US Adults Prefer Comprehensive Teaching
of Sex Education in Public Schools
Laurie Barclay, MD and Charles Vega, MD, FAAFP
While the rates of teen pregnancy and abortions have decreased
in recent years in the United States, research suggests that
one quarter of persons younger than the age of 15 years have
had vaginal intercourse. There are significant consequences
related to sexual activity in young people. The 15- to 24-year
old age group experienced a 10% increase in the rate of HIV
infection between 2000 and 2003, and this group comprises
approximately half of all new STI cases.
Under current law, only sex education programs
that focus exclusively on abstinence are eligible to receive
federal funding. However, there is a modicum of research
demonstrating the efficacy of such programs. The authors
of this study reviewed data from a national survey
regarding attitudes on sex education.
Comprehensive sex education, teaching about
prevention of sexually transmitted infections (STIs) and
pregnancy through abstinence as well as other birth control
methods, is preferred for public schools, according to the
results of a survey of US adults aged 18 to 83 years published
in the November issue of the Archives of Pediatrics & Adolescent
Medicine.
"The social merits and practical efficacy of sex education
in schools generate considerable debate among public health
professionals and government officials," write Amy Bleakley,
PhD, MPH, from the University of Pennsylvania in Philadelphia,
and colleagues. "Public opinion on sex education in
schools is, however, largely absent from discourse on this
issue, as few studies report on what types of sex education
the public supports."
This cross-sectional survey, part of the Annenberg National
Health Communication Survey, was conducted from July 2005
through January 2006, using a randomly selected, nationally
representative sample of 1096 US adults aged 18 to 83 years.
Rates of completion of the survey ranged from 73% to 76%.
Respondents were asked about their level of support for or
opposition to 3 different types of sex education in schools:
abstinence only, comprehensive sex education or "abstinence
plus" (teaching about abstinence and other birth control
methods to prevent pregnancy and STIs), and condom instruction.
Politically, 39.5% of the sample said they were moderate,
35.5% conservative, and 25% liberal. More than half of the
sample attended church only a few times a year or less often.
Approximately 82% of respondents indicated support for "abstinence
plus" programs teaching students about both abstinence
and other methods of preventing pregnancy and STIs; and 68.5%
supported teaching how to properly use condoms. Abstinence-only
education programs were supported by 36% and opposed by about
50% of respondents. Conservative, liberal, and moderate respondents
all supported abstinence-plus programs, although the extent
of support varied significantly.
Condom instruction was also supported by more than half
of all respondents grouped by religious service attendance,
except in those who attended services more than once a week
(37.9%), opposition to condom instruction was 52.6%.
"US adults, regardless of political ideology, favor
a more balanced approach to sex education compared with the
abstinence-only programs funded by the federal government," the
authors write.
Study limitations include exclusion of subjects relying
solely on cellular telephones, and the possibility that,
because of question wording, respondents did not fully appreciate
the extent of differences between abstinence-only and abstinence-plus
education.
The authors have disclosed no relevant financial relationships.
The authors thank the Annenberg School for Communication
and the Annenberg Foundation Trust at Sunnylands for their
generous support of the Annenberg National Health Communication
Survey.
In an accompanying editorial, Douglas Kirby, PhD, from ETR
Associates in Scotts Valley, California, notes that few abstinence-only
programs have been well evaluated and found to be effective.
"If we can agree to focus on programs with strong evidence
that they effectively reduce sexual risk, regardless of whether
they are abstinence-only or comprehensive programs, there
still remain important questions to resolve," Dr. Kirby
writes. "These include: How can we make programs even
more effective?... The more quickly we can resolve these
issues, the more rapidly we can reduce teen pregnancy and
STD [sexually transmitted disease] rates in this country."
Arch Pediatr Adolesc Med. 2006;140:1152-1156.
