In an effort to assess the impact of abstinence-only-until-marriage programs on HIV prevention among young people, researchers looked for studies of these programs conducted in high income countries (income per capita of at least $10,726). In order to be included in the current analysis, studies had to look at abstinence-only programs that presented abstinence as the “exclusive means” of HIV prevention or HIV and pregnancy prevention. In addition, the evaluation of the program had to be randomized or quasirandomized and include both participants who took part in the abstinence-only intervention and those in a control group.
Researchers identified 13 abstinence-only trials that met these criteria, all of which took place in the United States. A total of nearly 16,000 students participated in these 13 trials either as a member of an abstinence-only group (meaning they received took part in an abstinence-only program) or as member of a control group. Participants in the control groups received a range of interventions from “no treatment” to “usual care as defined by school” to an “abstinence plus” program.
Kristin Underhill, Paul Montgomery, Don Operario, “Sexual abstinence only programmes to prevent HIV infection in high income countries: systematic review,” British Medical Journal Online (July 2007), accessed 13 August 2007, http://bmj.com/cgi/content/full/335/7613/248.
Of the thirteen trials the researchers examined:
- No trial found a significant impact on the number of teens who engaged in unprotected vaginal intercourse either in the month or the year prior to the survey.
- No trial showed a benefit in lowering the rate of sexually transmitted diseases (STDs).
- No trial showed a benefit in lowering rates of reported pregnancies among participants.
- No trial found a significant difference in the number of sex partners between those teens who participated in the abstinence-only program and those teens in the control group.
- No trial found a significant effect on condom use among participants.
- No trial found a decrease in the incidence in vaginal sex among participants.
The researchers concluded that recent declines in the U.S. rate of teen pregnancy are probably the result of improved use of contraception rather than a decrease in sexual activity.
The researchers set out with the purpose of examining the effect of these programs as a means for preventing HIV transmission, but came away with much more. They found that the programs are ineffective in changing any of the behaviors that were examined including the rate of vaginal sex, number of sexual partners, and condom use. In addition, they found that the rates of pregnancy and STDs were also unaffected.