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School or community-based abstinence-only education

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

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Abstinence-only education promotes abstinence from sexual activity through 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 and pregnancy). Abstinence-only education may take place in schools or in community settings.

Expected Beneficial Outcomes

Reduced sexual activity
Reduced risky sexual behavior

Evidence of Effectiveness

There is mixed evidence about the effects of abstinence-only education on adolescent sexual activity. Overall, studies find no significant change, positive or negative, 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 (Denford 2017, Chin 2012, Cochrane-Underhill 2007, Mathematica-Trenholm 2007, Bennett 2005). Such programming appears to be associated with increases in pregnancy rates (Stanger-Hall 2010, Yang 2010a, Kohler 2008, DiCenso 2002). In some cases, however, abstinence-only education programs appear to decrease adolescents’ sexual activity and frequency of sex (Markham 2014, Markham 2012Chin 2012, Jemmott 2010, Bennett 2005).


United States

Legislation regarding sex education varies from state to state. As of 2017, 37 states require the inclusion of abstinence education, and 26 of these require that abstinence be stressed—27 when HIV education is taught. Nineteen states require that instruction emphasize the importance of engaging in sexual activity only within marriage (Guttmacher-Sex and HIV education).


In Wisconsin, when HIV or sex education is presented in public schools, instruction must include and stress abstinence as the only reliable way to avoid pregnancy and sexually transmitted infection. Sex education must include information on the importance of sex only within marriage (Guttmacher-Sex and HIV education).

Citations - Description

CG-HIV/AIDS and pregnancy - The Guide to Community Preventive Services (The Community Guide). HIV/AIDS, STIs, and pregnancy. Accessed on May 15, 2017

Citations - Evidence

Bennett 2005* - Bennett SE, Assefi NP. School-based teenage pregnancy prevention programs: A systematic review of randomized controlled trials. Journal of Adolescent Health. 2005;36(1):72–81. Accessed on March 22, 2017
Chin 2012* - Chin HB, Sipe TA, Elder R, et al. The effectiveness of group-based comprehensive risk-reduction and abstinence education interventions to prevent or reduce the risk of adolescent pregnancy, Human Immunodeficiency Virus, and sexually transmitted infections: Two systematic reviews for the Guide to Community Preventive Services. American Journal of Preventive Medicine. 2012;42(3):272-94. Accessed on March 22, 2017
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 2, 2017
Denford 2017* - Denford S, Abraham C, Campbell R, Busse H. A comprehensive review of reviews of school-based interventions to improve sexual-health. Health Psychology Review. 2017;11(1):33-52. Accessed on March 30, 2017
DiCenso 2002 - DiCenso A, Guyatt G, Willan A, Griffith L. Interventions to reduce unintended pregnancies among adolescents: Systematic review of randomised controlled trials. BMJ. 2002;324(7351):1426. Accessed on February 2, 2017
Jemmott 2010* - Jemmott JB 3rd, 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 February 2, 2017
Kohler 2008* - Kohler PK, Manhart LE, Lafferty WE. Abstinence-only and comprehensive sex education and the initiation of sexual activity and teen pregnancy. Journal of Adolescent Health. 2008;42(4):344–51. Accessed on February 2, 2017
Markham 2012 - Markham CM, Tortolero SR, Peskin MF, et al. Sexual risk avoidance and sexual risk reduction interventions for middle school youth: A randomized controlled trial. Journal of Adolescent Health. 2012;50(3):279-288. Accessed on February 8, 2017
Markham 2014 - Markham CM, Peskin MF, Shegog R, et al. Behavioral and psychosocial effects of two middle school sexual health education programs at tenth-grade follow-up. Journal of Adolescent Health. 2014;54(2):151-159. Accessed on February 8, 2017
Mathematica-Trenholm 2007 - Trenholm C, Devaney B, Fortson K, et al. Impacts of four Title V, Section 510 abstinence education programs. Princeton, NJ: Mathematica Policy Research, Inc. (MPR); 2007. Accessed on February 8, 2017
Stanger-Hall 2010 - Stanger-Hall KF, Hall DW. Abstinence-only education and teen pregnancy rates: Why we need comprehensive sex education in the US. PLOS One. 2011;6(10):e24658. Accessed on September 18, 2018
Yang 2010a* - Yang Z, Gaydos LM. Reasons for and challenges of recent increases in teen birth rates: A study of family planning service policies and demographic changes at the state level. Journal of Adolescent Health. 2010;46(6):517–24. Accessed on February 2, 2017

Citations - Implementation

Guttmacher-Sex and HIV education - Guttmacher Institute. Sex and HIV education. New York: Guttmacher Institute. Accessed on March 22, 2017

Page Last Updated

February 9, 2017

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