Government endorses 'abstinence-plus' sex education

Almost half of all American teens have had sex. The federal government now endorses an abstinence-plus approach to sex education

Like stem cell research and abortion, federal funding for sex education is a controversial issue that has long divided public opinion. Up until recently, federal funding for sex education was allocated almost entirely to programs with an abstinence-only agenda, but new policies are breaking with that tradition.

Over the next 5 years, the government will be granting $75 million annually to sex education programs that adopt teaching methods proven to reduce sexual risk behavior and unplanned pregnancies. Most of the approved methods advocate “abstinence-plus” education, which emphasizes the benefits of abstinence while also teaching about contraception and disease-prevention techniques, including condoms.

“No one is saying that teaching abstinence is a bad idea, but if kids choose to not abstain from sex, they also need to receive education about how prevent unplanned pregnancy and sexually transmitted infections,” says Lydia A. Shrier, MD, MPH, director of Clinic-based Research at Children’s Hospital Boston’s Division of Adolescent/Young Adult Medicine. “These types of programs offer a more comprehensive form of sex education that research has repeatedly shown is more effective at reducing sexual risk behavior.”

Current figures show that 46 percent of all American teenagers have had sex. These numbers, considered along with the U.S high teen birthrate–over 435,000 babies were born to teens in 2008, a much higher number than most other industrialized nations–suggest past approaches to sex education haven’t been effective enough. In response, the U.S. Department of Health and Human Services’ Office of Adolescent Health (OAH) selected 28 evidence-based sex education methods, recommending sex education programs replicate their methods to be eligible for the federal grant.

Lydia Shrier, MD, MPH

The Safer Sex Intervention, one of the programs recommended for replication by the OAH, was created by Shrier and has thus far been adopted by several different sex education programs across the country. It centers on interactivity and incorporates one-on-one counseling, role playing and video modeling to teach young women about sexually transmitted disease and pregnancy. While subject matter and teaching style are important, the intervention’s focus on the individual needs and thoughts about behavior change is its strongest feature. By fostering an adolescent/counselor relationship based on mutual respect, Shrier says the intervention empowers the adolescents to play a more active role in their education.

“Kids really look for the respect, approval and interest of authority figures in their lives, even if they don’t always show that to their parents,” Shrier says. “It’s been shown that teens respond well to relationships where educators listen to them and value what they have to say. Educators and counselors using our model really listen to the adolescents and provide useful advice based on their individual situations.”

Though comprehensive sex education for teenagers is controversial, Shrier says it’s more important in the digital age than ever before. “Kids today get information about sex from their peers, entertainment media, the Internet and other sources. The accuracy of the things they’re reading or hearing can be quite variable, ranging from correct to incomplete to downright wrong,” she says. “On-going, developmentally appropriate but frank conversations between kids and parents or other adults they can trust is vital to help them make healthy, informed choices about sex.”