Abstinence Programs Don't Cut HIV Risk

Researchers Say the Education Programs Have No Effect on Teen HIV Rates

Reviewed by Louise Chang, MD on August 02, 2007
From the WebMD Archives

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 studies.

"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 safe-sex practices.

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 funding.

The New York Times recently reported that 14 states have either rejected abstinence education or passed laws to greatly limit such programs.

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 underdeveloped countries.

Underhill says the debate surrounding these programs has been largely political.

"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 WebMD.

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 flawed.

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."

  • Want to talk with others about AIDS and HIV? Visit WebMD's AIDS/HIV Questions: Member to Member message board.
WebMD Health News


SOURCES: Underhill, K. British Medical Journal, Aug. 4, 2007; vol 335: pp 248-252. Kristen Underhill, research officer, Center for Evidence-Based Medicine, University of Oxford, England. Paul Montgomery, DPhil, lecturer, Center for Evidence-Based Intervention, University of Oxford, England. Nancy B. Kiviat, MD, professor of pathology, University of Washington, Seattle. Valerie Huber, executive director, National Abstinence Education Association. "Abstinence Education Faces an Uncertain Future," July 18, 2007, New York Times.

© 2007 WebMD, Inc. All rights reserved.