Sex education in the United States - AbsoluteAstronomy.com

Sex education in the United States is taught in two main forms: comprehensive and abstinence-only. Comprehensive sex education

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...

covers abstinence as a positive choice, but also teaches the benefits of contraception

Contraception

Contraception is the prevention of the fusion of gametes during or after sexual activity. The term contraception is a contraction of contra, which means against, and the word conception, meaning fertilization...

and the avoidance of 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 between sexually active individuals. Abstinence-only sex education emphasizes abstinence

Abstinence

Abstinence is a voluntary restraint from indulging in bodily activities that are widely experienced as giving pleasure. Most frequently, the term refers to sexual abstinence, or abstention from alcohol or food. The practice can arise from religious prohibitions or practical...

from sex prior to marriage and rejects methods such as contraception. The difference between the two approaches, and their impact on the behavior of adolescents, remains a controversial subject in the United States

United States

The United States of America is a federal constitutional republic comprising fifty states and a federal district...

. Numerous studies have shown conflicting results.

Current state of sex education in the United States

Almost all students in the U.S. receive some form of sex education at least once between grades 7 and 12; many schools begin addressing some topics as early as grades 4 or 5. However, what students learn varies widely, because curriculum decisions are so decentralized. Many states have laws governing what is taught in sex education classes or allowing parents to opt out. Some state laws leave curriculum decisions to individual school districts.

For example, a 1999 study by the Guttmacher Institute

Guttmacher Institute

The Guttmacher Institute is a non-profit organization which works to advance sexual and reproductive health. The institute operates in the United States and globally "through an interrelated program of social science research, policy analysis and public education." According to their mission...

found that most U.S. sex education courses in grades 7 through 12 cover puberty, HIV

HIV

Human immunodeficiency virus is a lentivirus that causes acquired immunodeficiency syndrome , a condition in humans in which progressive failure of the immune system allows life-threatening opportunistic infections and cancers to thrive...

, STDs

Sexually transmitted disease

, abstinence

Abstinence

, implications of teenage pregnancy

Pregnancy

Pregnancy refers to the fertilization and development of one or more offspring, known as a fetus or embryo, in a woman's uterus. In a pregnancy, there can be multiple gestations, as in the case of twins or triplets...

, and how to resist peer pressure. Other studied topics, such as methods of 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...

and infection prevention, sexual orientation

Sexual orientation

Sexual orientation describes a pattern of emotional, romantic, or sexual attractions to the opposite sex, the same sex, both, or neither, and the genders that accompany them. By the convention of organized researchers, these attractions are subsumed under heterosexuality, homosexuality,...

, sexual abuse

Sexual abuse

Sexual abuse, also referred to as molestation, is the forcing of undesired sexual behavior by one person upon another. When that force is immediate, of short duration, or infrequent, it is called sexual assault. The offender is referred to as a sexual abuser or molester...

, and factual and ethical information about abortion

Abortion

Abortion is defined as the termination of pregnancy by the removal or expulsion from the uterus of a fetus or embryo prior to viability. An abortion can occur spontaneously, in which case it is usually called a miscarriage, or it can be purposely induced...

, varied more widely.

There have been numerous studies on the effectiveness of both approaches, and conflicting data on American public opinion. Public opinion polls conducted over the years have found that the majority of Americans favor broader sex education programs over those that teach only abstinence, although abstinence educators recently published poll data with the opposite conclusion. The poll sponsored by the National Abstinence Education Association and conducted by Zogby International

Zogby International

IBOPE Zogby International is an international market research, opinion polling firm founded in 1984 by John Zogby. The company polls and consults for a wide spectrum of business media, government, and political groups, and conducts public opinion research in more than 70 countries...

found that:

When parents become aware of what abstinence education vs. comprehensive sex education actually teaches, support for abstinence programs jumps from 40% to 60%, while support for comprehensive programs drops from 50% to 30%. This sharp increase in support of abstinence education is seen across all political and economic groups. The majority of parents reject the so-called "comprehensive" sex education approach, which focuses on promoting and demonstrating contraceptive use. Sixty-six percent of parents think that the importance of the "wait to have sex" message ends up being lost when programs demonstrate and encourage the use of contraception.

Experts at University of California, San Francisco also encourage sex educators to include oral sex and emotional concerns as part of their curriculum. Their findings also support earlier studies that conclude:

...that sexual risk-taking should be considered from a dynamic relationship perspective, rather than solely from a traditional disease-model perspective. Prevention programs rarely discuss adolescents’ social and emotional concerns regarding sex....Discussion about potential negative consequences, such as experiencing guilt or feeling used by one's partner, may lead some adolescents to delay the onset of sexual behavior until they feel more sure of the strength of their relationship with a partner and more comfortable with the idea of becoming sexually active. Identification of common negative social and emotional consequences of having sex may also be useful in screening for adolescents at risk of experiencing more-serious adverse outcomes after having sex.

However, according to a 2004 NPR

NPR

NPR, formerly National Public Radio, is a privately and publicly funded non-profit membership media organization that serves as a national syndicator to a network of 900 public radio stations in the United States. NPR was created in 1970, following congressional passage of the Public Broadcasting...

survey, a majority of the 1001 parent groups polled wanted complete sex education in the schools. Respondents were relatively undivided over the issue. Over 80% of polled parents agreed with the statement "Sex education in school makes it easier for me to talk to my child about sexual issues", and under 17% agreed with the statement that their children were being exposed to "subjects I don't think my child should be discussing". Additionally 90% believed that their children’s sexual education was “not too early”. The study also reports that 49% of the respondents were "somewhat confident" that the values taught in their children's sexual education classes were similar to those taught at home, and 23% were somewhat less confident.
On September 15, 2010, The Centers of Disease Control and Prevention in Atlanta released a government report that found that "almost all U.S. teens have had formal sex education, but only about two-thirds have been taught about birth control methods." Many teenagers are reportedly not absorbing the sex education lessons. The report from CDC is based on face-to-face interviews with nearly 2,800 teenagers in their homes from 2006 through 2008.

Federal Funding for Sex Education Programs 2011

In 2010, Congress eliminated two federal programs that had been funding abstinence-only education; the Adolescent Family Life (AFL) Prevention program and the Community-Based Abstinence Education (CBAE) program; $13 million and $99 million a year, respectively for a total of $112 million a year.

That same year, two new evidenced-based sex education programs were initiated; the Personal Responsibility Education Program (PREP), and the Teen Pregnancy Prevention (TPP) initiative; $55 million and $100 million, respectively, for a total of $155 million a year.

Funding for Title V, Section 510 abstinence-only education had expired in 2009, but was reinstated by a provision in the 2010 health care reform law by Senator Orrin Hatch. Although this funding stands at $50 million a year, only $33 million seems to have actually been awarded.

Comprehensive sex education

A 2002 study conducted by the Kaiser Family Foundation

Kaiser Family Foundation

The Henry J. Kaiser Family Foundation , or just Kaiser Family Foundation, is a U.S.-based non-profit, private operating foundation headquartered in Menlo Park, California. It focuses on the major health care issues facing the nation, as well as the U.S. role in global health policy...

found that 58% of secondary school principals describe their sex education curriculum as comprehensive.

The American Psychological Association

American Psychological Association

The American Psychological Association is the largest scientific and professional organization of psychologists in the United States. It is the world's largest association of psychologists with around 154,000 members including scientists, educators, clinicians, consultants and students. The APA...

, the American Medical Association

American Medical Association

The American Medical Association , founded in 1847 and incorporated in 1897, is the largest association of medical doctors and medical students in the United States.-Scope and operations:...

, the National Association of School Psychologists

National Association of School Psychologists

The National Association of School Psychologists is the major national professional organization for school psychologists in the United States...

, the American Academy of Pediatrics

American Academy of Pediatrics

The American Academy of Pediatrics is the major professional association of pediatricians in the United States. The AAP was founded in 1930 by 35 pediatricians to address pediatric healthcare standards. It currently has 60,000 members in primary care and sub-specialist areas...

, the American Public Health Association

American Public Health Association

The American Public Health Association is Washington, D.C.-based professional organization for public health professionals in the United States. Founded in 1872 by Dr. Stephen Smith, APHA has more than 30,000 members worldwide...

, the Society for Adolescent Medicine and the American College Health Association, have all stated official support for comprehensive sex education. Comprehensive sex education curricula are intended to reduce sexually transmitted disease and out-of-wedlock or teenage pregnancies.

Proponents of this approach argue that sexual behavior after puberty is a given, and it is therefore crucial to provide information about the risks and how they can be minimized. They hold that abstinence-only sex ed and conservative

Social conservatism

Social Conservatism is primarily a political, and usually morally influenced, ideology that focuses on the preservation of what are seen as traditional values. Social conservatism is a form of authoritarianism often associated with the position that the federal government should have a greater role...

moralizing will only alienate students and thus weaken the message.

A report issued by the Department of Health and Human Services has found the "most consistent and clear finding is that sex education does not cause adolescents to initiate sex when they would not otherwise have done so." The same report also found that:

Family life or sex education in the public schools, which traditionally has consisted largely of providing factual information at the secondary school level, is the most general or pervasive approach to preventing pregnancy among adolescents....Adolescents who begin having sexual intercourse need to understand the importance of using an effective contraceptive every time they have sex. This requires convincing sexually active teens who have never used contraception to do so. In addition, sexually active teens who sometimes use contraceptives need to use them more consistently (every time they have sex) and use them correctly.

The proposed Responsible Education About Life Act

Responsible Education About Life Act

The Responsible Education About Life Act is a bill introduced in the U.S. Senate and the U.S. House of Representatives on March 22, 2007...

( and ) would provide federal funding for comprehensive sex education programs which include information on both abstinence and contraception and condoms.

Abstinence-only sex education

Abstinence-only sex education emphasizes abstinence

Abstinence

from sex to the exclusion of all other types of sexual and reproductive health education, particularly regarding birth control and safe sex. Adolescents are encouraged to be sexually abstinent until marriage and are not provided with information about contraception. In the Kaiser study, 34% of high-school principals said their school's main message was abstinence-only. Many religious groups consider premartial sex to be morally objectionable and some, such as Catholic church, object to the use of contraception even by married couple. And some of these groups often objects to teaching of contraception because they feel that teaching of contraception for school children presume premartial sex from the outset and somewhat imply that such things are morally permissible. These organisation advocate abstinence-only sex education because it is the only approach they find acceptable and in accordance with their religious teachings.

Some organizations promote what they consider to be "sexual purity", which encompasses abstaining from not only intercourse before marriage, but also from sexual thoughts, sexual touching, pornography

Pornography

Pornography or porn is the explicit portrayal of sexual subject matter for the purposes of sexual arousal and erotic satisfaction.Pornography may use any of a variety of media, ranging from books, magazines, postcards, photos, sculpture, drawing, painting, animation, sound recording, film, video,...

, and actions that are known to lead to sexual arousal. Advocates of abstinence-only sex education object to comprehensive curricula which fail to teach moral behavior; they maintain that curricula should promote conventional (or conservative) morality as healthy and constructive, and that value-free knowledge of the body may lead to immoral, unhealthy and harmful practices.

A comprehensive review of 115 program evaluations published in November 2007 by the National Campaign to Prevent Teen and Unplanned Pregnancy found that two-thirds of sex education programs focusing on both abstinence and contraception had a positive effect on teen sexual behavior. The same study found no strong evidence that programs that stress abstinence as the only acceptable behavior for unmarried teens delayed the initiation of sex, hastened the return to abstinence, or reduced the number of sexual partners. According to the study author:

"Even though there does not exist strong evidence that any particular abstinence program is effective at delaying sex or reducing sexual behavior, one should not conclude that all abstinence programs are ineffective. After all, programs are diverse, fewer than 10 rigorous studies of these programs have been carried out, and studies of two programs have provided modestly encouraging results. In sum, studies of abstinence programs have not produced sufficient evidence to justify their widespread dissemination."

Proponents of abstinence-only sex education object to curricula that fail to teach their standard of moral behavior; they maintain that a morality based on sex only within the bounds of marriage is "healthy and constructive" and that value-free knowledge of the body may lead to immoral, unhealthy, and harmful practices.

Abstinence-only sex education became more prominent in the U.S. over the last decade, largely as a result of over $1 billion in federal government

Federal government of the United States

The federal government of the United States is the national government of the constitutional republic of fifty states that is the United States of America. The federal government comprises three distinct branches of government: a legislative, an executive and a judiciary. These branches and...

funding initiatives. Through direct funding and matching grant incentives, the U.S. government steered more than a billion dollars to abstinence-only education programs between 1996 and 2006. However, few long-term, rigorous studies have been done on these programs, and their effectiveness remains a matter of question. While abstinence-only sex education is a controversial subject, the fact that complete abstinence itself (even within marriage) is the most effective preventative measure against both pregnancy and sexually transmitted disease

Sexually transmitted disease

s has never been in dispute. What is in dispute is whether abstinence-only sex education actually succeeds in increasing abstinence.

In 1996, the federal government attached a provision to a welfare reform

Welfare reform

Welfare reform refers to the process of reforming the framework of social security and welfare provisions, but what is considered reform is a matter of opinion. The term was used in the United States to support the Personal Responsibility and Work Opportunity Act...

law establishing a program of special grants to states for abstinence-only-until-marriage programs. The program, Title V, § 510(b) of the Social Security Act (now codified as ), is commonly known as Title V. It created very specific requirements for grant recipients. Under this law, the term “abstinence education” means an educational or motivational program which:

Has as its exclusive purpose teaching the social, psychological, and health gains to be realized by abstaining from sexual activity;
Teaches abstinence from sexual activity outside marriage as the expected standard for all school-age children;
Teaches that abstinence from sexual activity is the only certain way to avoid out-of-wedlock pregnancy, sexually transmitted diseases, and other associated health problems;
Teaches that a mutually faithful monogamous relationship in the context of marriage is the expected standard of sexual activity;
Teaches that sexual activity outside of the context of marriage is likely to have harmful psychological and physical effects;
Teaches that bearing children out of wedlock is likely to have harmful consequences for the child, the child’s parents, and society;
Teaches young people how to reject sexual advances and how alcohol and drug use increase vulnerability to sexual advances, and
Teaches the importance of attaining self-sufficiency before engaging in sexual activity.

Title V-funded programs were not permitted to advocate or discuss contraceptive methods except to emphasize their failure rates.

The program dedicated $50 million annually to be distributed among states choosing to participate. States accepting the funds were required to match every four federal dollars with three state-raised dollars. For the first five years of the initiative, every state but California participated in the program.

After its first five years, many states evaluated the effectiveness of their programs. A comprehensive review of 11 state evaluations conducted by Advocates for Youth showed some short-term benefits, but did not find any programs with lasting positive impact.

Research conducted by the Kaiser Family Foundation in 2002 indicated that, by that time, about a third of U.S. secondary schools

Secondary education in the United States

In most jurisdictions, secondary education in the United States refers to the last six or seven years of statutory formal education. Secondary education is generally split between junior high school or middle school, usually beginning with sixth or seventh grade , and high school, beginning with...

were using an abstinence-only approach. However, after their five-year evaluations, more states began declining the funding. By 2009, only 25 of the 50 states continued to receive and pursue Title V funding.

In 2000, the federal government began another large program to fund abstinence education, Community-Based Abstinence Education (CBAE). CBAE became the largest federal abstinence-only funding source, with $115 million granted for fiscal year 2006. The CBAE awards bypass state governments, offering federal grants directly to state and local organizations that provide abstinence-only education programs. Many of these grantees are faith-based or small non-profit organizations, including crisis pregnancy center

Crisis pregnancy center

A crisis pregnancy center , sometimes called a pregnancy resource center , is a non-profit organization established to counsel pregnant women against having an abortion....

s, which use their grants to provide abstinence-only programs and services in local public and private schools and to community groups.

Within the last decade, the federal government has encouraged abstinence-only education by steering over a billion dollars to such programs. Some 25 states now decline the funding so that they can continue to teach comprehensive sex education. Funding for one of the federal government's two main abstinency-only funding programs, Title V, was extended only until December 31, 2007; Congress is debating whether to continue it past that date.

Congress extended funding of Title V several times, through fiscal year 2006. In October 2007, Congress again extended funding, only until December 31, 2007. In 2010, the Obama administration and Congress eliminated two federal abstinence-only programs - the Community-Based Abstinence Education (CBAE) grant program and the Adolescent Family Life Act (AFLA) Prevention program. This leaves the Title V program as the only remaining federal abstinence education program.

Role of religion in abstinence-only sex education

The prevalence of religion

Religion

Religion is a collection of cultural systems, belief systems, and worldviews that establishes symbols that relate humanity to spirituality and, sometimes, to moral values. Many religions have narratives, symbols, traditions and sacred histories that are intended to give meaning to life or to...

in the United States contributes to the widespread implementation of abstinence-only sex education. Historically, contraception was generally condemned

Christian views on contraception

Prior to the 20th century, contraception was generally condemned by all the major branches of Christianity including the major reformers like Martin Luther and John Calvin...

by all the major branches of Christianity, the most common religion in America (though today there exists a wider variety of positions towards contraception within the religion). Some Christians consider birth control a sin, and sex education is based on the belief that sexual intercourse must be "free, total, faithful, and fruitful," and that this is impossible outside the context of marriage. The “Silver Ring Thing” is a nationwide abstinence-only-until-marriage program, and was heavily backed by the Christian church, which claimed, “This mission can only be achieved by offering a personal relationship with Jesus Christ as the best way to live a sexually pure life.”

Controversy

The difference between these two approaches, and their impact on teen behavior, remains a controversial subject. In the U.S., teenage birth rates had been dropping since 1991, but a 2007 report showed a 3% increase from 2005 to 2006. From 1991 to 2005, the percentage of teens reporting that they had ever had sex or were currently sexually active showed small declines. However, the U.S. still has the highest teen birth rate and one of the highest rates of STIs among teens in the industrialized world. Public opinion polls conducted over the years have found that the vast majority of Americans favor broader sex education programs over those that teach only abstinence, although abstinence educators recently published poll data with the opposite conclusion.

Proponents of comprehensive sex education, which include the American Psychological Association, the American Medical Association, the National Association of School Psychologists, the American Academy of Pediatrics, the American Public Health Association, the Society for Adolescent Medicine and the American College Health Association, argue that sexual behavior after puberty is a given, and it is therefore crucial to provide information about the risks and how they can be minimized; they also claim that denying teens such factual information leads to unwanted pregnancies and STIs.

The impact of the rise in abstinence-only education remains a question. To date, no published studies of abstinence-only programs have found consistent and significant program effects on delaying the onset of intercourse. In 2007, a study ordered by the U.S. Congress found that middle school students who took part in abstinence-only sex education programs were just as likely to have sex (and use contraception) in their teenage years as those who did not. Abstinence-only advocates claimed that the study was flawed because it was too narrow and began when abstinence-only curricula were in their infancy, and that other studies have demonstrated positive effects.

Criticism of abstinence-only sex education in the U.S. Congress

Two major studies by Congress

United States Congress

The United States Congress is the bicameral legislature of the federal government of the United States, consisting of the Senate and the House of Representatives. The Congress meets in the United States Capitol in Washington, D.C....

have increased the volume of criticism surrounding abstinence-only education.

In 2004, U.S. Congressman Henry Waxman

Henry Waxman

Henry Arnold Waxman is the U.S. Representative for , serving in Congress since 1975. He is a member of the Democratic Party. He is considered to be one of the most influential liberal members of Congress...

of California

California

California is a state located on the West Coast of the United States. It is by far the most populous U.S. state, and the third-largest by land area...

released a report that provides several examples of inaccurate information being included in federally funded abstinence-only sex education programs. This report bolstered the claims of those arguing that abstinence-only programs deprive teenagers of critical information about sexuality. The claimed errors included:

misrepresenting the failure rates of contraceptives
misrepresenting the effectiveness of condoms in preventing HIV
HIV
Human immunodeficiency virus is a lentivirus that causes acquired immunodeficiency syndrome , a condition in humans in which progressive failure of the immune system allows life-threatening opportunistic infections and cancers to thrive...

transmission, including the citation of a discredited 1993 study by Dr. Susan Weller, when the federal government had acknowledged it was inaccurate in 1997 and larger and more recent studies that did not have the problems of Weller's study were available
false claims that abortion
Abortion
Abortion is defined as the termination of pregnancy by the removal or expulsion from the uterus of a fetus or embryo prior to viability. An abortion can occur spontaneously, in which case it is usually called a miscarriage, or it can be purposely induced...

increases the risk of infertility
Infertility
Infertility primarily refers to the biological inability of a person to contribute to conception. Infertility may also refer to the state of a woman who is unable to carry a pregnancy to full term...

, premature birth
Premature birth
In humans preterm birth refers to the birth of a baby of less than 37 weeks gestational age. The cause for preterm birth is in many situations elusive and unknown; many factors appear to be associated with the development of preterm birth, making the reduction of preterm birth a challenging...

for subsequent pregnancies, and ectopic pregnancy
Ectopic pregnancy
An ectopic pregnancy, or eccysis , is a complication of pregnancy in which the embryo implants outside the uterine cavity. With rare exceptions, ectopic pregnancies are not viable. Furthermore, they are dangerous for the parent, since internal haemorrhage is a life threatening complication...
treating stereotypes about gender roles as scientific fact
other scientific errors, e.g. stating that "twenty-four chromosome
Chromosome
A chromosome is an organized structure of DNA and protein found in cells. It is a single piece of coiled DNA containing many genes, regulatory elements and other nucleotide sequences. Chromosomes also contain DNA-bound proteins, which serve to package the DNA and control its functions.Chromosomes...

s from the mother and twenty-four chromosomes from the father join to create this new individual" (the actual number is 23).

Out of the 13 grant-receiving programs examined in the 2004 study, the only two not containing "major errors and distortions" were Sex Can Wait and Managing Pressures before Marriage, each of which was used by five grantees, making them two of the least widely used programs in the study. With the exception of the FACTS program, also used by 5 grantees, the programs found to contain serious errors were more widely used, ranging in usage level from 7 grantees (the Navigator and Why kNOw programs) to 32 grantees (the Choosing the Best Life program). Three of the top five most widely used programs, including the top two, used versions of the same textbook, Choosing the Best, from either 2003 (Choosing the Best Life) or 2001 (Choosing the Best Path — the second most widely used program with 28 grantees — and Choosing the Best Way, the fifth most widely used program with 11 grantees).

In 2007, a study ordered by Congress found that middle school

Middle school

Middle School and Junior High School are levels of schooling between elementary and high schools. Most school systems use one term or the other, not both. The terms are not interchangeable...

students who took part in abstinence-only sex education programs were just as likely to have sex in their teenage years as those who did not. From 1999 to 2006, the study tracked more than 2,000 students from age 11 or 12 to age 16; the study included students who had participated in one of four abstinence education programs, as well as a control group who had not participated in such a program. By age 16, about half of each group students in the abstinence-only program as well as students in the control group were still abstinent. Abstinence program participants who became sexually active during the 7-year study period reported having similar numbers of sexual partners as their peers of the same age; moreover, they had sex for the first time at about the same age as other students. The study also found that students who took part in the abstinence-only programs were just as likely to use contraception when they did have sex as those who did not participate. Abstinence-only education advocates claim the study was too narrow, began when abstinence-only curricula were in their infancy, and ignored other studies that have shown positive effects.

Criticism of abstinence-only sex education by the scientific and medical communities

Abstinence-only education has been criticized in official statements by the American Psychological Association, the American Medical Association, the National Association of School Psychologists, the Society for Adolescent Medicine, the American College Health Association, the American Academy of Pediatrics, and the American Public Health Association, which all maintain that sex education needs to be comprehensive to be effective.

The AMA "urges schools to implement comprehensive... sexuality education programs that... include an integrated strategy for making condoms available to students and for providing both factual information and skill-building related to reproductive biology, sexual abstinence, sexual responsibility, contraceptives including condoms, alternatives in birth control, and other issues aimed at prevention of pregnancy and sexual transmission of diseases... [and] opposes the sole use of abstinence-only education..."

The American Academy of Pediatrics states that "Abstinence-only programs have not demonstrated successful outcomes with regard to delayed initiation of sexual activity or use of safer sex practices... Programs that encourage abstinence as the best option for adolescents, but offer a discussion of HIV prevention and contraception as the best approach for adolescents who are sexually active, have been shown to delay the initiation of sexual activity and increase the proportion of sexually active adolescents who reported using birth control."

On August 4, 2007, the British Medical Journal
British Medical Journal
BMJ is a partially open-access peer-reviewed medical journal. Originally called the British Medical Journal, the title was officially shortened to BMJ in 1988. The journal is published by the BMJ Group, a wholly owned subsidiary of the British Medical Association...

published an editorial concluding that there is "no evidence" that abstinence-only sex education programs "reduce risky sexual behaviours, incidence of sexually transmitted infections, or pregnancy" in "high income countries".

A comprehensive review of 115 program evaluations published in November 2007 by the National Campaign to Prevent Teen and Unplanned Pregnancy found that two-thirds of sex education programs focusing on both abstinence and contraception had a positive effect on teen sexual behavior. The same study found no strong evidence that abstinence-only programs delayed the initiation of sex, hastened the return to abstinence, or reduced the number of sexual partners. According to the study author:

"Even though there does not exist strong evidence that any particular abstinence program is effective at delaying sex or reducing sexual behavior, one should not conclude that all abstinence programs are ineffective. After all, programs are diverse, fewer than 10 rigorous studies of these programs have been carried out, and studies of two programs have provided modestly encouraging results. In sum, studies of abstinence programs have not produced sufficient evidence to justify their widespread dissemination."

Joycelyn Elders, former Surgeon General of the United States

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...

, is a notable critic of abstinence-only sex education. She was among the interviewees Penn & Teller

Penn & Teller

Penn & Teller are Las Vegas headliners whose act is an amalgam of illusion and comedy. Penn Jillette is a raconteur; Teller generally uses mime while performing, although his voice can occasionally be heard during their performance...

included in their Bullshit!
Bullshit!
Penn & Teller: Bullshit! is an American documentary television series that aired from 2003 to 2010 on the premium cable channel Showtime. In Canada, the series aired on The Movie Network and Movie Central.- Overview :...

episode on the subject.

Arthur Caplan

Arthur Caplan

Arthur L. Caplan, Ph.D., is Emmanuel and Robert Hart Professor of Bioethics and director of the Center for Bioethics at the University of Pennsylvania. Prior to coming to Penn in 1994, Caplan taught at the University of Minnesota, the University of Pittsburgh, and Columbia University. He was the...

, director of the Center for Bioethics at the University of Pennsylvania

University of Pennsylvania

The University of Pennsylvania is a private, Ivy League university located in Philadelphia, Pennsylvania, United States. Penn is the fourth-oldest institution of higher education in the United States,Penn is the fourth-oldest using the founding dates claimed by each institution...

, argues that abstinence-only sex education leads to the opposite of the intended results by spreading ignorance regarding sexually transmitted diseases and the proper use of contraceptives to prevent both infections and pregnancy.

In July 2009, researchers from the U.S. Centers for Disease Control and Prevention released their analysis of national data collected between 2002 and 2007. Their findings included:

Birth rates among U.S. teens had increased in 2006 and 2007, following large declines from 1991 to 2005.
About one-third of adolescents had not received instructions on methods of birth control before age 18.
In 2004, there were about 745,000 pregnancies among females younger than 20, including an estimated 16,000 pregnancies among girls between 10 and 14.
In 2006, about one million young people aged 10 to 24 were reported to have chlamydia, gonorrhea
Gonorrhea
Gonorrhea is a common sexually transmitted infection caused by the bacterium Neisseria gonorrhoeae. The usual symptoms in men are burning with urination and penile discharge. Women, on the other hand, are asymptomatic half the time or have vaginal discharge and pelvic pain...

, or syphilis
Syphilis
Syphilis is a sexually transmitted infection caused by the spirochete bacterium Treponema pallidum subspecies pallidum. The primary route of transmission is through sexual contact; however, it may also be transmitted from mother to fetus during pregnancy or at birth, resulting in congenital syphilis...

. Nearly one-quarter of females aged 15 to 19, and 45% of females aged 20 to 24, had a human papillomavirus
Human papillomavirus
Human papillomavirus is a member of the papillomavirus family of viruses that is capable of infecting humans. Like all papillomaviruses, HPVs establish productive infections only in keratinocytes of the skin or mucous membranes...

infection during 2003 and 2004.
In 2006, the majority of new diagnoses of HIV
HIV
Human immunodeficiency virus is a lentivirus that causes acquired immunodeficiency syndrome , a condition in humans in which progressive failure of the immune system allows life-threatening opportunistic infections and cancers to thrive...

infection among young people occurred among males and those aged 20 to 24.
From 2004 to 2006, about 100,000 females aged 10 to 24 visited a hospital emergency department for nonfatal sexual assault
Sexual assault
Sexual assault is an assault of a sexual nature on another person, or any sexual act committed without consent. Although sexual assaults most frequently are by a man on a woman, it may involve any combination of two or more men, women and children....

, including 30,000 females aged 10 to 14.
Hispanic
Hispanic
Hispanic is a term that originally denoted a relationship to Hispania, which is to say the Iberian Peninsula: Andorra, Gibraltar, Portugal and Spain. During the Modern Era, Hispanic sometimes takes on a more limited meaning, particularly in the United States, where the term means a person of ...

teens aged 15 to 19 are much more likely to become pregnant (132.8 births per 1,000 females) than non-Hispanic blacks (128 per 1,000) and non-Hispanic whites (45.2 per 1,000)
Non-Hispanic black youth in all age groups have the highest rates of new HIV and AIDS diagnoses.

Global influence on sexual education

In 2004, President George W. Bush

George W. Bush

George Walker Bush is an American politician who served as the 43rd President of the United States, from 2001 to 2009. Before that, he was the 46th Governor of Texas, having served from 1995 to 2000....

announced his Five-Year Global HIV

HIV

/AIDS

AIDS

Acquired immune deficiency syndrome or acquired immunodeficiency syndrome is a disease of the human immune system caused by the human immunodeficiency virus...

Strategy. Also known as the 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...

(PEPFAR), the plan committed the U.S. to provide $15 billion over five years toward AIDS relief in 15 countries in Africa

Africa

Africa is the world's second largest and second most populous continent, after Asia. At about 30.2 million km² including adjacent islands, it covers 6% of the Earth's total surface area and 20.4% of the total land area...

and the Caribbean

Caribbean

The Caribbean is a crescent-shaped group of islands more than 2,000 miles long separating the Gulf of Mexico and the Caribbean Sea, to the west and south, from the Atlantic Ocean, to the east and north...

, and in Vietnam

Vietnam

Vietnam – sometimes spelled Viet Nam , officially the Socialist Republic of Vietnam – is the easternmost country on the Indochina Peninsula in Southeast Asia. It is bordered by China to the north, Laos to the northwest, Cambodia to the southwest, and the South China Sea –...

. About 20% of the funding, or $3 billion over five years, was allocated for prevention. The program required that, starting in fiscal year 2006, one-third of prevention funding be earmarked specifically for abstinence-only-until-marriage programs. The earmark had numerous critics, including global AIDS prevention advocates, the U.S. Government Accountability Office, and a Congressionally authorized three-year evaluation of PEPFAR by the non-partisan Institute of Medicine

Institute of Medicine

The Institute of Medicine is a not-for-profit, non-governmental American organization founded in 1970, under the congressional charter of the National Academy of Sciences...

.

During its 2008 reauthorization of PEPFAR, Congress dropped the earmark, resorting instead to more flexible spending directives encouraging countries to spend at least 50% of prevention funds on abstinence and fidelity programs.

External links

Abstinence Comes To Albuquerque Documentary on Google Video
The Education of Shelby Knox PBS POV video documentary and companion website

Proponents

Critics

Humor

AbstinenceOnly.com A celebration of non-penetration
IronHymen.com Abstinence-Only Coolness for Girls

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Current state of sex education in the United States

Federal Funding for Sex Education Programs 2011

Comprehensive sex education

Abstinence-only sex education

Role of religion in abstinence-only sex education

Controversy

Criticism of abstinence-only sex education in the U.S. Congress

Criticism of abstinence-only sex education by the scientific and medical communities

Global influence on sexual education

See also

External links

Proponents

Critics

Humor