Just saying no may not be an effective strategy in keeping kids from having sex, a newly released study reports.
The research could have major implications for the $176 million in government funds that abstinence-only sex-education programs receive annually -- funding that is set to expire on June 30 unless Congress takes some action to extend it.
The evaluation, conducted by Mathematica Policy Research Inc. on behalf of the U.S. Department of Health and Human Services, examined the impact of the abstinence-only-until-marriage programs funded under the 1996 federal welfare reform law.
Through the study, more than 2,000 children were randomly assigned to groups that received abstinence-only counseling and those who received no counseling. Over the next four to six years, numerous surveys were done to determine the impact of these programs on the behavior of the kids.
Researchers found no evidence that these abstinence-only programs increased rates of sexual abstinence.
The study also showed that the students participating in these abstinence-only programs had a similar number of sexual partners as their peers not in the programs, and that the age of first sex was similar for both groups too.
"The basic takeaway message is that there are no differences between the two groups on any behavioral outcomes," says lead study author Christopher Trenholm, a senior researcher at Mathematica Policy Research.
Debate Continues Over Effectiveness
Rather than calming the disagreements over how the federal government should approach teen sex as a public health issue, the report has, if anything, added fuel to the debate
Some sexuality experts say the study only confirms what most sexuality researchers have already known -- that abstinence-only programs simply do not work.
"The data coming forth now is simple proof -- solid, unassailable evidence to back up what many of us have known from the get-go," says Joy Davidson, a certified sex therapist in New York City who is on the board of directors of the American Association of Sexuality Educators, Counselors and Therapist.
"There have been studies that have been done over the last few years at least that have made it quite clear that abstinence-only education is not only a waste of money, but it is a danger to young adults as well."
"This is a social agenda masquerading as teen pregnancy prevention," says Martha Kempner, vice president for information and communications at the Sexuality Information and Education Council of the U.S. "This administration has allowed ideology to trump science at every possible opportunity.
"I hope that Congress will look at this and see that there is a lot of money that is not working, and say 'hey, we need that money elsewhere.'"
On the other side of the argument, proponents of abstinence-only programs say the results of the study only show that more effort must be poured into the programs to reap true dividends.
"The Mathematica report does not support a conclusion that abstinence-only education programs should no longer be funded," said Dr. Gary Rose, president and CEO of the Medical Institute, in a statement released Friday. "To the contrary, the report specifically indicates that programs should continue with changes where necessary to make them more effective, particularly promoting support for abstinence among peer networks as an important feature."
"Many of the programs were in a stage of early development when the evaluation occurred," wrote Robert Rector, senior research fellow at the Heritage Foundation, a conservative think tank, in a critique of the report. He added that the fact that participants in the programs were quite young, and follow-up education was lacking could have contributed to the failure.
"The main lesson that should be taken from this study is that interventions at a very early age require significant follow-up, or they'll be less likely to alter teen risk behaviors," he wrote.
Some critics have also maintained that the lack of high school programs in the study shows that the study is not representative of the overall impact of this funding. Indeed, two of the programs focused on upper elementary school students and the other two, on middle school students. None of the four included a high school component.
Trenholm says these criticisms overlook the fact that most of the money earmarked for these programs does not go to high school programs anyway.
"We went where the funding went," Trenholm says. "Virtually every program taking funding was at the middle school and elementary levels, and not at the high school level."
Is 'Comprehensive' Any Better?
Proponents of abstinence-only sex education programs maintain that "comprehensive" sex-education programs -- those that introduce ideas of safe sex in addition to abstinence -- are untested and may not yield any better results.
"I don't think that this is quite true," Kempner says, adding that programs that go beyond abstinence have yet to receive the same federal funding and support enjoyed by their abstinence-only counterparts.
"We don't have any money," she says. "We need some money and some time like the abstinence-only people got."
Kempner adds that promising research backs up comprehensive programs.
"We have some good research suggesting that comprehensive programs are effective," she says. "I think that we will have much more support on comprehensive sex education, and I think this study will be a part of it."
Davidson argues that such programs could put more responsibility in the hands of the teens themselves, allowing them "make much better decisions" when it comes to sex.
"Abstinence-only education treats smart, thoughtful teens as if they are incapable of absorbing information or understanding themselves," she says.
"If government officials finally understand how important it is that young people receive complete and accurate sex information, whatever the cost of this study, it will have been worth it. It's time that people wake up."
Peer Relationships May Be Most Important
The report also included a hint of good news about teen sex in the United States.
"On the other side, we also did not see any increase in unprotected sex," Trenholm says, adding that many researchers had expected to see a spike in unsafe sex due to the fact that existing programs do not cover the proper use of birth control.
This, as well as other evidence uncovered in the study, suggests that peer relationships are particularly important when it comes to predicting abstinence -- an area for future study, Trenholm says.
"The idea is that future programs may want to seek out, build and maintain peer relations through clubs and other groups," Trenholm says. "In this way, I think it's suggestive of a good direction for the field to go in."