For the Record

Report Says Sex Ed Can Reduce Pregnancy, Jury Out on Ab-Only

Elizabeth Nash, Guttmacher Institute
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First published online:

A new report analyzing the impact evaluations of more than 100 teenage pregnancy prevention programs across the country that were judged to have employed rigorous research methods concludes that eight individual programs, and three different program models, demonstrated "high evidence of success"; the most effective individual program was able to affect teen sexual and contraceptive behavior for up to three years. Authored by Douglas Kirby and released May 30 by the National Campaign to Prevent Teen Pregnancy, Emerging Answers examines a wide range of interventions to reduce teen pregnancy and childbearing, including some that do not directly address sex.

Echoing the findings of several earlier individual studies and "meta-analyses," the report concludes that sexuality education programs can be successful in preventing teen pregnancy and, moreover, that encouraging abstinence and teaching about contraception are not incompatible. Specifically, it finds that comprehensive sexuality education programs that urge teens to postpone having intercourse but also discuss contraception do not accelerate the onset of sex, increase the frequency of sex or increase the number of partners, as critics of sex education allege, but they do increase the use of contraception when teens become sexually active.

On the other hand, the report concludes that there is no reliable evidence to date supporting the effectiveness of abstinence-only education. The jury is still out, Kirby says, because the quality of most abstinence-only program evaluations has been poor—notwithstanding the fact that the federal government has funded "demonstration programs" under the Adolescent Family Life Act since 1981 specifically to test their effectiveness. Kirby notes that in conjunction with the 1996 welfare reform law, which vastly expanded federal funding for abstinence-only education, a "well-designed" study is currently underway to evaluate abstinence-only program models. (Congress, however, last year pushed the due date for this evaluation from 2001 to 2005—in other words until after the 2002 reauthorization of the 1996 law—with an interim report due next January.) Meanwhile, only three of the evaluations of abstinence-only programs were deemed rigorous enough to be included in Emerging Answers, and none of the three "showed an overall positive effect on sexual behavior, nor did they affect contraceptive use among sexually active participants."

Among the eight individual programs demonstrating high evidence of success were five sexuality education programs, two "service learning" programs (which are designed to address nonsexual antecedents of teen pregnancy, such as economic disadvantage, detachment from work or school and lack of close relationships with parents or other adults) and one program that combines sexuality education and service-learning aspects in the context of providing comprehensive health care and social services.

The latter program, by far the most comprehensive, was also judged the most effective. The Children's Aid Society-Carrera Program (named for its creator, Michael Carrera) demonstrated that it significantly delayed the onset of sex among teenage females, increased their use of contraception and reduced their pregnancy and birth rates. This program is as intensive as it is comprehensive, with components including family life and sexuality education, individual academic assessment and tutoring, work-related activities, comprehensive health care, and sport and arts activities. The program also is expensive, costing up to $4,000 per student, suggesting that a serious strategy to reduce teen pregnancy rates, at least among highly disadvantaged individuals, may require a substantial financial commitment.

E. Nash