populations
with the highest risks of acquiring HIV or another STD," she tells
The Other Side of the Debate
But a proponent of abstinence-based programs rejects the idea that there is
little evidence showing they work. She calls the newly published review highly
National Abstinence Education Association Executive Director Valerie Huber
says the review failed to include peer-reviewed studies showing that the
programs effectively delay the onset of initial sexual activity, convince many
sexually active teens to stop having sex, and lead to fewer sex partners among
those who remain sexually active.
She points out that only one of the 13 studies included in the review
involved older teens who were most likely to be sexually active. The rest
evaluated programs targeting 10- to 14-year-olds.
She tells WebMD that the money spent on abstinence-based programs represents
just one of every 10 dollars spent on sex education in the U.S.
"We do have evidence that these programs work," she says. "We
know that the longer someone delays sexual initiation the fewer lifetime
partners they have. And the fewer lifetime sexual partners someone has, the
fewer STDs they are likely to get."
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