Am Fam Physician. 2007;75(7):1069-1070
Background: Sex education programs in schools cause considerable debate. The need for this education is apparent because cases of human immunodeficiency virus infection and acquired immunodeficiency syndrome increased by 10 percent from 2000 to 2003 in persons 15 to 24 years of age. In addition, this age group develops a significant number of sexually transmitted infections (STIs) compared with other age groups.
Federal programs have sponsored abstinence-only programs as their response to the high number of STIs and unwanted pregnancies in this age group. The requirements of these programs are specific, and education programs must fulfill them if they are to receive federal funding for sex education (see accompanying table). A review of the literature on abstinence-only education concluded that these programs neither delayed sex nor reduced teenage pregnancy. Balanced programs include abstinence information in addition to education about contraception and protection against STIs. Because public opinion plays a role in this debate, Bleakley and colleagues evaluated those opinions concerning sex education in schools.
The Study: The study design was a cross-sectional survey of randomly selected persons 18 to 83 years of age in the United States. The survey was part of the Annenberg National Health Communication Survey that was conducted by telephone from July 2005 through January 2006. The policy preferences for sex education included questions about abstinence-only programs, comprehensive sex education programs, and comprehensive sex education programs with condom instructions. Beliefs about each of the three programs were assessed using a 5-point scale from disagree (−2) to agree (+2). The data collected included self-reported political ideology, which was classified into three groups: liberal, moderate, or conservative.
| Social, psychological, and health gains are realized by abstaining from sexual activity |
| Abstinence from sexual activity outside of marriage is the expected standard for all school-age children |
| Abstinence is the only certain way to avoid out-of-wedlock pregnancy, sexually transmitted infections, and other sex-associated health problems |
| A mutually faithful monogamous relationship (i.e., marriage) is the expected standard of human sexual activity |
| Sexual activity outside of marriage is likely to have harmful psychological and physical effects |
| Bearing children outside of wedlock is likely to have harmful consequences for the child, the parents, and society |
| Ways to reject sexual advances |
| Alcohol and drug use increase vulnerability to sexual advances |
| Before engaging in sexual activity, self-sufficiency must be obtained |
Results: The study population included 1,096 participants with a mean age of 46.8 years. The race/ethnicity of the respondents was similar to other nationally representative surveys. The percentage of individuals supporting a combined abstinence and contraception educational program was 82 percent. Support for teaching of proper condom use was about 68 percent. An abstinence-only program was supported by 36 percent of the respondents and received the highest level of opposition. Most individuals in each political ideology group supported abstinence plus contraception programs, with the conservative group agreeing 70.0 percent of the time, the moderate group 86.4 percent, and the liberal group 91.6 percent.
Conclusion: Public opinion supports the combination of abstinence plus contraception education programs in schools. This support demonstrates that the scientific community and the public do not support the federal policy of abstinence-only programs.