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Are Abstinence-Only Programs Effective?

When one in four teenage girls has a sexually transmitted infection (STI) and teen birth rates have risen for the first time since 1991, it is time to reconsider Congress' bewildering commitment to abstinence-until-marriage programs. These programs teach that delaying sex until marriage is the only sure way to avoid STIs and unwanted pregnancy. Contraception is not discussed. More than $1 billion has been spent on these programs since 1996; $176 million was allocated last year. (To put this in context, consider that $215 million was allocated for the federal Title X family planning program.) Critics have argued that there is no evidence that these programs are effective. In response, the U.S. Department of Health and Human Services commissioned a rigorous experimental study to evaluate some of the strongest abstinence-only programs. The results came in last year. The programs evaluated had no effect on participants' delaying of sexual initiation, and they had no effect on their use of contraception. Do these results merit continued federal funding at this level? Apparently so. The program is scheduled to be refunded with more dollars than ever—even though 16 states refuse to put their own funds into these types of programs and therefore do not participate. Other science-based prevention options have been demonstrated to be effective. Several programs with a focus on abstinence plus contraception have undergone rigorous evaluation and demonstrated improvements, albeit modest ones, in teenagers' contraceptive use and delay of sexual initiation. Why aren't we investing in these better bets? Why do we continue to fund programs that deny teenagers the knowledge and skills they need to become healthy and mature fathers and mothers?

Freya Sonenstein, PhD, was a member of the technical work group for the nine-year, congressionally authorized Evaluation of Abstinence Education Programs under Title V. She directs the Center for Adolescent Health.

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