Abstinence-only sex education

Laura Bush with an AIDS orphan at a center in Zambia that promotes abstinence and faith for youth.

Abstinence-only sex education is a form of sex education that teaches not having sex outside of marriage. It often excludes other types of sexual and reproductive health education, such as birth control and safe sex. Comprehensive sex education, by contrast, covers the use of birth control and sexual abstinence.

Evidence does not support the effectiveness of abstinence-only sex education.^[1][2] It has been found to be ineffective in decreasing HIV risk in the developed world.^[3] It does not decrease rates of sexual activity or unplanned pregnancy when compared to comprehensive sex education.^[1]

The topic of abstinence-only education is controversial in the United States, with proponents claiming that comprehensive sex education encourages premarital sexual activity, and critics arguing that abstinence-only education is religiously motivated and that the approach has been proven ineffective and even detrimental to its own aims.

Description

Abstinence education teaches children and adolescents to abstain from sexual activity, and that this is the only certain method of avoiding pregnancy and sexually transmitted infections (STIs), and that abstinence until marriage is a standard by which to live. In the U.S., states may apply for federal funding of abstinence-only sex education programs. To be eligible for funding, programs must satisfy requirements given under the Social Security Act, which is reproduced here verbatim:^[4]

(2) For purposes of this section, the term "abstinence education" means an educational or motivational program which—

(A) has as its exclusive purpose, teaching the social, psychological, and health gains to be realized by abstaining from sexual activity;

(B) teaches abstinence from sexual activity outside marriage as the expected standard for all school age children;

(C) teaches that abstinence from sexual activity is the only certain way to avoid out-of-wedlock pregnancy, sexually transmitted diseases, and other associated health problems;

(D) teaches that a mutually faithful monogamous relationship in context of marriage is the expected standard of human sexual activity;

(E) teaches that sexual activity outside of the context of marriage is likely to have harmful psychological and physical effects;

(F) teaches that bearing children out-of-wedlock is likely to have harmful consequences for the child, the child’s parents, and society;

(G) teaches young people how to reject sexual advances and how alcohol and drug use increases vulnerability to sexual advances; and

(H) teaches the importance of attaining self-sufficiency before engaging in sexual activity.

Effectiveness

Systematic reviews of research evaluating abstinence-only sex education have concluded that it is ineffective at preventing unwanted pregnancy or the spread of STIs, among other shortfalls.^[1][5] A Cochrane systematic review suggests that abstinence-only education neither increases nor decreases HIV risk in high-income countries.^[3] In the developing world there is a lack of evidence of effect.^[6] In 2008, Douglas Kirby reviewed the evidence for the effectiveness of abstinence-only education programs and found little evidence to justify the use of such programs.^[7] A 2011 meta-analysis found that it was ineffective at reducing the risk of HIV infection among adolescents.^[8]

According to SIECUS, the Sexuality Information and Education Council of the United States, "[s]cientific evidence simply does not support an abstinence-only-until-marriage approach."^[9] A 2010 report by the Guttmacher Institute pointed out that pregnancy rates for teens 15–19 reversed their decline in 2006, near the peak of the Abstinence Only campaign in the United States.^[10] Sex education has been linked to a delay in the first time having sex.^[11][12]

Society and culture

General

Proponents of abstinence-only sex education argue that this approach is superior to comprehensive sex education because it emphasizes the teaching of morality that limits sex to that within the bounds of marriage, and that sex before marriage and at a young age has heavy physical and emotional costs.^[13] They suggest that comprehensive sex education encourages premarital sexual activity among teenagers, which should be discouraged in an era when HIV and other incurable STIs are widespread and when teen pregnancy is an ongoing concern. Many supporters of abstinence-only education do so out of the belief that comprehensive guides to sex or information about contraceptives will ultimately result in teens actively pursuing and engaging in sexual activities, while others oppose the endorsement of contraception for religious reasons.^[14] Teenagers are framed as less intelligent and less responsible than adults. They are seen as unable to control themselves due to 'raging hormones'. As a result, a teenager's sexual desire is something that needs to be controlled.^[15] Thus, dividing the teens into two separate categories in the minds of adults: "the innocent and the guilty, the vulnerable and the predatory, the pure and the corrupting."^[16]

Opponents and critics, which include prominent professional associations in the fields of medicine, public health, adolescent health, and psychology, argue that such programs fail to provide adequate information to protect the health of adolescents. Some critics also argue that such programs verge on religious interference in secular education. Opponents of abstinence-only education dispute the claim that comprehensive sex education encourages teens to have premarital sex.^[17] The idea that sexual intercourse should only occur within marriage also has serious implications for people for whom marriage is not valued or desired, or is unavailable as an option, particularly LGBT people living in places where same-sex marriage is not legal or socially acceptable.^{[18][19][20][21][22]} Abstinence-only education is often criticized for being overly heteronormative, idealizing the institution of heterosexual marriage to the denigration of queer relationships.^[23] According to Advocates for Youth, abstinence-only sex education distorts information about contraceptives, including only revealing failure rates associated with their use, and ignoring discussion of their benefits.^[24] The language surrounding medicine and health is construed as being both objective and value free.^[23] This objectivity is then adopted by conservative politicians and campaigners to assert authority which historically holds its basis in religion.

Another problem for abstinence education is the definition of abstinence. Santelli (2006) states that there is no strict definition of abstinence within the US federal government guidelines for teaching abstinence-only sex education, using a mixture of non-specific phrases, like "postponing sex" or "never had vaginal sex," while also using moralistic terms or phrases like virgin, chaste, and "making a commitment".^[25] This has resulted in sexual activities that are not penile-vaginal, including mutual masturbation, oral sex and anal sex, being considered outside of the scope of abstention from sex, which is termed technical virginity.^[26]

Global impact

The U.S. President's Emergency Plan for AIDS Relief (PEPFAR) is the U.S government's initiative to combat HIV/AIDS globally.^[27] PEPFAR works with the governments of 22 countries worldwide to create sustainable programs to prevent HIV and improve the lives of those suffering.^[28] PEPFAR provides funding to other countries to help combat HIV/AIDS. It does so with certain guidelines and restrictions on the recipients. PEPFAR promotes an "ABC" approach – Abstain, Be faithful, and use Condoms. Funding recipients may give information about condoms to youth over 15 years old, but cannot use the funding to provide condoms or promote usage. In countries receiving funds from PEPFAR, teens under the age of 15 are not allowed to receive information about condoms.^[29] The rationale behind this is to not encourage sexual activity despite evidence that condom use does not cause promiscuity.^[30] PEPFAR was founded in 2003 with the mandate that 33% of its funds provided for prevention be used for abstinence-only education. Since the reauthorization in 2008, this mandate was removed, with a shift toward directives to spend at least 50% on abstinence-only education.^[31] The role of parters has been an area of debate surrounding PEPFAR. In 2006, 23% of all the community partners were faith-based and debate exists over whether the U.S. should be allowing grants specifically written for faith-based organizations and prevention.^[32] A few countries that have received PEPFAR funding – specifically Mozambique and Rwanda – have expressed distaste for the U.S.' push for faith-based education and abstinence-only funding.^[32] Human rights groups have expressed concern that condom availability has decreased since PEPFAR's involvement in the global AIDS crisis.^[33]

The $1.3 billion that the U.S. government spent on programs to promote abstinence in sub-Saharan Africa had no meaningful impact.^[34][35][36]

Religion and sexual education

Religious doctrines take varying stances on contraception and pre-marital sex, some of which are covered by:

• Religion and birth control
• Christian views on contraception
• Protestant views on birth control
• Catholic teachings on sexual morality
• Sexuality and Mormonism
• Fornication
• Premarital sex in Islam

See also

• Sex education in the United States
• Religious views on birth control
• Sexual norm
• Virginity pledge
• Abstinence-only sex education in Uganda
• Abstinence, be faithful, use a condom

References