Abstinence-Only and Comprehensive Sex Education and the Initiation of Sexual Activity and Teen Pregnancy
Affiliations
- Department of Health Services, University of Washington, Seattle Washington
- Center for AIDS and STD, University of Washington, Seattle Washington
Affiliations
- Department of Epidemiology, University of Washington, Seattle Washington
- Center for AIDS and STD, University of Washington, Seattle Washington
Affiliations
- Department of Health Services, University of Washington, Seattle Washington
Correspondence
- Address correspondence to: William E. Lafferty, M.D., Associate Professor/Director, Department of Health Services, Health & Policy Research Track, Health Sciences Center, Box 357660, Seattle, WA 98195-7660.
Abstract
Purpose
The role that sex education plays in the initiation of sexual activity and risk of teen pregnancy and sexually transmitted disease (STD) is controversial in the United States. Despite several systematic reviews, few epidemiologic evaluations of the effectiveness of these programs on a population level have been conducted.
Methods
Among never-married heterosexual adolescents, aged 15–19 years, who participated in Cycle 6 (2002) of the National Survey of Family Growth and reported on formal sex education received before their first sexual intercourse (n = 1719), we compared the sexual health risks of adolescents who received abstinence-only and comprehensive sex education to those of adolescents who received no formal sex education. Weighted multivariate logistic regression generated population-based estimates.
Results
Adolescents who received comprehensive sex education were significantly less likely to report teen pregnancy (ORadj = .4, 95% CI = .22– .69, p = .001) than those who received no formal sex education, whereas there was no significant effect of abstinence-only education (ORadj = .7, 95% CI = .38–1.45, p = .38). Abstinence-only education did not reduce the likelihood of engaging in vaginal intercourse (ORadj = .8, 95% CI = .51–1.31, p = .40), but comprehensive sex education was marginally associated with a lower likelihood of reporting having engaged in vaginal intercourse (ORadj = .7, 95% CI = .49–1.02, p = .06). Neither abstinence-only nor comprehensive sex education significantly reduced the likelihood of reported STD diagnoses (ORadj = 1.7, 95% CI = .57–34.76, p = .36 and ORadj = 1.8, 95% CI = .67–5.00, p = .24 respectively).
Conclusions
Teaching about contraception was not associated with increased risk of adolescent sexual activity or STD. Adolescents who received comprehensive sex education had a lower risk of pregnancy than adolescents who received abstinence-only or no sex education.
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