Panel says evidence is insufficient to know effectiveness of abstinence programs

By Rob Stein
Washington Post Staff Writer
Saturday, November 7, 2009

Sex-education programs that encourage teens to delay sexual activity and teach them about contraception cut risky sexual behavior, increase condom use and lower the chances of getting the AIDS virus and other infections, a panel of independent experts concluded in a report released Friday.

But there is insufficient evidence to know whether programs that focus on encouraging teens to remain sexually abstinent until marriage are effective, the panel concluded.

The conclusions came after the Task Force on Community Preventive Services, an independent 15-member panel that issues public-health recommendations, reviewed an analysis of 83 studies of sexual-education programs conducted between 1980 and 2007. The analysis was conducted by a 19-member team of experts assembled by the federal Centers for Disease Control and Prevention to examine the politically sensitive question.

The findings come as Congress considers whether to approve President Obama's request to discontinue earmarking funding specifically for abstinence programs and instead allocate funding based on whether scientific research supports the approach.

The findings were welcomed by advocates of programs that reduce teen pregnancy and critics of abstinence programs.

"At long last, evidence and common sense have returned to public-health policy," said James Wagoner of Advocates for Youth. "The task force report endorses the comprehensive approach to prevention that includes condoms and birth control. We should be spending taxpayer dollars only on evidence-based programs."

The findings were condemned by advocates of abstinence programs. They say that the analysis in fact shows that such programs are effective and that comprehensive sexual-education programs are not.

"If you compare the statistical significance of outcome measures related to sexual activity and sexual initiation, the data is better for the abstinence-education program than the comprehensive program," said Valerie Huber of the National Abstinence Education Program.

Two members of the CDC team issued a dissenting report disputing the findings. They argued, among other things, that the analysis actually shows that comprehensive sexual-education programs in schools do not significantly increase teen condom use, reduce teen pregnancy or sexually transmitted diseases.

"This is an important finding because the school classroom is where most teens receive sex education," said Irene Erickson of the Institute for Research and Evaluation, who issued the dissenting report with Danielle Ruedt of the Georgia Governor's Office of Children and Families. "Furthermore, the data indicated that many types of [comprehensive] programs do not work, even in non-school settings, yet the recommendations do not identify what those are. Unfortunately, the report's conclusion that comprehensive sex-education programs are broadly effective simply ignores these findings. This is misleading to policymakers who are seeking evidence-based programs, especially for schools."

Randy Elder of the CDC, who works with the task force, disputed that argument, saying the critics' case was flawed.

"All of those points were considered by the task force. They reflect a fundamental misunderstanding of a systematic review process," he said. "The whole point of what we are doing is to aggregate data from as many studies that are critical to answering the question. What they were doing was chopping up the evidence into very fine subsets to poke holes."

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