Sexual Health Promotion through
Comprehensive Sexuality Education
Adolescent sexual health
issues, like teen pregnancy and STDs/STIs, must be addressed with complex prevention
efforts, including comprehensive sexuality education; that is, developmentally appropriate
education that begins in kindergarten and continues through the 12th grade. Research has
shown that comprehensive sexuality education is effective in providing adolescents with
the tools - the knowledge, the skills, the attitudes and values - to make responsible
choices about their sexual health. In contrast, no research has shown abstinence-only
education to effectively delay the onset of sexual intercourse.
Research has shown that balanced programs -- that discuss both abstinence and
contraception, including condoms -- do not increase sexual intercourse among teens.(1)
The CDC confirms that "the dual approach of delaying first intercourse among all
adolescents and increasing condom use among those who are sexually active has succeeded in
reducing overall risk through improvements in both behaviors."(2)
The 1997 Youth Risk Behavior Surveillance, a national school-based survey conducted by the
CDC confirms other national trend data on the sexual behavior of American teens: rates of
sexual experience have stabilized and condom use has increased for teens in the 1990s.(3)
A World Health Organization review of 35 studies found that the programs most effective in
changing young peoples behavior are those that address abstinence, contraception and
STD prevention. (4)
In a United Nations review of 68 studies on the effects of sexual health education
on young peoples sexual behavior, "little evidence was found to support the
contention that sexual health and HIV education promote promiscuity." (5)
Best practices in sexuality education
According to Kirbys analysis of
scientifically evaluated programs, effective sexuality education:
focuses clearly on reducing sexual behaviors that lead to unintended pregnancy,
and/or HIV/STD infection;
uses behavioral goals,
teaching methods, and materials that are appropriate to the
age, sexual experience, and culture of the students;
is based on theoretical
approaches that have been demonstrated to be effective in
influencing other health-related risky behaviors;
takes places over a
sufficient length of time to complete important activities
employs a variety of
teaching methods that involve the participants and allows them
to personalize the information;
accurate information about the risks of unprotected intercourse and
how to avoid unprotected intercourse;
that address the social/peer pressures related to sexual behavior;
provides practice of
communication, negotiation, and refusal skills; and
utilizes teachers or
peers who believe in the programs being implemented, and
provides training for them.
Programs must take place
before young people begin experimenting with sexual behaviors if they are to result in a
delay of sexual intercourse. (6)
Teenagers who have comprehensive sexuality education are more likely to use contraceptives
than those who have not participated in a program. (7)
Research doesnt support abstinence-only
There is no published scientific research demonstrating that abstinence-only programs have
actually delayed the onset of intercourse or reduced any other measure of sexual activity
among teens. (8)
The National Institute of Health Consensus Panel on AIDS stated that abstinence-only
approaches to sexuality education "places policy in direct conflict with science and
ignores the overwhelming evidence that other programs are effective." (9)
Abstinence-only programs have often used fear, guilt and shame as techniques to scare
adolescents into `rejecting sex and contraception. Abstinence-only programs also fail to
provide honest, accurate information about contraception, if contraception is discussed at
Abstinence-only programs also fail to address many of the antecedents of early first
sexual intercourse. (11)
What kind of a future do we want for our youth?
We want to help young people grow into sexually healthy adults. We want kids to grow up
being able to have good, mutual, satisfying, healthy, planned for sexual relationships.
But when young people choose not to abstain from sexual intercourse and when they do not
have accurate information about contraceptives, including where to obtain them and how to
use them they are also facing serious sexual health risks (e.g., unintended pregnancy,
sexually transmitted infections) that will affect their future as adults. If we are
serious about helping young people to delay intercourse, the evidence requires the use of
more complex approaches, including comprehensive sexuality education.
1. Kirby, D. "School-Based Programs to
Reduce Sexual Risk-Taking Behaviors: Sexuality and HIV/AIDS Education, Health Clinics, and
Condom Availability programs." Santa Cruz, CA: 1994.
2. Centers for Disease Control and Prevention, Morbidity and Mortality Weekly Report, 47
(36): 749-52, September 18, 1998.
3. Centers for Disease Control and Prevention, Morbidity and Mortality Weekly Report. CDC
Surveillance Summaries: Youth Risk Behavior
Surveillance -- United States, 1997. 47 (SS-3): 749-752, August 14, 1998.
4. Grunseit, A. and S. Kippax. Effects of Sex Education on Young Peoples Sexual
Behavior. Geneva: World Health Organization, 1993.
5. Joint United Nations Programme on HIV/AIDS. Impact of HIV and sexual Health Education
on the Sexual Behavior of Young People: a
review update, 1997.
6. Kirby, D. "School-Based Programs to Reduce Sexual Risk-Taking Behaviors: A review
of effectiveness," Public Health Reports,
7. Grunseit, A. and S. Kippax. Effects of Sex Education.
8. Kirby, D. No Easy Answers: Research Findings on Programs to Reduce Teen Pregnancy.
Washington, DC: National Campaign to
Prevent Teen Pregnancy, 1997.
9. National Institutes of Health, Consensus Development Conference Statement, February
10. Planned Parenthood Federation of America, Inc. Fact sheet: Helping Young People to
Delay Sexual Intercourse, 1997.
11. Haffner, D. "Whats Wrong with Abstinence-Only Sexuality Education
Programs?" SIECUS Report, 25 (4), April/May 1997.