Abstinence-Only and Comprehensive Sex Education and the Initiation of Sexual Activity and Teen Pregnancy
Abstract
Purpose The role that sex education plays in the initiation of sexual activity and risk of teen pregnancy and sexually transmitted disease (STD) is controversial in the United States. Despite several systematic reviews, few epidemiologic evaluations of the effectiveness of these programs on a population level have been conducted. Methods Among never-married heterosexual adolescents, aged 15-19 years, who participated in Cycle 6 (2002) of the National Survey of Family Growth and reported on formal sex education received before their first sexual intercourse (n = 1719), we compared the sexual health risks of adolescents who received abstinence-only and comprehensive sex education to those of adolescents who received no formal sex education. Weighted multivariate logistic regression generated population-based estimates. Results Adolescents who received comprehensive sex education were significantly less likely to report teen pregnancy (OR(adj) = .4, 95% CI = .22- .69, p = .001) than those who received no formal sex education, whereas there was no significant effect of abstinence-only education (OR(adj) = .7, 95% CI = .38-1.45, p = .38). Abstinence-only education did not reduce the likelihood of engaging in vaginal intercourse (OR(adj) = .8, 95% CI = .51-1.31, p = .40), but comprehensive sex education was marginally associated with a lower likelihood of reporting having engaged in vaginal intercourse (OR(adj) = .7, 95% CI = .49-1.02, p = .06). Neither abstinence-only nor comprehensive sex education significantly reduced the likelihood of reported STD diagnoses (OR(adj) = 1.7, 95% CI = .57-34.76, p = .36 and OR(adj) = 1.8, 95% CI = .67-5.00, p = .24 respectively). Conclusions Teaching about contraception was not associated with increased risk of adolescent sexual activity or STD. Adolescents who received comprehensive sex education had a lower risk of pregnancy than adolescents who received abstinence-only or no sex education.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Some of these studies had several methodological problems, as reviewers themselves recognize, which might account for the lack of significant findings.
“However, some of these studies had several methodological problems, as reviewers themselves recognize, which might account for the lack of significant findings.”
From Relationships, love and sexuality: what the Filipino teens think and feel (2009) · cites this paper as [73]
Some studies about abstinence programs have found no statistically significant effects on sexual behavior.
“It is true that some studies about abstinence programs have found no statistically significant effects on sexual behavior [73-75].”
From Relationships, love and sexuality: what the Filipino teens think and feel (2009) · cites this paper as [73]
Cites
Condom Use and the Risk of Genital Human Papillomavirus Infection in Young Women
Winer, R. L., Hughes, J. P., Feng, Q., O'Reilly, S., Kiviat, N. B., Holmes, K. K., & Koutsky, L. A. (2006) · New England Journal of Medicine · doi:10.1056/nejmoa053284 · Cited by 694 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Stanger-Hall, K. F., & Hall, D. W. (2011) · PLoS ONE · doi:10.1371/journal.pone.0024658 · Cited by 402 · see citing works
Consequences of Sex Education on Teen and Young Adult Sexual Behaviors and Outcomes
Lindberg, L. D., & Maddow-Zimet, I. (2012) · Journal of Adolescent Health · doi:10.1016/j.jadohealth.2011.12.028 · Cited by 232 · see citing works
Twenge, J. M., Sherman, R. A., & Wells, B. E. (2017) · Archives of Sexual Behavior · doi:10.1007/s10508-016-0798-z · Cited by 122 · see citing works
Parkes, A., Henderson, M., Wight, D., & Nixon, C. (2011) · Perspectives on Sexual and Reproductive Health · doi:10.1363/4303011 · Cited by 120 · see citing works
Let's Talk about Sext: How Adolescents Seek Support and Advice about Their Online Sexual Experiences
Razi, A., Badillo-Urquiola, K., & Wisniewski, P. J. (2020) · Proceedings of the 2020 CHI Conference on Human Factors in Computing Systems · doi:10.1145/3313831.3376400 · Cited by 89 · see citing works
Krugu, J. K., Mevissen, F. E. F., Prinsen, A., & Ruiter, R. A. C. (2016) · Reproductive Health · doi:10.1186/s12978-016-0161-9 · Cited by 82 · see citing works
It is Time to Teach Safe Sexting
Patchin, J. W., & Hinduja, S. (2020) · Journal of Adolescent Health · doi:10.1016/j.jadohealth.2019.10.010 · Cited by 79 · see citing works
Kerpelman, J. L., McElwain, A. D., Pittman, J. F., & Adler-Baeder, F. M. (2016) · Youth & Society · doi:10.1177/0044118x13479614 · Cited by 72 · see citing works
Van Ouytsel, J., Ponnet, K., & Walrave, M. (2017) · Journal of Adolescence · doi:10.1016/j.adolescence.2016.12.005 · Cited by 59 · see citing works
The Role of Parents and Families in Teen Pregnancy Prevention: An Analysis of Programs and Policies
Silk, J., & Romero, D. (2014) · Journal of Family Issues · doi:10.1177/0192513x13481330 · Cited by 37 · see citing works
Relationships, love and sexuality: what the Filipino teens think and feel
de Irala, J., Osorio, A., del Burgo, C. L., Belen, V. A., de Guzman, F. O., Calatrava, M. D. C., & Torralba, A. N. (2009) · BMC Public Health · doi:10.1186/1471-2458-9-282 · Cited by 35 · see citing works
McKay, E. A., Placencio-Castro, M., Fu, M. R., & Fontenot, H. B. (2022) · Sexuality Research and Social Policy · doi:10.1007/s13178-021-00664-w · Cited by 10 · see citing works
- Authors
- Kohler, P. K., Manhart, L. E., & Lafferty, W. E.
- Affiliations
- University of Washington (US)
- Corresponding author
- Lafferty, William E.
- Venue
- Journal of Adolescent Health
- Publisher
- Elsevier BV
- Published
- 2008-04
- Volume
- 42
- Issue
- 4
- Pages
- 344-351
- ISSN
- 1054-139X (ISSN-L)
- OpenAlex
- W2125198099
- Cited by
- 647
- References
- 1
- Citations by year
- 2026: 16 · 2025: 26 · 2024: 28 · 2023: 29 · 2022: 46 · 2021: 37 · 2020: 38 · 2019: 52 · 2018: 40 · 2017: 31 · 2016: 60 · 2015: 41 · 2014: 44 · 2013: 42 · 2012: 34
- FWCI
- 53.51
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Adolescent Health (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute of Allergy and Infectious Diseases (P30AI027757)
- Topics
- Health Sciences › Health Professions › General Health Professions › Adolescent Sexual and Reproductive Health
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Reproductive Health and Contraception
- Social Sciences › Psychology › Clinical Psychology › Sexuality, Behavior, and Technology
- Keywords
- abstinence-only education, comprehensive sexuality education, adolescent sexual initiation, adolescent pregnancy, sexually transmitted infections, adolescent contraception, vaginal intercourse, National Survey of Family Growth, adolescent sexual health
- MeSH terms
- Adolescent, Female, Health Surveys, Humans, Pregnancy, Pregnancy in Adolescence, Sexual Behavior, Sex Education, Sexual Abstinence, Sexually Transmitted Diseases, United States, Program Evaluation, Risk Reduction Behavior
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
