Abstinence-Only Education Policies and Programs: A Position Paper of the Society for Adolescent Medicine

Society for Adolescent Medicine supports abstinence as a healthy goal for teenagers but critiques abstinence-only educational policies and programs.

The Society for Adolescent Medicine today released Abstinence-Only Education Policies and Programs: A Position Paper of the Society for Adolescent Medicine. The Society for Adolescent Medicine (SAM) supports abstinence from sexual intercourse as “a healthy choice for teenagers” but critiques government policies and programs that promote abstinence-only or abstinence until marriage as the only prevention message for teenagers. SAM recommends that “ ‘Abstinence-only’ as a basis for health policy and programs should be abandoned.”

The paper concludes abstinence from sexual intercourse represents a healthy choice for teenagers, as teenagers face considerable risk from unintended pregnancy and sexually transmitted infections (STIs) including infection with the human immunodeficiency virus (HIV). The paper, however, notes that few Americans remain abstinent until marriage and most initiate sexual intercourse as adolescents. Recent data indicate the median age at first intercourse for women is 17.4 years, while the median age at first marriage is 25.3 years. While abstinence from sexual intercourse is theoretically fully protective from pregnancy and STIs, in actual practice, abstinence often is not maintained which leaves teenagers vulnerable to pregnancy and sexually transmitted infections. Lead author Dr. John Santelli, a Professor of Population and Family Health and Pediatrics at Columbia University said today that “abstinence is a very healthy choice for teenagers - but sex education for teenagers needs to give teenagers all the facts – all the medically accurate information they need to protect themselves.”

SAM recommends that efforts to promote abstinence should be based on sound science. Drawing a distinction between abstinence as a behavior and abstinence-only programs, the paper concludes there is no evidence base for providing “abstinence only” or “abstinence until marriage” messages as a sole option for teenagers. In reviewing scientific literature, SAM finds abstinence-only programs demonstrate little evidence of efficacy in delaying initiation of sexual intercourse. Conversely, efforts to promote abstinence as part of comprehensive reproductive health promotion programs (which provide information about contraceptive options and protection from STIs) have successfully delayed initiation of sexual intercourse.

SAM also finds ethical problems with abstinence-only programs, because they provide misinformation to teenagers and withhold information needed to make informed choices. Typically, abstinence-only education programs provide incomplete and/or misleading information about contraceptives, or no contraceptive information at all. In many communities, abstinence-only education (AOE) has replaced comprehensive sexuality education. SAM believes federally funded abstinence until marriage programs neglect and stigmatize gay and lesbian youth. These programs also neglect real health needs for contraception and STI testing among sexually experienced youth, putting these youth at increased risk for unintended pregnancy and STIs, including HIV.

The position paper, including the specific recommendations from The Society for Adolescent Medicine, can be found at http://www.adolescenthealth.org/PositionPapers.htm. A scientific review paper on Abstinence and Abstinence-Only Education: A Review of US Policies and Programs was also published today in the January 2006 Journal of Adolescent Health. http://journals.elsevierhealth.com/periodicals/jah

For additional information on the SAM position paper: please contact:

· John Santelli, MD (lead author) at Columbia U: js2637@columbia.edu.

· John Kulig, MD (SAM President) New England Medical Center: jkulig@tufts-nemc.org

· Estherann Grace, MD (SAM Board member), Boston Children’s Hospital: Estherann.Grace@childrens.harvard.edu

· Mary-Ann Shafer, MD (SAM Board member), U California San Francisco: shafer@itsa.ucsf.edu

· Mary Ott, MD (position paper co-author), Indiana U: maott@iupui.edu

Founded in 1968, the Society for Adolescent Medicine is a multidisciplinary organization committed to improving the physical and psychosocial health and well-being of all adolescents through advocacy, clinical care, health promotion, health service delivery, professional development, and research.