Public Release: 

Tweens sexual activity delayed by theory-based abstinence-only program

Penn study shows early intervention important to decrease STDs, HIV, pregnancy

University of Pennsylvania School of Medicine

Philadelphia - A new study weighs in on the controversy over sex education, finding that an abstinence-only intervention for pre-teens was more successful in delaying the onset of sexual activity than a health-promotion control intervention. After two years, one-third of the abstinence-only group reported having sex, compared to one-half of the control group. The study by researchers at the University of Pennsylvania appears in the February 1 edition of the Archives of Pediatrics & Adolescent Medicine.

While abstinence-only intervention did not eliminate sexual activity all together, this is the first randomized controlled study to demonstrate that an abstinence-only intervention reduced the percentage of adolescents who reported any sexual intercourse for a long period, in this case two years, following the intervention.

"It is extremely important to find an effective intervention that delays sexual activity; the younger someone is when they have sex for the first time, the less likely they are to use condoms," said lead author John B. Jemmott III, PhD, professor of Communication in Psychiatry and of Communication at the University of Pennsylvania's School of Medicine and Annenberg School for Communication. "Abstinence-only interventions may have an important role in delaying sexual activity until a time later in life when the adolescent is more prepared to handle to consequences of sex. This can reduce undesirable consequences of sex, including pregnancy and sexually transmitted infections like HIV/AIDS."

There was a 33 percent reduction in self-reported sexual intercourse from the abstinence-only group, compared to the control group, by the end of the study. Of the students who reported that they were sexually active during the study, there were fewer reports of recent sexual activity from the abstinence-only intervention participants (20.6 percent) compared to the control participants (29.0 percent).

The authors cautioned that before any policy issues are discussed, more research is needed to determine the efficacy of abstinence-only education for different populations, including replication of a study like this in young African Americans. "Policy should not be based on just one study, but an accumulation of empirical findings from several well-designed, well-executed studies," said Dr. Jemmott.

A total of 662 African American students in grades 6 and 7 participated in this randomized controlled trial, which was held on Saturdays in classrooms at four public schools participating in the study. The students were randomly assigned to an 8-hour abstinence-only intervention, an 8-hour safer sex-only intervention, an 8- or 12-hour combined abstinence and safer-sex intervention, or an 8-hour health-promotion control group. Participants in the comprehensive intervention had reduced reports of multiple sexual partners compared with the control group (8.8 percent vs. 14.1 percent).

Researchers determined that none of the interventions had significant effects on consistent condom use or unprotected sex. For those who lost their virginity during the two year study, there was no difference in consistent condom use between the abstinence-only intervention and the control group.

The abstinence-only intervention was based on principles shown to be effective in reducing the risk of sexually transmitted infections (STIs), including HIV/AIDS, and did not use a moralistic tone or portray sex in a negative light. It encouraged abstinence as a way to eliminate the risk of pregnancy and STIs. During the 8-hour abstinence-only session, study facilitators used brief and interactive small group activities to build the pre-teens' knowledge of HIV and STIs, bolster beliefs supporting practicing abstinence, and improve skills and confidence to help negotiate abstinence and resist pressure to have sex.

The researchers noted that, in the United States, the consequences of early sexual involvement - including HIV, other STIs, and unintended pregnancies - are especially great among African American adolescents. An effective abstinence-only intervention could stave off unwanted consequences until adolescents mature and are prepared to handle the consequences of sex.

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Other study authors included Loretta S. Jemmott, PhD, RN, professor of Nursing at the University of Pennsylvania School of Nursing and Geoffrey T. Fong, PhD, of the University of Waterloo and Ontario Institute for Cancer Research in Waterloo, Ontario, Canada. The study was supported by a grant from the National Institute of Mental Health.

Penn Medicine is one of the world's leading academic medical centers, dedicated to the related missions of medical education, biomedical research, and excellence in patient care. Penn Medicine consists of the University of Pennsylvania School of Medicine (founded in 1765 as the nation's first medical school) and the University of Pennsylvania Health System, which together form a $3.6 billion enterprise.

Penn's School of Medicine is currently ranked #3 in U.S. News & World Report's survey of research-oriented medical schools, and is consistently among the nation's top recipients of funding from the National Institutes of Health, with $367.2 million awarded in the 2008 fiscal year.

Penn Medicine's patient care facilities include:

  • The Hospital of the University of Pennsylvania - the nation's first teaching hospital, recognized as one of the nation's top 10 hospitals by U.S. News & World Report.
  • Penn Presbyterian Medical Center - named one of the top 100 hospitals for cardiovascular care by Thomson Reuters for six years.
  • Pennsylvania Hospital - the nation's first hospital, founded in 1751, nationally recognized for excellence in orthopaedics, obstetrics & gynecology, and behavioral health.

Additional patient care facilities and services include Penn Medicine at Rittenhouse, a Philadelphia campus offering inpatient rehabilitation and outpatient care in many specialties; as well as a primary care provider network; a faculty practice plan; home care and hospice services; and several multispecialty outpatient facilities across the Philadelphia region.

Penn Medicine is committed to improving lives and health through a variety of community-based programs and activities. In fiscal year 2008, Penn Medicine provided $282 million to benefit our community.

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