Journal of Adolescent Health
Volume 42, Issue 4 , Pages 344-351, April 2008

Abstinence-Only and Comprehensive Sex Education and the Initiation of Sexual Activity and Teen Pregnancy

  • Pamela K. Kohler, R.N., M.P.H.

      Affiliations

    • Department of Health Services, University of Washington, Seattle Washington
    • Center for AIDS and STD, University of Washington, Seattle Washington
    • ,
  • Lisa E. Manhart, Ph.D.

      Affiliations

    • Department of Epidemiology, University of Washington, Seattle Washington
    • Center for AIDS and STD, University of Washington, Seattle Washington
    • ,
  • William E. Lafferty, M.D.

      Affiliations

    • Department of Health Services, University of Washington, Seattle Washington
    • Corresponding Author InformationAddress 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.

Received 17 April 2007; accepted 29 August 2007. published online 31 January 2008.

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.

Keywords: Sexually transmitted disease, Teen pregnancy, Sex education, Abstinence

 

PII: S1054-139X(07)00426-0

doi:10.1016/j.jadohealth.2007.08.026

Refers to article:

  • Converging Evidence Leaves Policy Behind: Sex Education in the United States

    Norman A. Constantine
    Journal of Adolescent Health April 2008 (Vol. 42, Issue 4, Pages 324-326)

Journal of Adolescent Health
Volume 42, Issue 4 , Pages 344-351, April 2008

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