There is no doubt that abstinence-based approaches have gathered political and financial support in the United States where they have become strongly associated with the moral and religious inclinations of the Republican Party and the Presidency of George W. Bush.
As a result, the current situation is that of the $1.5 billion spent on abstinence education since 1982 more than 80% has been spent under the current Presidency. Approximately $204 million was granted in the President’s 2007 Budget to abstinence-only education programmes.
The bulk of this funding has been available annually since 1996 when an amendment to health and welfare legislation affecting support to families initiated an annual cycle of federal funding to abstinence education 58. From this point funding became available to states if they matched the Government grant with some money of their own. This money then became available to organisations through several funding strands if they agreed to use it for work that meets the following eight characteristics defining abstinence education as that which:
- Has as its exclusive purpose teaching the social, psychological, and health gains to be realized by abstaining from sexual activity;
- Teaches abstinence from sexual activity outside marriage as the expected standard for all school-age children;
- Teaches that abstinence from sexual activity is the only certain way to avoid out-of-wedlock pregnancy, sexually transmitted diseases, and other associated health problems;
- Teaches that a mutually faithful, monogamous heterosexual relationship in the context of marriage is the expected standard of human sexual activity;
- Teaches that sexual activity outside of the context of marriage is likely to have harmful psychological and physical effects;
- Teaches that bearing children out of wedlock is likely to have harmful consequences for the child, the child’s parents, and society;
- Teaches young people how to reject sexual advances and how alcohol and drug use increases vulnerability to sexual advances; and
- Teaches the importance of attaining self-sufficiency before engaging in sexual activity.
The situation is the UK is rather different in that abstinence education has no support in public policy and receives no funding from government, although there is an expectation that sex educators in schools will emphasise the potential benefits of delaying or abstaining from sexual activity alongside providing information about contraception, sexual health services, sexuality and gender issues.
What is the current situation with abstinence education in the US?
Despite federal financial support the picture of what takes place in schools and colleges across the United States is difficult to piece together since most policies on sex education are decided at state level and even then school districts may enjoy a considerable degree of latitude to determine exactly what form provision takes within this policy context.
However, a survey in 1999 found that all school districts with a sex education policy required that abstinence be taught and around 4 in 5 required that it be promoted as the best option for young people. About 35% not only required abstinence to be covered but either did not allow discussion of contraceptives or allowed discussion only of their failure rates. The other 51% required that abstinence be taught as the preferred option, but also allowed discussion of contraception as an effective means of protection. Only 14% had a policy of teaching abstinence as part of a comprehensive programme 61.
Recent research has suggested that while overall abstinence education continues to grow in influence, some states are actively seeking to consolidate comprehensive provision. As of May 2007, ten states had chosen not to receive federal funding for abstinence education . New York followed suit in September 2007.
Is abstinence education supported by young people, parents and schools?
No. Surveys of teachers, parents and young people consistently show little support for abstinence education. In the US a recent major survey found overwhelming support for sex education in school and little local controversy about its provision and organisation within schools. However, the survey did find some differences in parental views on the focus it should have with 46% preferring an abstinence-plus approach, 36% a comprehensive approach and 15% abstinence only.
In the UK an even greater proportion of parents and young people support comprehensive approaches to sex education 65 Young people want AIDS education in school and want to be informed of the facts that will enable them to make their own informed decisions.
Why is the debate about abstinence education important in terms of HIV/AIDS prevention?
Globally, the greatest HIV/AIDS burden falls on young people. Sex education is recognised as a major component of HIV prevention targeting young people; what form it takes and whether or not it works impacts directly on the HIV risk to which they are exposed. AIDS education for young people is a crucial factor in determining the extent to which they are at risk of HIV infection.
With the allocation of $15 billion under the President’s Emergency Plan For AIDS Relief, abstinence education is being promoted in some of the countries worst affected by HIV and AIDS 69. This raises a number of concerns about whether this is an appropriate approach in contexts where HIV is very prevalent and sexual intercourse before marriage is widespread, and, particularly, whether such programmes will withhold accurate information about condoms.
Despite generating considerable debate and political support, particularly in the United States, abstinence education represents, primarily, a minority moral movement rather than an effective response.
All the evidence clearly shows that the best way to progress HIV prevention through sex education is through comprehensive programmes. Despite generating considerable debate and political support, particularly in the United States, abstinence education represents, primarily, a minority moral movement rather than an effective response to the sexual health needs and behaviour of young people.
As the experiences around the world demonstrate – a good example of which can be found in Uganda – what works in terms of sex education for HIV prevention is a comprehensive approach that is sensitive to the needs and experiences of particular groups. For unmarried, sexually active young people abstinence messages are not effective, whereas promoting faithfulness to one partner, condom use and abstinence is effective. Abstinence messages work to some extent for younger sexually inactive people, but they need to have information about contraception and risk-reduction behaviour for when they do decide to have sex. Everyone has the right to the information that can enable them to protect themselves against HIV infection – it is neither Christian nor moral to refuse them.
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