The AMA says “Comprehensive Sex Ed Said to Have Most Impact.” Baloney.
More Outrage about President Obama’s “Misrepresentations” in His Healthcare Reform Speech Last Night
September 10, 2009How to Keep Normal Labor Normal – Part 2 – The Costs of Abnormal Labor
September 11, 2009An AMA report says abstinence should be one part – but not the only one – of teaching kids about sexual activity. Are they correct, or not?
An AMA News article reports:
Sex education that provides information about abstinence, condom use and other contraceptive methods is the most effective way to reduce the growing number of teenagers who contract a sexually transmitted infection or become pregnant.
So federal funding should flow to comprehensive programs proven to address these public health issues, according to a Council on Science and Public Health report adopted at the AMA Annual Meeting.
The studies reviewed found “no delay of initiating sexual activity, no reduction in the number of sexual partners and no increase in abstinence” from abstinence-only programs, said Stuart Gitlow, MD, MPH, who presented the council’s report.
“What we’re talking about is comprehensive programs which, of course, include abstinence, but we can’t just stick our heads in the sand and expect them to do the right thing. We have to provide them with all of the information they need to make responsible, adult decisions,” said Barry Sheppard, MD, a thoracic surgeon and alternate delegate for the California Medical Association.
Some delegates argued that abstinence-only education was being subjected to tougher standards than other sex education programs and had not been given enough of a chance to make an impact.
“What works in California may not work in Mississippi,” said Freda Bush, MD, an ob-gyn and alternate delegate for the Mississippi State Medical Assn. “We need to work together to find and fund what works to help protect America’s children.”
However, there’s another side to this controversial topic that the article and the AMA apparently ingnored.
Jennifer A. Shuford, MD, MPH and Sheetal Malhotra, MBBS, MS, of the Medical Institute for Sexual Health in Austin, TX, provide what I think is a more objective review of the actual evidence:
There is a common misperception that comprehensive sex education (CSE) programs are more effective than abstinence education (AE) programs for teens. However, existing data do not support this conclusion.
Although many CSE programs have been evaluated, they have provided little evidence of their effectiveness regarding important outcomes.
To date, CSE programs have shown no evidence of effectiveness at decreasing teen pregnancy or STIs, or of increasing consistent condom use for more than 3 months.
Only two of five CSE programs measuring sexual debut as an outcome delayed the onset of sexual intercourse for 12 months.
And only three programs increased frequency of condom use (but not consistent use) over the same period. 64% of 25 CSE programs measuring teen condom use saw no increased condom use for any subgroup for any time period.
On the other hand, four AE programs increased the percentage of youth remaining sexually abstinent and three significantly reduced sexual activity of participants 12 to 24 months after the program.
Further, studies have found that AE did not decrease condom use for teens who later became sexually active, as is commonly purported.
These data suggest that AE programs may have significant positive effects unmatched by CSE programs.
This may surprise some, as CSE programs profess to promote abstinence in addition to condoms and contraceptives, offering ‘added value.’
However, according to the data above, CSE should not be considered a superior replacement for AE.
Instead, each program should be rigorously evaluated and honestly judged by its impact on the health of our youth.
Here are some of my other blogs on the topic:
