Abstinence, be faithful, use a condom
Encyclopedia
Abstinence, be faithful, use a condom, also known as the ABC strategy or abstinence-plus sex education, also known as abstinence-based sex education, is a sex education
policy based on harm reduction
which modifies the approach of abstinence-only sex education by including education about safe sex
and birth control
methods. Abstinence-only sex education is strictly to promote the sexual abstinence until marriage, and does not teach about safe sex or contraceptives. The abstinence-based sex education program is meant to stress abstinence and include information on safe sex practices. In general terms, this strategy of sex education is a compromise between abstinence-only education and comprehensive sex education. The ABC approach was developed in response to the growing epidemic of HIV/AIDS in Africa
, and to prevent the spread of other sexually transmitted disease
s.
Abstinence-based sex education can include issues of human relationships, the basic biology of human reproduction, safe sex methods and contraceptives, HIV/AIDS information, and masturbation in place of sex. It recommends sexual abstinence
outside marriage as an ideal, having only a single long-term sexual partner. The use of condom
s and other safe sex practices is advocated only if it is not possible to remain with a single sexual partner. Advocating this ideal, whilst pragmatically dealing with the fact that abstinence only sex education is ineffective by itself, has made the ABC approach more palatable to many African governments and relief agencies.
The ABC approach has notably been used in African countries like Uganda
. Its positive impact has been confirmed by a 2009 Stanford University survey.
Abstinence - The ABC approach encourages young adults to use abstinence until marriage, the most effective way to avoid HIV infection. The program develops skills for practicing abstinence and encourages participants to adopt social norms that support abstinence.
Be Faithful - In addition to abstinence, the ABC approach encourages participants to eliminate casual sex partners and to practice fidelity within their marriages and other sexual relationships. This reduces exposure to HIV. In Uganda between 1989–1995, President Museveni
reported a 20% decline in casual sex partners, and an 11% decline in reported cases of HIV.
Use a Condom - The final component to the ABC approach is "correct and consistent condom use." While understanding the benefits of abstinence, participants are instructed how to apply and use a condom. This is an example of risk reduction during cases when risk elimination is not practiced. Students are also taught that condoms do not protect against all forms of sexually transmitted diseases.
and 1990s
, the popularity of the "abstinence plus" sex education program grew into a common method of teaching students, in the United States
, about sexuality. The program understood that it would not be possible to stop all teenagers from having sex, but still stressed that abstinence is the only guaranteed way of avoiding unwanted pregnancies and contraction of STDs. The most important message to teens from the program comes from Dr. Joycelyn Elders, President Clinton's
first Surgeon General
, that "if they have a baby there is an 80% likelihood they'll be poor, ignorant, and slaves for the rest of their lives." In 1997 the Department of Health and Human Services
established a "Girl Power!" campaign focusing on girls ages 9–14 which encouraged abstinence as a form of empowerment. For those who would reject abstinence, though, abstinence-only messages provided little to no hope to prevent pregnancy and spread of disease. To account for this, some states included information about contraceptives in their sex education programs along with encouragement for students to be abstinent. Of the states that, in 1995, required abstinence education, fourteen also included the use of contraception within the curriculum.
In September 1995, Hawaii
passed the Abstinence-Based Education Policy. (Policy # 2110). It is meant to support abstinence and help develop skills to continue abstinence, help teens who have had sexual intercourse to abstain from further, and to proved teens with information on contraceptives and methods for preventing sexually transmitted diseases and pregnancy.
HIV/AIDS is one of the leading causes of deaths in the United States and 1 in 300 people are living with HIV/AIDS. Around one million people have HIV/AIDS in the United States. More than 524,000 people in the United States have died of HIV/AIDS. Around 40,000 people are infected each year.
President's Emergency Plan for AIDS Relief
has been criticised for prioritising "A" and "B" over "C" within its funding criteria. "C" activities may only be directed at "high-risk" groups, and not to the general population.
is a proposed alternative approach as is SAVE (Safer practices, Available medication, Voluntary testing & counselling and Empowerment through education).
Critics furthermore allege that the strategy overlooks the epidemic's social, political, and economic causes and "vulnerable populations", e.g. sex worker
s and "those who lack the ability to negotiate safe sex" as well as risk groups such as homosexuals and intravenous drug users.
Critics also argue that using the word "abstinence," then teaching about safe sex and contraceptives, can be contradictory.
Benedict XVI has criticised some harm reduction policies with regards to HIV/AIDS, saying that "if the soul is lacking, if Africans do not help one another, the scourge [of HIV] cannot be resolved by distributing condoms; quite the contrary, we risk worsening the problem". Whilst this position has been widely denounced for misrepresenting and oversimplifying the role of condoms in preventing infections, there has been expert scientific opinion and evidence supporting it.
Archbishop Gabriel Charles Palmer-Buckle of Accra has stated that "the Catholic Church [offers] three methods to help solve this problem of AIDS in Africa: "A", abstain; "B", be faithful; "C", chastity, which is in consonance with traditional African values. Those Planned Parenthood
people are only talking about condoms. By the way, they know full well that the condoms devoted to Africa are sub-standard." There is no reliable source that condoms in Africa are inferior.
Sex education
Sex education refers to formal programs of instruction on a wide range of issues relating to human sexuality, including human sexual anatomy, sexual reproduction, sexual intercourse, reproductive health, emotional relations, reproductive rights and responsibilities, abstinence, contraception, and...
policy based on harm reduction
Harm reduction
Harm reduction refers to a range of public health policies designed to reduce the harmful consequences associated with recreational drug use and other high risk activities...
which modifies the approach of abstinence-only sex education by including education about safe sex
Safe sex
Safe sex is sexual activity engaged in by people who have taken precautions to protect themselves against sexually transmitted diseases such as AIDS. It is also referred to as safer sex or protected sex, while unsafe or unprotected sex is sexual activity engaged in without precautions...
and birth control
Birth control
Birth control is an umbrella term for several techniques and methods used to prevent fertilization or to interrupt pregnancy at various stages. Birth control techniques and methods include contraception , contragestion and abortion...
methods. Abstinence-only sex education is strictly to promote the sexual abstinence until marriage, and does not teach about safe sex or contraceptives. The abstinence-based sex education program is meant to stress abstinence and include information on safe sex practices. In general terms, this strategy of sex education is a compromise between abstinence-only education and comprehensive sex education. The ABC approach was developed in response to the growing epidemic of HIV/AIDS in Africa
HIV/AIDS in Africa
HIV/AIDS is a major public health concern and cause of death in Africa. Although Africa is home to about 14.5% of the world's population, it is estimated to be home to 67% of all people living with HIV and to 72% of all AIDS deaths in 2009.-Overview:...
, and to prevent the spread of other sexually transmitted disease
Sexually transmitted disease
Sexually transmitted disease , also known as a sexually transmitted infection or venereal disease , is an illness that has a significant probability of transmission between humans by means of human sexual behavior, including vaginal intercourse, oral sex, and anal sex...
s.
Abstinence-based sex education can include issues of human relationships, the basic biology of human reproduction, safe sex methods and contraceptives, HIV/AIDS information, and masturbation in place of sex. It recommends sexual abstinence
Sexual abstinence
Sexual abstinence is the practice of refraining from some or all aspects of sexual activity for medical, psychological, legal, social, philosophical or religious reasons.Common reasons for practicing sexual abstinence include:*poor health - medical celibacy...
outside marriage as an ideal, having only a single long-term sexual partner. The use of condom
Condom
A condom is a barrier device most commonly used during sexual intercourse to reduce the probability of pregnancy and spreading sexually transmitted diseases . It is put on a man's erect penis and physically blocks ejaculated semen from entering the body of a sexual partner...
s and other safe sex practices is advocated only if it is not possible to remain with a single sexual partner. Advocating this ideal, whilst pragmatically dealing with the fact that abstinence only sex education is ineffective by itself, has made the ABC approach more palatable to many African governments and relief agencies.
The ABC approach has notably been used in African countries like Uganda
Uganda
Uganda , officially the Republic of Uganda, is a landlocked country in East Africa. Uganda is also known as the "Pearl of Africa". It is bordered on the east by Kenya, on the north by South Sudan, on the west by the Democratic Republic of the Congo, on the southwest by Rwanda, and on the south by...
. Its positive impact has been confirmed by a 2009 Stanford University survey.
Components
Abstinence, Be Faithful, Use a Condom consists of three components:Abstinence - The ABC approach encourages young adults to use abstinence until marriage, the most effective way to avoid HIV infection. The program develops skills for practicing abstinence and encourages participants to adopt social norms that support abstinence.
Be Faithful - In addition to abstinence, the ABC approach encourages participants to eliminate casual sex partners and to practice fidelity within their marriages and other sexual relationships. This reduces exposure to HIV. In Uganda between 1989–1995, President Museveni
Yoweri Museveni
Yoweri Kaguta Museveni is a Ugandan politician and statesman. He has been President of Uganda since 26 January 1986.Museveni was involved in the war that deposed Idi Amin Dada, ending his rule in 1979, and in the rebellion that subsequently led to the demise of the Milton Obote regime in 1985...
reported a 20% decline in casual sex partners, and an 11% decline in reported cases of HIV.
Use a Condom - The final component to the ABC approach is "correct and consistent condom use." While understanding the benefits of abstinence, participants are instructed how to apply and use a condom. This is an example of risk reduction during cases when risk elimination is not practiced. Students are also taught that condoms do not protect against all forms of sexually transmitted diseases.
Growth and popularity in the United States
Starting primarily in the 1980s1980s
File:1980s decade montage.png|thumb|400px|From left, clockwise: The first Space Shuttle, Columbia, lifted off in 1981; American President Ronald Reagan and Soviet leader Mikhail Gorbachev eased tensions between the two superpowers, leading to the end of the Cold War; The Fall of the Berlin Wall in...
and 1990s
1990s
File:1990s decade montage.png|From left, clockwise: The Hubble Space Telescope floats in space after it was taken up in 1990; American F-16s and F-15s fly over burning oil fields and the USA Lexie in Operation Desert Storm, also known as the 1991 Gulf War; The signing of the Oslo Accords on...
, the popularity of the "abstinence plus" sex education program grew into a common method of teaching students, in the United States
United States
The United States of America is a federal constitutional republic comprising fifty states and a federal district...
, about sexuality. The program understood that it would not be possible to stop all teenagers from having sex, but still stressed that abstinence is the only guaranteed way of avoiding unwanted pregnancies and contraction of STDs. The most important message to teens from the program comes from Dr. Joycelyn Elders, President Clinton's
Bill Clinton
William Jefferson "Bill" Clinton is an American politician who served as the 42nd President of the United States from 1993 to 2001. Inaugurated at age 46, he was the third-youngest president. He took office at the end of the Cold War, and was the first president of the baby boomer generation...
first Surgeon General
Surgeon General of the United States
The Surgeon General of the United States is the operational head of the Public Health Service Commissioned Corps and thus the leading spokesperson on matters of public health in the federal government...
, that "if they have a baby there is an 80% likelihood they'll be poor, ignorant, and slaves for the rest of their lives." In 1997 the Department of Health and Human Services
United States Department of Health and Human Services
The United States Department of Health and Human Services is a Cabinet department of the United States government with the goal of protecting the health of all Americans and providing essential human services. Its motto is "Improving the health, safety, and well-being of America"...
established a "Girl Power!" campaign focusing on girls ages 9–14 which encouraged abstinence as a form of empowerment. For those who would reject abstinence, though, abstinence-only messages provided little to no hope to prevent pregnancy and spread of disease. To account for this, some states included information about contraceptives in their sex education programs along with encouragement for students to be abstinent. Of the states that, in 1995, required abstinence education, fourteen also included the use of contraception within the curriculum.
In September 1995, Hawaii
Hawaii
Hawaii is the newest of the 50 U.S. states , and is the only U.S. state made up entirely of islands. It is the northernmost island group in Polynesia, occupying most of an archipelago in the central Pacific Ocean, southwest of the continental United States, southeast of Japan, and northeast of...
passed the Abstinence-Based Education Policy. (Policy # 2110). It is meant to support abstinence and help develop skills to continue abstinence, help teens who have had sexual intercourse to abstain from further, and to proved teens with information on contraceptives and methods for preventing sexually transmitted diseases and pregnancy.
HIV/AIDS is one of the leading causes of deaths in the United States and 1 in 300 people are living with HIV/AIDS. Around one million people have HIV/AIDS in the United States. More than 524,000 people in the United States have died of HIV/AIDS. Around 40,000 people are infected each year.
Criticisms
The usefulness of the ABC concept is highly debated. The three elements are interpreted differently by different actors and critics argue that often abstinence and faithfulness is unduly promoted over condoms and other measures such as education, female empowerment and making available modern antiviral drugs. For example, the U.S.United States
The United States of America is a federal constitutional republic comprising fifty states and a federal district...
President's Emergency Plan for AIDS Relief
President's Emergency Plan For AIDS Relief
The President's Emergency Plan For AIDS Relief was a commitment of $15 billion over five years from United States President George W. Bush to fight the global HIV/AIDS pandemic...
has been criticised for prioritising "A" and "B" over "C" within its funding criteria. "C" activities may only be directed at "high-risk" groups, and not to the general population.
Liberal critics
Critics argue that in many countries women are frequently infected by their unfaithful husbands while being faithfully married, and thus women who follow the recommendations of ABC promoters face an increased risk of HIV infection. Condoms, needles, and negotiationCondoms, needles, and negotiation
Condoms, needles, and negotiation, also known as the CNN approach, is a harm reduction approach to reducing the rate of transmission of sexually transmitted diseases such as AIDS through the use of safer sex and reducing the risks in intravenous drug use through the provision on clean needles.In...
is a proposed alternative approach as is SAVE (Safer practices, Available medication, Voluntary testing & counselling and Empowerment through education).
Critics furthermore allege that the strategy overlooks the epidemic's social, political, and economic causes and "vulnerable populations", e.g. sex worker
Sex worker
A sex worker is a person who works in the sex industry. The term is usually used in reference to those in the sex industry that actually provide such sexual services, as opposed to management and staff of such industries...
s and "those who lack the ability to negotiate safe sex" as well as risk groups such as homosexuals and intravenous drug users.
Critics also argue that using the word "abstinence," then teaching about safe sex and contraceptives, can be contradictory.
Conservative critics
PopePope
The Pope is the Bishop of Rome, a position that makes him the leader of the worldwide Catholic Church . In the Catholic Church, the Pope is regarded as the successor of Saint Peter, the Apostle...
Benedict XVI has criticised some harm reduction policies with regards to HIV/AIDS, saying that "if the soul is lacking, if Africans do not help one another, the scourge [of HIV] cannot be resolved by distributing condoms; quite the contrary, we risk worsening the problem". Whilst this position has been widely denounced for misrepresenting and oversimplifying the role of condoms in preventing infections, there has been expert scientific opinion and evidence supporting it.
Archbishop Gabriel Charles Palmer-Buckle of Accra has stated that "the Catholic Church [offers] three methods to help solve this problem of AIDS in Africa: "A", abstain; "B", be faithful; "C", chastity, which is in consonance with traditional African values. Those Planned Parenthood
Planned Parenthood
Planned Parenthood Federation of America , commonly shortened to Planned Parenthood, is the U.S. affiliate of the International Planned Parenthood Federation and one of its larger members. PPFA is a non-profit organization providing reproductive health and maternal and child health services. The...
people are only talking about condoms. By the way, they know full well that the condoms devoted to Africa are sub-standard." There is no reliable source that condoms in Africa are inferior.
External links
- USAID: The ABCs of HIV Prevention
- Avert.org: The ABC of HIV prevention
- YouthAids: http://projects.psi.org/site/PageServer?pagename=Statistics_nr&gclid=CPzf7biOu5kCFRBbagodNmG54w
- Defining the ABC Approach http://www.state.gov/s/gac/partners/guide/abc/56568.htm