From the Times:
The ongoing debate over sex education has been rekindled by a provocative new study suggesting that teaching abstinence can delay the start of sexual activity among inner-city youngsters — if it is freed from the moralistic overtones and ideological restrictions that were the hallmark of abstinence-only programs under the Bush administration.
The study, published in the Archives of Pediatrics and Adolescent Medicine, a journal of the American Medical Association, was led by a husband-wife team at the University of Pennsylvania. They randomly assigned 662 African-American students in grades six and seven to one of four different programs — an eight-hour abstinence-only program stressing the benefits of delaying intercourse; an eight-hour safer-sex program stressing condom use; a comprehensive intervention that covered both abstinence and condoms; and a control group that offered health information unrelated to sexual behavior.
The only program that successfully delayed the start of sexual activity was the abstinence-only instruction. By the end of two years, only a third of the abstinence-only group had engaged in sexual intercourse compared with almost half of the control group.
I, like many others who specialize in the care of adolescents, have taken a dim view of so-called "abstinence-only" sex education programs. In fact, I co-authored a position paper (PDF) for the Society of Adolescent Medicine in which we argued against funding for such programs. During the previous adminstration, the programs in question tended to be fraught with ideological language, and to encourage an unrealistic goal of abstinence until marriage. We also argued that such programs were ineffective, and left adolescents unprepared for informed decision-making about contraception and disease prevention when they made the very common decision to engage in intercourse.
The abstract for the study indicates that the program praised by the Times was free of value-judgement language, and advocated for a delay in "sexual debut" (an adolescent medicine term of art I find equal parts amusing and disturbing) until a point of greater maturity, but not necessarily marriage. Apparently, participants in both the abstinence-only and the condom-use focused groups used condoms to an equal degree when they did eventually have sex, which is an encouraging sign, though it does raise the question about where the participants in the former group got their information about contraception.
One thing I think I should make clear is that I always, without exception, include abstinence in my discussions with adolescent patients that have not yet become sexually active. I consider it the standard of care to do so, and I think most conscientious providers do the same. The beef is not with advocating for abstinence per se, but in denying adolescents information about contraception that they will eventually need to stay healthy.
Without access to the full-text of the article (which, thanks to the particular online subscriptions of my hospital, I cannot get) I can't fully evaluate the study. Certainly, the abstinence-only program seems to have been effective at reaching its goal of delaying sexual activity. In addition, the kids enrolled who did become sexually active apparently used condoms to the same degree that kids in the condom-use education program did. I'm not sure how to account for that, which confounds my interpretation of the study.
If appropriately-developed abstinence programs can delay the onset of sexual activity, then of course I think we need to incorporate them into our approach to sex education in general. However, it's also important to keep in mind that some participants in all programs ended up having sex (as is reliably the case, despite the protestations of the famously non-abstinent) and in those circumstances it's important to be sure that teenagers know how to keep themselves free of unintended pregnancy or STIs. I remain skeptical that abstinence-only programs really meet the needs of all adolescents, but am willing to see what further study shows.