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No, Rep. Spitzer, Abstinence Education is not HIV Prevention

No, Rep. Spitzer, Abstinence Education is not HIV Prevention

at 1:26 pm

Yesterday the House of Representatives passed their version of the Texas budget for the next two years. Part of this budget proposal moves $3 million from HIV prevention programs to further fund abstinence education in Texas schools. In defending this budget change, Rep. Stuart Spitzer stated, “It may not be working well, but abstinence education is HIV prevention. They are essentially the same thing.” Rep. Spitzer is more correct than he may realize in the first part of that statement. Abstinence-until-marriage education is not only not working well in Texas, it has never been shown to be effective in changing the sexual behaviors of teens.

In his exhaustive review of sex education studies, Emerging Answers 2007, Dr. Douglas Kirby stated that “there does not exist any strong evidence that any abstinence program delays the initiation of sex, hastens the return to abstinence, or reduces the number of sexual partners. In addition, there is strong evidence from multiple randomized trials demonstrating that some abstinence programs chosen for evaluation because they were believed to be promising actually had no impact on teen sexual behavior. That is, they did not delay the initiation of sex, increase the return to abstinence or decrease the number of sexual partners.” (Kirby 2007)

Another study looked at the difference in sexual activity rates and pregnancy rates before and after teens went through either an abstinence education course, a comprehensive course, or no sex education course. “Adolescents who received comprehensive sex education were significantly less likely to report teen pregnancy than those who received no formal sex education, whereas there was no significant effect of abstinence-only education.” (Kohler 2008)

Many proponents of abstinence education tout the successes of individual abstinence programs. However, when these programs have been studied, they have not been shown to be effective at changing teen sexual behaviour. And the few studies that abstinence proponents cite are not of abstinence-until-marriage programs, such as that taught here in Texas, but of more comprehensive programs that talk about abstinence, but just as one method of safe sexual activity, while also teaching about contraception and sexual health. There have been, as far as Secular Texas can find, no peer reviewed studies showing that abstinence-until-marriage sex education is effective in reducing teen sexual behavior or teen pregnancies.

To bring this all closer to home, in the twenty years that Texas has spent trying to convince our teens to remain abstinent until they are married, Texas has consistently ranked in the top 10 states for teen sexual activity (CDC, 1993 - 2014), the top 5 states for teen pregnancy rate (Kost, 2013), the highest rate in the nation for repeat teen pregnancies (CDC 2013), and among the bottom 5 states for condom use by sexually active teens (CDC, 1993 - 2014). In short, despite all the efforts of abstinence-until-marriage sex education, Texas has some of the most dangerous sexual behavior among teens in the entire nation.

Texas actually conducted a study of our own abstinence-until-marriage programs in 2004, performed by Texas A&M University. This study found “the number of adolescents who had had sexual intercourse did not change or increased after they had received abstinence only sex education.” Looking at the actual numbers, the increase is quite dramatic. After going through the abstinence-until-marriage course, the number of students having engaged in sexual activities had increased 20% among girls and a shocking 62% among boys (Hopkins, 2005). Abstinence-until-marriage sex education is not only “not working well” in Texas, it isn’t working at all.

Coming back to the last part of Rep. Spitzer’s comment, that abstinence education is essentially HIV prevention, this cannot be further from the truth. As shown here, according to all peer-reviewed research on the subject, abstinence education is essentially doing nothing at all.

In Dr. Kirby’s 2008 comparison of abstinence education and comprehensive sex education for HIV/AIDS prevention, he found, “Rigorous evaluations using large experimental designs have assessed multiple abstinence programs, including at least three abstinence-until-marriage programs, and have found that these curricula have no overall impact on adolescents’ delay in initiation of sex, age at initiation of sex, return to abstinence, number of sexual partners, or condom or contraceptive use.” He goes on to conclude about abstinence education, “Taken as a whole, this evidence certainly does not justify the widespread replication of abstinence sex education programs.” As to comprehensive sex education programs he concludes, “In contrast, the results for comprehensive programs are very encouraging, both in increasing abstinence and in improving other sexual behaviors among youth. Nearly half of the 48 comprehensive programs delayed adolescents’ initiation of sex, one fourth reduced the frequency of sex, and nearly half reduced the number of sexual partners. In addition, nearly half of the comprehensive programs increased condom or contraceptive use and three fifths reduced various measures of sexual risk behavior. Thus, overall, more than two thirds of the 48 comprehensive programs had a positive effect on one or more sexual behaviors and two fifths had a positive impact on two or more sexual behaviors among youth.” (Kirby 2008)

The methods for reducing teen sexual activities and dangerous sexual behaviors are known to us, and they are absolutely not abstinence-until-marriage education. Comprehensive sex education programs have been shown to reduce teen sexual activity whereas abstinence education simply does not. Comprehensive sex education also provides vital information and encouragement regarding STI prevention, testing and medical treatment, whereas abstinence education -- especially in Texas -- is more likely to leave teens so fearful of STIs that they do not seek medical treatment.

Rep. Spitzer’s ideological attack on HIV prevention is not only irresponsible, but is in complete disregard for the reality of the world in which we live. State policy must be based on known realities, no matter how tough to admit or how far from our ideological comfort zones.

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