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



      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.


      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.


      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).


      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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      Linked Article

      • Converging Evidence Leaves Policy Behind: Sex Education in the United States
        Journal of Adolescent HealthVol. 42Issue 4
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          School-based sex education has the potential to prevent sexually transmitted infections and unwanted pregnancies and to promote healthy sexuality. Yet local, state, and national sex education policies in the United States comprise a bewildering patchwork of mandates, funding restrictions, omissions, and compromises, often at odds from one level to the next. As a result, the sex education received by most students is fragmented, incomplete, and frequently based on ineffective approaches and curricula [1–3]—an unacceptable state of affairs in a time of increasing teen birth rates and epidemics of sexually transmitted infections among American youth [4,5].
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