Expert Panel Rejects Abstinence-Only Sex Ed

Nov. 6, 2009 -- There's no evidence that abstinence-only sexual education programs cut teens' risk of sexually transmitted disease, HIV, or pregnancy, a task force of public health experts finds.

But the panel finds that sex ed that includes information about condomsand delaying sexual initiation does work by:

• Reducing the number of teens who have sex.
• Reducing the frequency of sexual activity in teens who have sex.
• Reducing the number of sex partners in teens who have sex.
• Reducing sexually transmitted infections.
• Increasing use of condoms and other methods of birth control.

The panel is the 12-member Task Force on Community Preventive Services, chaired by Jonathan Fielding, MD, MPH, MBA, the public health director of Los Angeles County. It recommends various public-health interventions based on an extensive analysis of all available data. Panel members are appointed by the CDC.

The task force evaluated 62 studies and 83 study arms that evaluated various "comprehensive risk reduction" sex-ed strategies -- that is, strategies for both abstinence and risk reduction. The task force also evaluated 21 studies and 23 study arms that evaluated various abstinence-only sex-ed strategies.

The CDC will publish the findings in a scientific journal in about a year's time. But the task force today released its bottom-line recommendations:

• On risk-reduction strategies: "The task force recommends group-based comprehensive risk reduction delivered to adolescents to promote behaviors that prevent or reduce the risk of pregnancy, HIV, and other sexually transmitted infections."
• On abstinence-only strategies: "The task force concludes that there is insufficient evidence to determine the effectiveness of group-based abstinence education delivered to adolescents to prevent pregnancy, HIV, and other sexually transmitted diseases."

"The finding of insufficient evidence [for abstinence-based sex ed] really means that based on the evidence available, the task force could not come to any conclusions," Randy Elder, PhD, the CDC's scientific director of systematic reviews, tells WebMD. "It is really a big question mark, with the implication being we need more research in this area before we can make any determination whether this intervention does or doesn’t work."

This hasn't prevented an objection by two members of the review team that presented evidence in favor of abstinence-only sex ed to the task force.

The task-force recommendations "fail to acknowledge the effectiveness of abstinence education programs at reducing teen sexual activity and make comparative effectiveness claims about comprehensive risk reduction versus abstinence education that are based on weakly supported assumptions," claim Irene Ericksen, a research analyst for The Institute for Research & Evaluation, a Salt Lake City nonprofit organization that has reported favorably on abstinence-only programs; and Danielle Ruedt, MPH, with the Georgia Governor's Office of Children and Families.

Ericksen and Ruedt have released a nine-page rebuttal of the task force findings.

"The task force fully considered all the points they raised based on the entire body of evidence, rather than those relatively minor points addressed in the press release," Elder says.

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