Abstinence-only approach too can help, says a new study. Abstinence need not necessarily be the prerogative of the condom-denouncing zealots.
US researchers have found that sustained abstinence education could delay the first sexual intercourse of pre-teens. Interestingly it works better than safe sex lectures, and the effect lasted for two full years when the subjects were followed up.
AdvertisementA total of 662 African American students in grades 6 and 7 were chosen for the study.
An 8-hour abstinence-only intervention targeted reduced sexual intercourse; an 8-hour safer sex-only intervention targeted increased condom use; 8-hour and 12-hour comprehensive interventions targeted sexual intercourse and condom use; and an 8-hour health-promotion control intervention targeted health issues unrelated to sexual behavior. Participants also were randomized to receive or not receive an intervention maintenance program to extend intervention efficacy.
The primary outcome was self-report of ever having sexual intercourse by the 24-month follow-up. Secondary outcomes were other sexual behaviors.
The participants' mean age was 12.2 years; 53.5% were girls; and 84.4% were still enrolled at 24 months. Abstinence-only intervention reduced sexual initiation. The model-estimated probability of ever having sexual intercourse by the 24-month follow-up was 33.5% in the abstinence-only intervention and 48.5% in the control group. Fewer abstinence-only intervention participants (20.6%) than control participants (29.0%) reported having coitus in the previous 3 months during the follow-up period.
Abstinence-only intervention did not affect condom use, the researchers reported in their findings published in Archives of Paediatrics and Adolescent Medicine.
The 8-hour and 12-hour comprehensive interventions reduced reports of having multiple partners compared with the control group. No other differences between interventions and controls were significant.
Theory-based abstinence-only interventions may have an important role in preventing adolescent sexual involvement, they concluded.
Lead researcher Dr John Jemmott, professor of Communication in Psychiatry and of Communication at the University of Pennsylvania, said: "It is extremely important to find an effective intervention that delays sexual activity; the younger someone is when they have sex for the first time, the less likely they are to use condoms.
"Abstinence-only interventions may have an important role in delaying sexual activity until a time later in life when the adolescent is more prepared to handle to consequences of sex. This can reduce undesirable consequences of sex, including pregnancy and sexually transmitted infections like HIV/Aids."
In an accompanying editorial, editor of the journal, Dr Frederick Rivara, of the University of Washington and Seattle Children's Hospital and associate editor, Dr Alain Joffe, of Johns Hopkins University, in Baltimore, wrote: "This is an immensely important issue, and one that clearly will not be solved through any single intervention.
"The results of this study now must be combined with those from other studies on prevention of sexually transmitted infections and unintended pregnancy and become part of the knowledge base for the formation of public policy on sexuality education in our schools and for our children."
"No public policy should be based on the results of one study, nor should policy-makers selectively use scientific literature to formulate a policy that meets preconceived ideologies."
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