By Rob Stein
Washington Post Staff Writer
Monday, February 1, 2010; 4:19 PM
Sex education classes that focus on encouraging children to remain abstinent can convince a significant proportion to delay sexual activity, researchers reported Monday in a landmark study that could have major implications for the nation's embattled efforts to protect young people against unwanted pregnancies and sexually transmitted diseases.
In the first carefully designed study to evaluate the controversial approach to sex ed, researchers found that only about a third of 6th and 7th graders who went through sessions focused on abstinence started having sex in the next two years. In contrast, nearly half of students who got other classes, including those that included information about contraception, became sexually active.
"I think we've written off abstinence-only education without looking closely at the nature of the evidence," said John B. Jemmott III, a professor at the University of Pennsylvania, who led the federally funded study. "Our study shows this could be one approach that could be used."
The research, published in the Archives of Pediatric & Adolescent Medicine, comes amid intense debate over how to reduce sexual activity, pregnancies, births and sexually transmitted diseases among children and teenagers. After declining for more than a decade, births, pregnancies and STDs among U.S. teens have begun increasing again.
The Obama administration eliminated more than $150 million in federal funding targeted at abstinence programs, which are relatively new and have little rigorous evidence supporting their effectiveness. Instead it is launching a new $114 million pregnancy prevention initiative that will fund only programs that have been shown scientifically to work. The administration Monday proposed expanding that program to $183 million next year. The move came after intensifying questions about the effectiveness of abstinence programs.
"This new study is game-changing," said Sarah Brown, who leads the National Campaign to Prevent Teen and Unplanned Pregnancy. "For the first time, there is strong evidence that an abstinence-only intervention can help very young teens delay sex and reduce their recent sexual activity as well."
The new study is the first to evaluate an abstinence program using a carefully "controlled" design that compared it directly to alternative strategies -- considered the highest level of scientific evidence.
"This takes away the main pillar of opposition to abstinence education," said Robert Rector, a senior research fellow at the Heritage Foundation who wrote the criteria for federal funding of abstinence programs. "I've always known that abstinence programs have gotten a bad rap."
Even long-time critics of the approach praised the new study, saying it provided strong evidence that such programs can work and may deserve taxpayer support.
"One of the things that's exciting about this study is that it says we have a new tool to add to our repertoire," said Monica Rodriguez, vice president for education and training at the Sexuality Information and Education Council of the United States.
Based on the findings, Obama administration officials said programs like the one evaluated in the study could be eligible for federal funding.
"No one study determines funding decisions, but the findings from the research paper suggest that this kind of project could be competitive for grants if there's promise that it achieves the goal of teen pregnancy prevention," said Health and Human Services Department spokesman Nicholas Pappas.
Several critics of abstinence-only approach argued that the curriculum tested was not representative of most abstinence programs. It did not take on a moralistic tone as many abstinence programs do. Most notably, the sessions encouraged children to delay sex until they are ready, not necessarily until they were married, did not portray sex outside of marriage as never appropriate or disparage condoms.
"There is no data in this study to support the 'abstain-until marriage' programs, which research proved ineffective during the Bush administration," said James Wagoner, president of Advocates for Youth.
But abstinence supporters disputed that, saying that the new program was essentially the same as other good abstinence programs.
"For our critics to use 'marriage' as the thing that sets the program in this study apart from federally funded programs is an exaggeration and smacks of an effort to dismiss abstinence education rather than understanding what it is," Valerie Huber of the National Abstinence Education Association.
The new study involved 662 African-American students who were randomly assigned to go through one of five programs: An eight-hour curriculum that encouraged them to delay having sex; an eight-hour program focused on teaching safe sex; an eight- or 12-hour program that did both; or an eight-hour program focused on teaching the youngsters other ways to be healthy, such as eating well and exercising.
Over the next two years, 33.5 percent of the students who went through the abstinence program started having sex, compared to 52 percent who were just taught safe sex. About 42 percent of the students who went through the comprehensive program started having sex, and about 48.5 percent of those who just learned about other ways to be healthy. The abstinence program had no negative effects on condom use, which has been a major criticism of the abstinence approach.
"The take-home message is that we need a variety of interventions to address an epidemic like HIV, sexually transmitted diseases and pregnancy," Jemmott said. "There are populations that really want an abstinence intervention. They are against telling children about condoms. This study suggests abstinence programs can be part of the mix of programs that we offer."