Abstinence-Only Sex Education Programs Not Effective At Preventing Spread Of HIV

Abstinence-only sex education programs are not effective at reducingthe risk of HIV transmission in developed countries, according to astudy published in the Aug. 4 issue of the British Medical Journal, the New York Times reports (Bakalar, New York Times, 8/14).

For the study, Kristen Underhill, a research officer at the University of Oxford,and colleagues searched 30 electronic databases that includedinformation from January 1980 to February 2007. The search identified13 abstinence-only education trials involving about 15,940 young peoplein the U.S. The programs aimed to prevent only HIV or both pregnancyand HIV. The trials assessed self-reported biological outcomes, such asHIV incidence and sexually transmitted infections. They also assessedself-reported behavioral outcomes, including the incidence or frequencyof unprotected vaginal, anal or oral sex; incidence or frequency of anyvaginal, anal or oral sex; number of partners; condom use; and sexualinitiation (Underhill et al., BMJ, 8/4). Most of theprograms were based in schools and directed at children in grades fivethrough eight. One program targeted adults ages 18 to 21. There werevarious control groups, including those in modified programs and, insome cases, no programs at all, the Times reports.

Findings

The study found that abstinence-only programs had no significant effectin either decreasing or increasing risky behavior when compared withthe control groups, the Times reports. Seven of thetrials tracked STIs and found no significant short- or long-termbenefit to abstinence-only sex education programs. None of the programsmade any significant difference in preventing pregnancy, reducingunprotected sex or delaying sexual initiation, according to the study (New York Times, 8/14).

Conclusions

"Should the funding of abstinence-only interventions continue at itscurrent levels, policymakers and practitioners might considerallocating more resources to methodologically rigorous evaluations withoutcomes that directly indicate HIV risk," the authors wrote. Theresearchers also said that ongoing school-based and community-basedtrials will "help remedy some gaps in knowledge" about HIV preventionand that "additional trials may be necessary, particularly to assessinterventions run by faith-based organizations" (BMJ,8/4). Underhill said, "We hope our review encourages a closer look atthe empirical research regarding HIV prevention programs," adding, "Itappears that this evidence base is frequently neglected in debates overabstinence-based prevention" (New York Times, 8/14).

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