Tuesday, February 16, 2010

Sex Education: Beyond NO Agreement! Revisited

Please note: This is a combined post by The Curator of The Sexhibition and
Is Still Here of Surviving Survival.
 
A research study regarding the positive merits of “abstinence-only” sex education has been bogged down in blogged down misreporting so much that we decided to take a fresh look at this important topic.
 
The study, which has generated worldwide publicity, appears in the February edition of Archives of Pediatrics & Adolescent Medicine. Normally an academic study entitled “Efficacy of a Theory-Based Abstinence-Only Intervention Over 24 Months” would draw little attention in the popular press. However, the term “Abstinence-Only” was the red flag that drew journalists and bloggers like moths to a flame. Add that the study concludes in part, “abstinence-only intervention reduced sexual initiation,” and the story went virtually viral on the Internet and was noted on most news outlets. (By the way, “reduced sexual initiation” is science-speak for “lost their virginity!”)
 
So, what’s the problem? Well, frankly much of the information released and reprinted was very misleading at best, and downright wrong at worst. It may not be the fault of bloggers or journalists, but because the abstract (brief synopsis) of the study that was released publicly is all too brief, and begs gross generalizations that are unsupported by the actual study.
 
Sadly, the entire issue of abstinence has become politicized by the right and left, as well as various religious ideologies here and abroad.
 
Here is the basic finding of the study: The number of adolescents reporting that they had lost their virginity was one-third less with an “abstinence-only program” delivered in sixth and seventh grade, according to John B. Jemmott III, PhD, of the University of Pennsylvania, and colleagues in the February Archives of Pediatric & Adolescent Medicine.
 
Let’s tackle three obvious problems right up front: First, all of the findings are based on the self-reporting of the participants, who were 662 African-American sixth- and seventh-graders attending four low-income middle schools in the Philadelphia area; Second, the “abstinence-only” program used in the study was unusual. In fact, it would not have qualified for abstinence-only federal funding because it did not rely on moral principles, nor did it criticize condom usage; and Third, there is no way to know if there is a cause and effect relationship from the results of ONE study.
 
OK, so here’s a more in-depth recap of the study, without histrionics or as few embellishments as possible. It’s from Medpage Today, written by John Gever, Senior Editor, and reviewed by Robert Jasmer, MD; Associate Clinical Professor of Medicine, University of California, San Francisco and Dorothy Caputo, MA, RN, BC-ADM, CDE, Nurse Planner. Read it here, or at the Medpage Today website.
 
Jemmott and colleagues tested five different programs on the kids that included:
 
— Eight hours of “abstinence-only” education addressing risks of HIV and other STD’s, as well as pregnancy, seeking to promote waiting to engage in oral, anal, and vaginal intercourse "until later in life when the adolescent is more prepared to handle the consequences of sex."
 
— Eight hours of safer-sex instruction, encouraging condom use but not sexual abstinence.
 
— Eight hours of comprehensive education combining support for abstinence as well as safer-sex content.
 
— Twelve hours of comprehensive education.
 
— Eight hours of general health education and promotion regarding chronic diseases, not addressing sexual behaviors.
 
Each of these five programs were taught in one-hour modules over two weekend sessions, except for the 12-hour comprehensive program, which was taught in three sessions.
 
In addition, half the participants in each program were randomly selected to receive "booster" education, including three-hour sessions given six weeks and three months after the initial program; six issues of a newsletter; and six 20-minute individual counseling sessions with the original instructors over a 21-month period.
 
The children were quizzed about their sexual behaviors to provide a baseline, and five more times for two years after the initial intervention.
 
The proportion of teens receiving the abstinence-only program who reported they had had intercourse at least once was 32.6 percent, compared with 41 percent to 52 percent among participants assigned to other intervention programs. These included comprehensive education covering both abstinence, and methods to prevent pregnancy and sexually transmitted diseases (STD’s), as well as a program focusing on "safer sex."
 
At least superficially, the findings contrast with earlier studies in which abstinence-only interventions appeared ineffective, Medpage Today notes, but: Although the abstinence-only program appeared more effective in delaying loss of virginity, it had little or no effect on other sexual behaviors including multiple sex partners, engaging in unprotected sex, and consistency in condom use.
 
Although the reliance on participants' self-reports of sexual behavior was a significant limitation, Jemmott and colleagues cautioned, they called the results "promising."
 
"They suggest that theory-based abstinence-only interventions can have positive effects on adolescents' sexual involvement," they wrote. "This is important because abstinence is the only approach that is acceptable in some communities and settings in both the U.S. and other countries."
 
The stated conclusion of the study was, “theory-based abstinence-only interventions may have an important role in preventing adolescent sexual involvement.”
 
We think it is very important to note that this is just one study that has not been repeated. It is normal practice in any scientific endeavor, to seek independent confirmation before accepting results as fact. In addition, the number of variables in this study is staggering, especially considering this is a social study, and not purely scientific.
 
We should point out the study's lead author has released a statement that, "Policy should not be based on just one study, but an accumulation of empirical findings from several well-designed, well-executed studies."
 
Yet a simple search of current news and blog posts referring to the study will indicate results ranging from “abstinence-only program shows promise” to “study affirms abstinence education.”
 
If there can be any conclusion, perhaps it is simply to suggest that other studies need to be conducted. The sexual well-being of our children is vital for them to grow into healthy, well-adjusted adults.
 
After a decade-long decline, teen pregnancy rates rose in 2006. When the teen pregnancy rate dropped in the 1990s, it was largely because of increased contraception use. With the Bush administration in power, though, Congress directed a whole lot of money towards abstinence-only education — telling kids just to keep it in their pants until. The result? A four percent rise in teen births, and a one percent rise in abortion.
 
The U.S. also has the highest rate of teen pregnancy, birth and abortion of any industrialized, Western nation. Seven percent of all teenage girls here get pregnant.
 
These statistics are undisputed.


— The Curator and Is Still Here

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