Abstinence, Sex, and STD/HIV Education Programs for Teens: Their Impact on Sexual Behavior, Pregnancy, and Sexually Transmitted Disease

Abstract

Abstract Given very high rates of teen pregnancy and sexually transmitted disease in the United States, many schools and other youth-serving organizations have developed different types of sex and STD/HIV education programs to reduce teen pregnancy and/or STD rates. I searched for studies of these programs that had strong experimental designs, measured impact on actual sexual behavior, were published since 1990, and met other criteria. Fifty-four studies meeting these criteria were classified into one of five types: curriculum-based programs, clinician-patient interactions in clinic settings, video- and computer-based programs, programs for parents and their families, and multicomponent programs. By far the greatest number of studies measured the impact of sex and STD/HIV education programs. Nevertheless, all five groups of programs had at least one study demonstrating some positive impact on behavior, indicating that multiple approaches can be effective at changing behavior. Sex and STD/HIV education programs that focused only on abstinence consistently failed to have any significant effect on sexual behavior. In contrast, comprehensive programs that encouraged both abstinence and condom/contraceptive use consistently did not increase sexual behavior, but about two thirds of them had a positive impact on delaying sex, reducing the frequency of sex or number of partners, or increasing condom or contraceptive use. Programs that incorporated 17 characteristics were highly likely to be effective at changing behavior in positive directions. Other types of interventions also included one or more effective programs but had fewer studies and weaker evidence. A very intensive, comprehensive, and long-term program had the most dramatic results and reduced the teen pregnancy rate reported by female teens by about half for 3 years.