1. Rickenback, Christina F. MSN, APRN, CPNP

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The issue of abstinence-only sex education in the school setting is a controversial topic, but in my opinion, it does not put adolescents at any increased risk as compared with more comprehensive sex education programs.


In 1996, the U.S. Congress authorized Title V Section 110 of the Social Security Act, which provided funding for schools to administer abstinence-only sex education programs. Guidelines for the programs include teaching the following:


* benefits (social, psychological, and health related) of abstinence from sexual activity


* abstinence outside of marriage as the expected standard


* abstinence as the only certain way to avoid pregnancy, sexually transmitted infections (STIs), and other associated health problems


* monogamous, mutually faithful marital relationships as the expected standard


* the harmful psychological and physical effects of sex outside marriage


* the detrimental effects of having children outside marriage


* the effects of alcohol and drugs leading to increased vulnerability to sexual advances


* the importance of attaining independence and self-sufficiency before becoming sexually active



The guidelines do not include content related to contraception, abortion, safe sex, or healthy sexuality, because the Title V law precludes any program receiving federal funding from including content inconsistent with the above eight guidelines. Not discussing controversial or sensitive topics is not limited to abstinence-only programs; comprehensive sex education curricula also have been found to be deficient in these areas. However, the abstinence-only curricula do consistently include education about antecedents of sexual behavior, including life skills related to improving communication with parents and peers, risk avoidance, and self-esteem, all of which are valuable to the developing teen.


Researchers have looked at the effectiveness of abstinence-only as well as comprehensive sex education programs, and the findings are mixed (DiCenso, Guyatt, Willan, & Griffith, 2002). Some studies show an increase in sexual activity rates for both boys and girls and increases in pregnancy rates in the partners of boys who participate in abstinence-only programs. Other studies show no difference in STI rates for participants when compared to a control group. However, traditional education programs were not necessarily more effective; researchers have found that these programs did not delay intercourse, did not improve birth control use, and did not decrease pregnancy rates among teens who participated (Katz, 2006). So, it is exceedingly clear that no sex education program (comprehensive or abstinence-only) has ever demonstrated success in persuading teens to postpone sex until marriage.


The guidelines for abstinence-only sex education are valid and positive approaches to the issue of adolescent sexual education. Teaching that abstinence is the only certain way to avoid pregnancy and STIs is accurate. Clear expectations for behavior are also positive. Adolescents need to know that the media do not portray sexual activity accurately, because abstinence, contraception, unplanned pregnancy, STIs, and emotional issues are rarely presented.


Furthermore, adolescents need information about the effect of alcohol and drugs on their ability to make good choices, and they need skills that will help them avoid risky situations. Adolescents need to be informed about the increased social risks for children born to young, single parents. Open discussion about financial, social, and emotional issues regarding teen pregnancy is also important, and a general dialogue about goal setting and delayed gratification can help foster discussion of personal aspirations.


In my opinion, abstinence-only education does not put adolescents at any increased risk as compared with comprehensive sex education programs but rather provides them with important discussion of life skills. Because federal funding is available for abstinence-only education, many schools (which may not have had funding for any sex education programs and therefore may have avoided teaching about sex) will be adhering to these guidelines. A good program presents accurate facts about sexual activity, and its effects on adolescents presents clear/positive expectations for behavior and allows discussion of ways to avoid early sexual activity.




DiCenso, A., Guyatt, G., Willan, A., & Griffith, L. (2002). Interventions to reduce unintended pregnancies: Systematic review of randomized controlled trials. British Medical Journal, 324, 1426-1454. [Context Link]


Katz, A. (2006). What's the agenda? Abstinence-only education programs. AWHONN's Lifelines, 10(1), 30-33. [Context Link]

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