Abstinence programs

As long as I was in Washington, I never met anybody that I thought was good enough, who knew enough, or who loved enough, to make sexual decisions for anybody else. [..] We've tried ignorance for a thousand years, it's time we try education. Abstinence programs (also known as "oops-only misinformation") are US governmental mandates requiring the teaching of sexual abstinence in preference to proven sex education techniques. There are also mandates affecting international HIV/AIDS funding programs, but these are not addressed here.

Origins and policies
There has been much debate in the United States about how to combat teen pregnancy and sexually transmitted diseases (STDs). In general, religious conservatives favor either leaving any education out of the schools, or implementing so-called "abstinence-only" programs. Liberals tend to favor more comprehensive sex-education. But what actually works?

Since 1996, the U.S. has been increasing funds directed towards abstinence education. To qualify for funding, programs must meet the so-called "A-H" criteria, the first of which states that a program must "[h]ave as its exclusive purpose teaching the social, psychological, and health gains to be realized by abstaining from sexual activity." A later statute commissioned a scientific evaluation of the efficacy of four typical and common abstinence programs.

Efficacy: The abstinence from evidence is not evidence for abstinence
A report by the conservative Heritage Foundation issued in 2002 cited the efficacy of abstinence programs. Examination of the references shows references that contain preliminary data, are small in scale and scope, or lack statistical significance. There also appears to be an over-reliance on a single author and a single institute.

In a 2004 report commissioned by Democratic Congressman Henry Waxman, funded programs were examined for scientific accuracy. Although these programs are funded by the federal government under the Title V "A-H" criteria, they are not examined for accuracy. A majority of the programs were found to contain serious inaccuracies. For example, condom effectiveness was routinely dismissed, often by citing discredited studies. Programs often contained inaccurate information about abortion, including that abortion causes sterility in 10% of cases. The Waxman Report contains further details of frank distortions and lies.

When abstinence programs failed to reduce the teenage birthrate, the Bush administration instructed the US Centers for Disease Control to stop gathering data, and also forced them to shelve a project identifying those sex education programs which worked, after they found that none of the successful ones were "abstinence-only".

The House Oversight Committee charged the Bush administration with favoring politics over science in choosing abstinence programs. Testimony from bipartisan officials in July 2007, including four current or former Surgeons General, accused government officials of pressuring them to misrepresent science, including sex education, for political purposes. Additionally, some abstinence programs are openly sexist and misleading.

Studies have consistently failed to show success from abstinence-only programs but have shown positive results from contraceptive use. One of the more amusing aspects of abstinence education, the "virginity pledge", has been shown to be an abject failure.

The most recent, and most damning, evidence comes in a large-scale study commissioned by the federal government and released in early 2007. The executive summary states that "[f]indings indicate that youth in the program group were no more likely than control group youth to have abstained from sex and, among those who reported having had sex, they had similar numbers of sexual partners and had initiated sex at the same mean age."

In the 2010 the CDC found a massive regional disparity in the rates of teen pregnancy with states that stress abstinence only faring worse than those with comprehensive sex education.

President George W. Bush pushed for abstinence programs in Africa (under the President’s Emergency Plan for AIDS Relief, PEPFAR) in an attempt to prevent the spread of AIDS. While PEPFAR managed to save over 25 millions lives, the abstinence program proved to be ineffective in Africa, just like in the US.

Sexism
One may notice that the many of the most vocal advocates of abstinence, being socially conservative, have "traditional" views of gender relations and believe that the abstinence programs should be aimed, mostly, at women. This is because men seeking sex are often seen as "Boys being boys", whereas it is supposedly the women's "place" to refrain from sex. This often leads to sexual women being demonized as a "means to an end", the end being scaring other women away from the idea of sex, whereas sexual men are often let off the hook or, at the very least, not being penalized/shamed to the same degree.

Summary
The latest study has called into question American public health policy Like any other public health intervention, sex education must be based on sound scientific evidence. While some politics inevitably creeps into public policy decisions, science must be the determining factor. There is no proof that abstinence-only programs succeed at their stated mission; any scientific approach to public health policy would scrap them in favor of proven interventions.

Other resources

 * Scientific American. 296(1):30, 2007 Jan.
 * I Drew This: "None dare call it education"

Appendix I: A-H Definition of Abstinence Education for Title V, Section 510 Programs

 * A: Have as its exclusive purpose teaching the social, psychological, and health gains to be realized by abstaining from sexual activity
 * B: Teach abstinence from sexual activity outside marriage as the expected standard for all school-age children
 * C: Teach that abstinence from sexual activity is the only certain way to avoid out-of-wedlock pregnancy, sexually transmitted diseases, and other associated health problems
 * D: Teach that a mutually faithful, monogamous relationship in the context of marriage is the expected standard of sexual activity
 * E: Teach that sexual activity outside the context of marriage is likely to have harmful psychological and physical effects
 * F: Teach that bearing children out of wedlock is likely to have harmful consequences for the child, the child’s parents, and society
 * G: Teach young people how to reject sexual advances and how alcohol and drug use increases vulnerability to sexual advances
 * H: Teach the importance of attaining self-sufficiency before engaging in sexual activity