Teaching Fear

VI. Effectiveness of Sexuality Education

For good reason, the battle over sexuality education often focuses on the issue of effectiveness, as measured by changes in behavior of students. Research evaluating program effectiveness has shown that the best way to motivate students to delay the onset of sexual activity is to provide them with full and accurate information. In 1994, researchers at the World Health Organization released a report analyzing the evaluative research that has been done worldwide on sexuality education. After a detailed analysis of each of the 35 studies done on this subject, the authors concluded that there is no support for the contention that sexuality education encourages sexual experimentation or increased activity. To the degree that an effect of comprehensive sexuality education was identifiable, it was postponed initiation of sexual intercourse and/or effective use of contraceptives.

The major data used to defend abstinence-only programs -- based on government evaluations -- has been seriously discredited. Researchers at the American Psychological Association have examined these evaluations, which reported the effect of such programs was to change students' behavior, increasing abstinence and decreasing sexual activity. The APA study found that the government's evaluators had obtained suspect findings and failed to interpret those results with adequate caution. Moreover, according to the APA, they made unsupported claims about the relationship between sexual attitudes and sexual behavior.

Some examples identified by the APA of the flaws in the positive evaluations of the fear-based, abstinence-only programs:

  • Citing no evidence to support the assumption, evaluators claimed that sexual activity in adolescence interferes with educational achievement and the quality of future relationships.
  • Evaluators failed to provide information on how participants were selected to participate in their studies, nor did they provide information about the characteristics of the sample populations, such as age, gender, ethnic background, family composition. In addition they failed to provide information about the schools, such as geographic location or whether they were public or private.
  • Of perhaps greatest significance, evaluators did pre- and post-tests of students' attitudes and beliefs about sexuality, and made the unsupported assumption that a change in reported attitude automatically determined a change in behavior.
  • Evaluators failed to collect any long-term follow-up data, thus making it impossible to determine the extent to which any changes in students' attitudes and behaviors endured over time.

The APA researchers concluded:
Evaluators of these programs have concluded that [abstinence-only] curricula . . . are effective in promoting attitudes of sexual abstinence and in decreasing sexual activity among teens. However, because of the universally poor quality of the program evaluations that we have reviewed, we conclude that such claims are completely unwarranted. To date, we are aware of no methodologically sound studies that demonstrate the effectiveness of curricula that teach abstinence as the only effective means of preventing teen pregnancy. Although credible evidence is lacking to show the effectiveness of abstinence-only sex education programs, methodologically sound studies have shown that more comprehensive sexual education approaches, which provide students with behavioral strategies for avoiding sexual intercourse, can be successful in delaying the onset of sexual activity and in reducing rates of unprotected intercourse among teens. (emphasis added)

Those studies referred to as showing the effectiveness of comprehensive programs are summarized by Douglas Kirby in a paper titled "School Based Programs to Reduce Sexual Risk-Taking Behaviors: Sexuality and HIV/AIDS Education, Health Clinics and Condom Availability Programs" (March 21, 1994). Among Kirby's findings:
  • About 93 percent of all high schools offer sexuality or HIV education; about 85 percent of American adults support sexuality education in the schools and about 94 percent support HIV education.
  • Studies demonstrated that comprehensive programs do not hasten the onset of intercourse -- they either delay it or have no effect -- and evidence of this is particularly compelling for older students.
  • Sexuality education and HIV education do not increase either the frequency of intercourse or the number of partners. One study found that adolescent males who had received AIDS instruction with resistance skills engaged in fewer acts of intercourse and had fewer sexual partners than did students who had not previously received such instruction.
  • Two comprehensive curricula, Postponing Sexual Involvement and Reducing the Risk, significantly delayed the onset of sexual intercourse.
  • The weight of evidence from national surveys indicates that sexuality education programs somewhat increase the use of contraceptives, and HIV education programs somewhat increase the use of condoms.
Kirby also found no evidence showing that abstinence-only programs have any effect on the onset or frequency of intercourse. None of the published studies focusing on these programs showed a significant impact on the initiation of intercourse. Further, Kirby notes, as did the APA researchers, that the studies were limited methodologically.

Proponents of abstinence-only programs refer to what they call the "San Marcos Miracle" to support their claims of effectiveness. In promotional materials from Teen Aid, Inc. the claim is made that in San Marcos, California, after two years of using Teen Aid programs in the schools, the number of teen pregnancies went from 147 to 20. A former counselor in the San Marcos schools has disputed that claim, saying that "it simply didn't happen, there were no statistics to support that, there never have been." In addition, other San Marcos school officials have stated that the figures were falsified and came from a school counselor who did not use a scientific method to generate them. An assistant superintendent from San Marcos has said that the statistics are misleading and probably being used by people for their own objectives.

The Alan Guttmacher Institute has recently released a report, Sex and America's Teenagers, compiling data on teen sexual activity and pregnancy rates. In addition to concluding that teenagers have become more successful at preventing pregnancy, the study suggests that the most effective method of preventing teen pregnancy is comprehensive sexuality education that includes skills training in decision-making and communicating with partners, and access to information about contraception. The study concludes that such programs do not encourage sexual activity.

Finally, the Surgeon General of the United States has also weighed in on the issue of sexuality education. Dr. Joycelyn Elders:

AIDS is a tremendous threat to the future of our society. It is destroying the most valuable resource we'll ever have, our children. Our children must develop healthy attitudes about their sexuality. Education is the only vaccine we have against the AIDS virus...Abstinence-only education really does not address the full range of issues related to sexuality. We try and use various scare tactics, and we do not give our children the information they need to make decisions. And they have a lot of misinformation in them. I think we have to have a comprehensive health education program, that includes all the information that young people need to know. . . I think that we have to be very concerned about this very vocal minority that is targeting our children. First of all, it's a certain religious bias that's a part of what they're about. And, secondly... they're... using, if you will, our children and we must stand up and begin to fight. (emphasis added)

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