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Health Behaviors - Sexual Activity - Reduce Sexually Transmitted Infections (STIs) & pregnancy

Abstinence-only education

Health Factors:	Sexual Activity
Decision Makers:	Government - Local, Government - State, Government - Federal, Schools
Evidence Rating:	Mixed Evidence
Population Reach:	10-19% of WI's population
Impact on Disparities:	No impact on disparities likely

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Description

Abstinence-only education promotes abstinence from sexual activity (either delayed initiation or abstinence until marriage). These programs generally mention condoms or other birth control methods only to highlight their failure rates (CG-HIV/AIDS-Interventions for adolescents).

Expected Beneficial Outcomes

Delayed initiation of sex

Evidence of Effectiveness

There is mixed evidence about the effects of abstinence-only education. Overall, studies find no significant change to adolescents' frequency of sex, incidence of unprotected sex, number of partners, sexual initiation, HIV and STI incidence, or condom use as a result of abstinence-only education (Cochrane-Underhill 2007, CG-HIV/AIDS-Interventions for adolescents).

Some studies find that abstinence-only education may decrease adolescents' sexual activity, frequency of sex (CG-HIV/AIDS-Interventions for adolescents), and number of sexual partners (Jemmott 2010). However, these decreases can often be accompanied by increases in pregnancy rates and sexually transmitted infection (CG-HIV/AIDS-Interventions for adolescents).

Implementation Examples

United States

Legislation concerning sex education varies from state to state. As of 2012, thirty-nine states require the inclusion of abstinence education, and twenty-eight of these require that abstinence be stressed. Nineteen states require that instruction emphasize the importance of engaging in sexual activity only within marriage (Guttmacher-Sex and HIV 2012).

Citations - Description

CG-HIV/AIDS-Interventions for adolescents - The Guide to Community Preventive Services (The Community Guide). Prevention of HIV/AIDS, other STIs and pregnancy: Interventions for adolescents. Accessed on June 23, 2012
Webpage: http://www.thecommunityguide.org/hiv/adolescents.html

Citations - Evidence

Cochrane-Underhill 2007* - Underhill K, Operario D, Montgomery P. Abstinence-only programs for HIV infection prevention in high-income countries. Cochrane Database of Systematic Reviews. 2007;(4):CD05421. Accessed on February 24, 2012
Webpage: http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD005421.pub2/abstract

Jemmott 2010* - Jemmott JB, Jemmott LS, Fong GT. Efficacy of a theory-based abstinence-only intervention over 24 months: A randomized controlled trial with young adolescents. Archives of Pediatrics & Adolescent Medicine. 2010;16(2):152–9. Accessed on August 8, 2012
Webpage: http://www.ncbi.nlm.nih.gov/pubmed/20124144.

Citations - Implementation Examples

Guttmacher-Sex and HIV 2012 - Guttmacher Institute. Sex and HIV education. 2012. Accessed on June 20, 2012
Webpage: http://www.guttmacher.org/sections/adolescents.php?pub=spib

* Journal subscription may be required for access.

Comments from Users about this Policy/Program (Cost, Feasibility, Lessons Learned)

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Health Factors

Health Behaviors

Tobacco Use

Diet & Exercise

Alcohol Use

Sexual Activity

Clinical Care

Access to Care

Quality of Care

Social & Economic Factors

Education

Employment
Income

Income

Family & Social Support

Community Safety

Physical Environment

Environmental Quality

Built Environment

Decision Makers

Businesses & Employers

Community Organizations

Government - Local

Government - State

Government - Federal

Healthcare Organizations

Individuals

Schools

Evidence Rating

Level of effectiveness based on a scan of academic literature and key recommendations of leading organizations.

Scientifically Supported Numerous studies or systematic review(s) with positive results
Some Evidence Research suggests positive impacts; further study may be warranted
Expert Opinion Recommended by credible groups*; research evidence limited
Insufficient Evidence Evidence limited or unavailable; further study warranted
Mixed Evidence Evidence mixed; further study warranted
Evidence of Ineffectiveness Research consistently shows program is detrimental or has no effect

Although many policies and programs are recommended by credible groups, we apply the rating ‘expert opinion’ only when policies are recommended but limited scientific evidence of effectiveness is available.

* The American Heritage Dictionary defines credible as 'capable of being believed; plausible.' and 'worthy of confidence; reliable.' To be considered an 'expert recommendation,' policies and programs must be recommended by one or more organizations that are recognized for their impartial expertise in the area of interest and have limited evidence available.

Potential Population Reach

Portion of Wisconsin's population likely to be reached by a policy or program if implemented statewide, based on its characteristics (e.g., target population(s), geographic limitations, and potential implementers).

	<1%			20-49%
	1-9%			50-99%
	10-19%			100%

Potential Population Reach

	<1%			20-49%
	1-9%			50-99%
	10-19%			100%

Potential Impact on Health Disparities

Likely impact of a given policy or program on racial/ethnic, socioeconomic, geographic or other disparities in Wisconsin based on its characteristics (e.g., target audience, mode of delivery, etc.) and best available evidence related to disparities.

Likely to decrease disparities
No impact on disparities likely
Likely to increase disparities