Abstinence-only sexual education vs. comprehensive sexual education, with emphasis on the attitudes, knowledge, and behaviors of adolescents

Abstract

In 2003, the Youth Risk Behavior Surveillance survey reported that 46.7% of high school students had been sexually active.1 In 2000, 9.1 million of the 18.9 million new cases of STDs came from young people age 15-24.2 Due to these statistics, there is an ongoing debate concerning teenage sexual education in the United States and how to make a greater impact on the attitudes, knowledge, and behavior of adolescents.

Purpose: To determine whether Abstinence-Only or Comprehensive sexual education has more of an impact on the attitudes, knowledge and sexual behaviors of adolescents.

Methods: An evidence based literature review was completed using published studies involving Abstinence-Only and Comprehensive sexual education. These studies were then evaluated to determine which method has the greatest impact on the knowledge, attitudes, and behaviors of adolescents.

Results: Of the eleven Comprehensive sexual education studies, eight were Evidence Level I and three were Evidence Level II-1. Ten Abstinence-Only programs were evaluated, four were Evidence Level I, three were Evidence Level II-1, two were Evidence Level II-2, and one was Evidence Level II-3. There was one Evidence Level I study that directly compared Abstinence-Only and Comprehensive sexual education. The bulk of the literature supports Comprehensive sexual education as having the greatest impact on adolescents’ attitudes, knowledge, and behaviors.

Conclusion: Based on a thorough review of the literature, Comprehensive sexual education was given a B recommendation (at least fair evidence that the intervention improves important health outcomes) and Abstinence-Only sexual education was given a C recommendation (no recommendation for or against this intervention because the balance of benefits and harms is too close to justify a stronger recommendation.)