• Explaining Research – Abstinence only education

    There’s a bit of a hubbub about a new study that many are touting as proof that abstinence-only education works.  From the abstract:

    Outcome Measures The primary outcome was self-report of ever having sexual intercourse by the 24-month follow-up. Secondary outcomes were other sexual behaviors.

    Results The participants’ mean age was 12.2 years; 53.5% were girls; and 84.4% were still enrolled at 24 months. Abstinence-only intervention reduced sexual initiation (risk ratio [RR], 0.67; 95% confidence interval [CI], 0.48-0.96). The model-estimated probability of ever having sexual intercourse by the 24-month follow-up was 33.5% in the abstinence-only intervention and 48.5% in the control group. Fewer abstinence-only intervention participants (20.6%) than control participants (29.0%) reported having coitus in the previous 3 months during the follow-up period (RR, 0.94; 95% CI, 0.90-0.99). Abstinence-only intervention did not affect condom use. The 8-hour (RR, 0.96; 95% CI, 0.92-1.00) and 12-hour comprehensive (RR, 0.95; 95% CI, 0.91-0.99) interventions reduced reports of having multiple partners compared with the control group. No other differences between interventions and controls were significant.

    Here’s the deal.  They randomized group of young African Americans in 6th and 7th grade to receive one of a number of different types of sexual education.  One centered on “abstinence-only”.  Another group got a “safer-sex” intervention.  Yet another got a combination of the two.  There was also a control group that got none of this.

    It’s important that you understand just what was meant by each of these.  So I’m giving you their descriptions (may be behind a paywall for you):

    Abstinence-Only Intervention

    The 8-hour abstinence-only intervention encouraged abstinence to eliminate the risk of pregnancy and STIs including HIV. It was designed to (1) increase HIV/STI knowledge, (2) strengthen behavioral beliefs supporting abstinence including the belief that abstinence can prevent pregnancy, STIs, and HIV, and that abstinence can foster attainment of future goals, and (3) increase skills to negotiate abstinence and resist pressure to have sex. It was not designed to meet federal criteria for abstinence-only programs. For instance, the target behavior was abstaining from vaginal, anal, and oral intercourse until a time later in life when the adolescent is more prepared to handle the consequences of sex. The intervention did not contain inaccurate information, portray sex in a negative light, or use a moralistic tone. The training and curriculum manual explicitly instructed the facilitators not to disparage the efficacy of condoms or allow the view that condoms are ineffective to go uncorrected.

    Safer Sex–Only Intervention

    The 8-hour safer sex–only intervention encouraged condom use to reduce the risk of pregnancy and STIs, including HIV, if adolescents had sex. It was designed to (1) increase HIV/STI knowledge, (2) enhance behavioral beliefs that support condom use, and (3) increase skills to use condoms and negotiate condom use. It was not designed to influence abstinence.

    And, when all was said and done, the abstinence-only program resulted in fewer adolescents having intercourse in the three months before they did follow-up.  In essence, it resulted in less sex than the other interventions.  It also didn’t result in less condom use, which has been found in previous studies.

    You should note that the abstinence only program described above is not the same as many other abstinence only programs.  It didn’t recommend no sex until marriage; it recommended waiting until you are “more prepared to handle the consequences of sex”.  It also was factually and theoretically based.  It also presented data on condoms accurately.  It also did not moralize.

    And it worked.

    That’s right.  If we’re going to hold with science, then we have to accept the results.  This study showed that this abstinence only program worked.  It should receive further funding and more investigation.  We should consider this type of curriculum as an option to implement.

    You can’t ignore it because it doesn’t fit your ideology.

    That said, you also can’t extrapolate further than the findings.  This study does not mean that all abstinence-only programs work.  In fact, many other studies have shown that other abstinence-only programs fail.  This was a specific, theory-based abstinence-only program.  It doesn’t vindicate one administration any more than it condemns another.

    When you do science, you agree to accept the results.  We should acknowledge that this type of abstinence-only program may have a place in sex education for children in 6th and 7th grade.  And, we should do more research to make sure those results hold in other populations and other settings.  That’s how it goes in research.

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