Abstinence Education: Just Giving the Kids Ideas

ResearchBlogging.orgYet another piece of evidence for the futility of abstinence education. Masters et al., publishing in the journal Perspectives on Sexual and Reproductive Health, show that an adolescent's attitude about sex is a much stronger indicator that they will actually have it than their attitudes about abstinence.

The study followed around 300 teenagers from Seattle over a year after interviewing them about their attitudes about sex and abstinence and their intentions to have sex or abstain. They wanted to know how their initial attitudes and intentions about sex and abstinence interacted over time.

They found the following (from the abstract):

Adolescents who had positive attitudes and intentions about abstinence had a reduced likelihood of subsequently engaging in sex (odds ratio, 0.6 for each), whereas those with positive attitudes and intentions about having sex had an elevated likelihood of engaging in sex (2.2 and 3.5, respectively). A regression model including only sex cognitions accounted for substantially more variation in sexual activity than did one including only abstinence cognitions (15-26% vs. 6-8%). Significant interaction effects were also seen: Among teenagers with low levels of sex intention, greater abstinence intention had little relationship to the predicted probability of having sex, but among teenagers with high levels of sex intention, greater abstinence intention was associated with increases in the predicted probability of having sex. (Emphasis mine.)

In other words, kids who had positive attitude about abstinence had less sex and those with positive attitudes about sex had more. No shocker there. However, their attitudes about sex were much more predictive than their attitudes about abstinence. For the teens that weren't that interested in sex to begin with, feelings about abstinence had no effect on their probability of having it. For the teens who had sex on the brain already, if they were also interested in being abstinent, it actually increased their probability of having sex. It is like it gave them ideas!

Note that this data did not follow a particular abstinence education program. There have been plenty of studies that have done so and nearly none of them show a positive effect. What this study did is look at what teenagers think and whether it changes how they act. The prediction from their results is that adolescents who receive greater abstinence education (increasing their abstinence intention) would have either no effect (if they didn't care about sex) or a bad effect (if they did).

(Just to be correct, you should realize that the terms attitude and intention have technical meanings in this paper. Basically, an attitude is an opinion about the goodness and badness of a behavior. An attitude informs an intention which predicts the likelihood of performing that behavior. It has to do with a model they are working on to explain the behavior of teenager. Maybe a lost cause, but good luck with that...)

In developing a model about teenage behavior, their argument here is that adolescents do not separate their feelings about sex and abstinence. By increasing their intention to remain abstinent using abstinence education, you are also heightening their awareness of sex and making and socially and emotionally laden topic. This has the unfortunate side-effect of making them want it all the more. Where if you made abstinence less of a big deal, presumably they would forget about it.

They also suggest that adolescents may view abstinence as a developmental stage rather than a prevailing life decision. Abstinence proceeds sexual behavior in their view, but not necessarily abstinence until marriage. The authors analogize this to a "sexual escalator," a pregnant analogy if I ever heard one (oh wait...that is a horrible pun. Sorry.) Adolescents becoming aware of sex and abstinence get on the escalator. They go through abstinence and eventually into sexual behavior, whereas their relatively unaware peers are not developing as quickly.

Anyway, since I have horribly butchered this paper already, I will let them explain the significance (from the discussion):

Our results also indicate that abstinence cognitions may be poorer predictors of sexual behavior than sex cognitions. Positive abstinence attitudes and intentions significantly predicted a lower likelihood of engaging in sex, but positive sex attitudes and intentions were more powerful predictors; as expected, they predicted a higher likelihood of having sex. Regression models that included sex cognitions accounted for substantially more of the variation in sexual activity than did those including only abstinence cognitions. It is critical to precisely define cognitive variables when using them to predict behavior. Furthermore, our research highlights the value of considering sexuality in a way that acknowledges its potential to be a positive element of adolescents' lives, since conceptualizing adolescent sexual behavior exclusively as something to be prevented may preclude examination of youths' complex thinking regarding abstinence and sexual activity.

Abstinence cognitions and sex cognitions also appear to interact in ways that have not been elucidated. In teenagers with low levels of sex intention, greater abstinence intention had little effect on the predicted probability of having sex, but in teenagers with high levels of sex intention, greater abstinence intention was associated with an increased probability of having sex. This increase could be due to youths' perception of abstinence as part of the developmental trajectory that eventually leads to sexual activity. In this model, adolescents who have stepped onto the "sexual escalator" will start at abstinence and move toward sexual activity. These teenagers will have strong opinions about abstinence and about having sex, and may have opportunities to choose between the two that their peers who have not stepped onto the "escalator" may lack. Teenagers who have not yet given sex or abstaining from sex much thought may not be choosing abstinence so much as finding the "sex versus abstinence" choice not relevant.

Furthermore, teenagers with high abstinence intentions may, paradoxically, be less well equipped to decide and negotiate their preferences regarding sexual activity. For example, participation in "virginity pledging," often an element of abstinence-only education programs, has been associated with a reduced likelihood of contraceptive or condom use at first intercourse. Strong abstinence intentions may be linked with a view of sexual behavior that minimizes the role of personal choice and agency in making sexual decisions, particularly for females. Teenagers' identification of themselves as people committed to abstinence could keep them from considering situations in which they might someday choose to engage in sexual behavior and from learning how they might then protect themselves against unwanted pregnancy and STDs. (Citations removed.)

What should we do with this information?

1) It is one more piece of evidence that abstinence education is not particularly helpful -- and this case is actively unhelpful. If increasing the adolescent's desire to abstain only heightens their awareness of sex and moves them into a more sexually developed stage (from their point of view), then abstinence education alone will not work. Thus, why has abstinence education funding increased from 9 million in 1997 to 176 million in 2007? It has a lot to do with conservatives putting their fingers in their ears and saying la-la-la about the wealth of counterevidence about abstinence.

2) These authors also suggest that adolescent opinion about sex and abstinence is a complicated business. These are young people who are still working out what they think about this issue. Considering the complexity of the issue, surely a more holistic program that includes contraceptive education would be more successful at promoting healthy habits. Further, the emphasis should be only successfully integrating sexual behavior into the rest of your life.

Hat-tip: Science Daily

Masters, N.T., Beadnell, B.A., Morrison, D.M., Hoppe, M.J., Gillmore, M.R. (2008). The Opposite of Sex? Adolescentsââ¬â¢ Thoughts About Abstinence and Sex, and Their Sexual Behavior. Perspectives on Sexual and Reproductive Health, 40(2), 87-93. DOI: 10.1363/4008708

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Encouraging young healthy people to frustrating and unnatural life of celibacy throughout their youth is downright immoral in my book. Rather they should be encouraged to form stable relationships, even if these don't last forever.

Great post, very informative. With regard to the reason for the big spending on abstinence despite the lack of evidence it reduces sexual activity, I'm not sure that reducing sexual activity is the real goal. Making people feel guilty and shamed might be closer to it.

With regard to the comment above re: encouraging kids to form stable relationships, ultimately, a very good goal, but on the way, let's try to help kinds have healthy and respectful relationships even if the first ones might not be very stable.

By le.gai.savant (not verified) on 07 Aug 2008 #permalink

My 14-year-old just told me that the study in your post was a "no-brainer." He has been subjected to abstinence education in our public schools and frequent indoctrination at his favorite church. However, neither has managed to get that chastity ring on his finger. No, he has not indulged as of yet and the flower is still on the vine, but he says he is looking forward to his college days, when he intends on securing a monogomas relationship and "test-driving the equipment." I still stress manogamous-smanagomous, protect thyself!
I have always wanted grandkids, but it might be time for me to arm myself with some research studies, attend some school board meetings, and see if we can get a little more realistically oriented with our sex ed.

Thanks for sharing your finds and your thoughts!