Transitions: The Controversy over Abstinence-Only-Until-Marriage Programs
Volume 12, No. 3, March 2001

This Transitions is also available in [PDF] format.

Out of concern for the growing abstinence-only-until-marriage movement, major scientific and medical institutions have reviewed the evidence and made statements in support of comprehensive sexuality education, including access to contraception and condoms.

"Current research findings do not support the position that the abstinence-only approach to sexuality education is effective in delaying the onset of intercourse." ¹

The American Medical Association, 1999

"…It is a matter of grave concern that there is such a large incentive to adopt unproven abstinence-only approaches." "…the effective programs identified to date provide information about safer sex, condoms, and contraceptives, in addition to encouraging abstinence." ²

Office of National AIDS Policy, September 2000

"…Investing hundreds of millions of dollars of federal and state funds over five years in abstinence-only programs with no evidence of effectiveness constitutes poor fiscal and public health policy…. Congress, as well as other federal, state and local policy makers, [should] eliminate requirements that public funds be used for abstinence-only education." ³

The Institute of Medicine, October 2000

"Proponents of abstinence-only policies argue that providing information about contraception or providing condoms to adolescents sends a mixed message to youth and may promote sexual activity." However, "expert panels that have studied this issue, have concluded that comprehensive sex and HIV/AIDS education programs and condom availability programs can be effective in reducing high-risk sexual behaviors among adolescents. In addition, these reviews and expert panels conclude that school-based sex education and condom availability programs do not increase sexual activity among adolescents. ³

The Institute of Medicine, October 2000

"…Two trends have contributed to the declines in teenage birth and pregnancy rates. First, the long-term increase in the proportion of teenaged women who were sexually experienced leveled [off]… In addition, among sexually experienced teenagers who used any method of contraception, condom use increased substantially." ⁴

Centers for Disease Control and Prevention, 1997

"Although sexual abstinence is a desirable objective, programs must include instruction in safer sex behavior, including condom use. The effectiveness of these programs is supported by strong scientific evidence." ⁵

The National Institutes of Health, 1997

"All adolescents should be counseled about the correct and consistent use of latex condoms to reduce risk of infection." ⁶

American Academy of Pediatrics, January 2001

"Given the weight of scientific evidence demonstrating the efficacy of safer-sex interventions and the absence of clear and compelling data demonstrating a significant and consistent treatment advantage for abstinence programs, it is difficult to understand the logic behind the decision to earmark funds specifically for abstinence programs. Unfortunately, much of the public health policy debate appears to have been ideologically motivated rather than empirically driven. However, no matter how widespread, politically viable, or popular a program may be, efficacy in preventing and modifying behaviors associated with ST[D]/HIV must remain the primary criterion by which programs are changed." ⁷

Editorial: Preventing Sexually Transmitted Infections among Adolescents: A Clash of Ideology and Science. Journal of the American Medical Association, May 1998

References:

1. Council on Scientific Affairs. Report of the Council on Scientific Affairs. [Action of the AMA House of Delegates 1999 Interim Meeting, CSA Report 7-I-99]. Chicago, IL: American Medical Association, 1999.
2. Office of National AIDS Policy. Youth and HIV/AIDS 2000: A New American Agenda. Washington, DC: The White House, September 2000.
3. Committee on HIV Prevention Strategies in the United States, Institute of Medicine. No Time to Lose: Getting More from HIV Prevention. Washington, DC: The Institute, October 2000.
4. Centers for Disease Control & Prevention. State-Specific Birth Rates for Teenagers, United States, 1990-1996. Morbidity & Mortality Weekly Report 1997; 46:838-842.
5. National Institutes of Health. Consensus Development Conference Statement. Rockville, MD: The Institutes, 1997.
6. American Academy of Pediatrics. Adolescents and human immunodeficiency virus infection: the role of the pediatrician in prevention and intervention. [Policy statement]. Pediatrics 2001; 107:188-190.
7. DiClemente RJ. Preventing sexually transmitted infections among adolescents: a clash of ideology and science. [Editorials] JAMA May 20, 1998; 279:1574-1575.