Abstinence programs

{{bronze}}{{sex}}{{uspolitics}}{{cquote|As long as I was in Washington, I never met anybody that I thought was good enough, who knew enough, or who loved enough, to make sexual decisions for anybody else. [..] We've tried ignorance for a thousand years, it's time we try education.|||{{wpl|Joycelyn Elders}}<ref>''[[Penn & Teller: Bullshit!]]'', episode 4.10, ''Abstinence''</ref>}}
'''Abstinence programs''' (also known as "'''oops-only misinformation'''") are [[USA|US]] [[government]]al mandates requiring the teaching of [[sex]]ual [[abstinence]] in preference to proven [[sex education]] techniques. There are also mandates affecting international HIV/[[AIDS]] funding programs, but these are not addressed here.

==Origins and policies==
[[Image:Safety first no touching.gif|thumb|left|200px|Girls have cooties!!]]
There has been much [[debate]] in the [[United States]] about how to combat teen [[pregnancy]] and sexually transmitted diseases ([[STD]]s). In general, [[Religion|religious]] [[conservative]]s favor either leaving any [[education]] out of the schools, or implementing so-called "abstinence-only" programs. [[Liberal]]s tend to favor more comprehensive sex-education. But what actually works?

Since 1996, the [[United States|U.S.]] has been increasing funds directed towards abstinence education. To qualify for funding, programs must meet the so-called [http://www.rationalwiki.com/wiki/Abstinence_programs#Appendix_I:_A-H_Definition_of_Abstinence_Education_for_Title_V.2C_Section_510_Programs "A-H" criteria], the first of which states that a program must "[h]ave as its exclusive purpose teaching the social, psychological, and health gains to be realized by abstaining from sexual activity."<ref>[http://www.mathematica-mpr.com/publications/pdfs/impactabstinence.pdf Christopher Trenholm,Barbara Devaney,Ken Fortson,Lisa Quay,Justin Wheeler,Melissa Clark. Impacts of Four Title V, Section 510 Abstinence Education Programs. Final Report, April 2007. Submitted by statute to the U.S. Department of Health and Human Services, Office of the Assistant Secretary for Planning and Evaluation.]</ref> A later statute commissioned a [[Science|scientific]] evaluation of the efficacy of four typical and common abstinence programs.<ref>[http://www.apha.org/apha/PDFs/HIV/The_Waxman_Report.pdf United States House of Representatives Committee on Government Reform—Minority Staff, Special Investigations Division (December 2004). The content of federally-funded abstinence-only education programs (PDF)]</ref>

==Efficacy: The abstinence from evidence is not evidence for abstinence==
[[Image:Abstinence.jpg|thumb|left|200px|Unfortunately, abstinence has its [[virgin birth|limitations]].]]
A report by the conservative [[Heritage Foundation]] issued in 2002 cited the efficacy of abstinence programs. Examination of the references shows references that contain preliminary data,<ref>Stan E. Weed, Title V Abstinence Education Programs: Phase I Interim Evaluation Report to Arkansas Department of Health, Institute for Research and Evaluation, October 15, 2001</ref> are small in scale and scope, or lack statistical significance. There also appears to be an over-reliance on a single [[author]] and a single institute.<ref>Stan E. Weed, The Institute for Research and Evaluation</ref>

In a 2004 report commissioned by [[Democratic Party|Democratic]] Congressman Henry Waxman, funded programs were examined for scientific accuracy. Although these programs are funded by the federal government under the Title V "A-H" criteria, they are not examined for accuracy. A majority of the programs were found to contain serious inaccuracies. For example, [[condom]] effectiveness was routinely dismissed, often by citing discredited studies.<ref>Susan Weller, A Meta-Analysis of Condom Effectiveness in Reducing Sexually Transmitted HIV, Social Science and Medicine, 1635–44 (June 1993).</ref> Programs often contained inaccurate information about [[abortion]], including that abortion causes sterility in 10% of cases.<ref>cf 2</ref> The Waxman Report contains further details of frank distortions and [[Deceit|lies]].

When abstinence programs failed to reduce the teenage birthrate, the [[George W. Bush|Bush administration]] instructed the US Centers for Disease Control to stop gathering data, and also forced them to shelve a project identifying those sex education programs which worked, after they found that none of the successful ones were "abstinence-only".<ref>Union of Concerned Scientists (2004) [http://www.ucsusa.org/assets/documents/scientific_integrity/scientific_integrity_in_policy_making_july_2004_1.pdf "Scientific Integrity in Policy Making: An Investigation into the Bush Administration's Misuse of Science"]</ref>

The House Oversight Committee charged the Bush administration with favoring [[politics]] over science in choosing abstinence programs. Testimony from bipartisan officials in July 2007, including four current or former Surgeons General, accused government officials of pressuring them to misrepresent science, including sex education, for political purposes.<ref>http://web.archive.org/web/20070301063926/http://oversight.house.gov/features/politics_and_science/example_abstinence.htm</ref> Additionally, some abstinence programs are openly [[Sexism|sexist]] and misleading.<ref>http://www.washingtonpost.com/wp-dyn/articles/A26623-2004Dec1_2.html</ref>

Studies have consistently failed to show success from abstinence-only programs but have shown positive results from contraceptive use.<ref>John S. Santelli, MD, MPH, Laura Duberstein Lindberg, PhD, Lawrence B. Finer, PhD and Susheela Singh, PhD.Explaining Recent Declines in Adolescent Pregnancy in the United States: The Contribution of Abstinence and Improved Contraceptive Use.January 2007, Vol 97, No. 1 | American Journal of Public Health 150-156. 
Joshua R. Mann, MD, MPH and Curtis Stine, MD.THE ROLES OF ABSTINENCE AND CONTRACEPTION IN DECLINING PREGNANCY RATES. June 2007, Vol 97, No. 6 | American Journal of Public Health 969. Letter regarding contribution of abstinence and contraception to declining teen pregnancy rates.
John S. Santelli, Laura Duberstein Lindberg, Lawrence B. Finer, and Susheela Singh
SANTELLI ET AL. RESPOND
Am J Public Health, Jun 2007; 97: 969 - 970.
Study found decreasing teen pregnancy rates associated with contraceptive use. One letter criticized methodology, response from authors destroyed counter-argument.</ref>One of the more amusing aspects of abstinence education, the [[Silver Ring Thing|"virginity pledge"]], has been shown to be an abject failure.<ref>Reborn a virgin: adolescents' retracting of virginity pledges and sexual histories.Rosenbaum JE.American Journal of Public Health. 96(6):1098-103, 2006 Jun. CONCLUSIONS: Adolescents who initiate sexual activity are likely to recant virginity pledges, whereas those who take pledges are likely to recant their sexual histories. Thus, evaluations of sexual abstinence programs are vulnerable to unreliable data. In addition, virginity pledgers may incorrectly assess the sexually transmitted disease risks associated with their prepledge sexual behavior.</ref><ref>Kristen Underhill, Paul Montgomery, Don OperarioSexual abstinence only programmes to prevent HIV infection in high income countries: systematic review.BMJ 2007;335:248, (published 26 July 2007)</ref>

The most recent, and most damning, [[evidence]] comes in a large-scale study commissioned by the federal government and released in early 2007. The executive summary states that "[f]indings indicate that youth in the program group were no more likely than control group youth to have abstained from sex and, among those who reported having had sex, they had similar numbers of sexual partners and had initiated sex at the same mean age."<ref>cf 1</ref>

In the 2010 the CDC found a massive regional disparity in the rates of teen pregnancy with states that stress abstinence only faring worse than those with comprehensive sex education.<ref>http://thehill.com/blogs/healthwatch/state-issues/125059-cdc-finds-stark-regional-disparities-in-teen-pregnancy-rates</ref>

President [[George W. Bush]] pushed for abstinence programs in [[Africa]] (under the President’s Emergency Plan for AIDS Relief, PEPFAR) in an attempt to prevent the spread of [[AIDS]].<ref name=africa>[http://www.sfchronicle.com/health/article/Stanford-HIV-study-casts-doubt-on-abstinence-7388494.php Stanford HIV study casts doubt on abstinence efforts in Africa] by Erin Allday (May 2, 2016 Updated: May 2, 2016 5:08pm) ''San Francisco Chronicle''.</ref> While PEPFAR managed to save over 25 millions lives,<ref>{{Cite web |title=What is PREPFAR? |url=https://www.hiv.gov/federal-response/pepfar-global-aids/pepfar |access-date=2023-03-21 |website=HIV.gov |language=en}}</ref> the abstinence program proved to be ineffective in Africa, just like in the US.<ref name=africa/>

==Sexism==
One may notice that the many of the most vocal advocates of abstinence, being [[social conservative|socially conservative]], have "traditional" views of gender relations and believe that the abstinence programs should be aimed, mostly, [[Purity culture|at women]]. This is because men seeking sex are often seen as "Boys being boys",<ref group=note>Now they just make it a zero sum game: Any success of the boys is caused by the women's failure at chastity, and women's success of being abstinent will lead to all boys being "losers".</ref> whereas it is supposedly the women's "place" to refrain from sex. This often leads to sexual women [[Slut|being demonized]] as a "means to an end", the end being scaring other women away from the idea of sex, whereas sexual men are often let off the hook or, at the very least, [[Double standard|not being penalized/shamed to the same degree]].

==Summary==
The latest study has called into question American public health policy<ref>http://www.nytimes.com/2007/07/18/education/18abstain.html?_r=1&oref=slogin</ref> Like any other public health intervention, sex education must be based on sound scientific evidence. While ''some'' politics inevitably creeps into public policy decisions, science must be the determining factor. There is no proof that abstinence-only programs succeed at their stated mission; any scientific approach to public health policy would scrap them in favor of proven interventions.

==See also==
*[[Premarital sex]]
*[[Birth control]]
*[[Scientific storkism]], Understanding where babies come from, in an abstinence only world.
*[[Wishful thinking]]

==Other resources==
*Scientific American. 296(1):30, 2007 Jan.
*[http://www.glasswings.com.au/comics/idrewthis/2007/08/octan-drew-this-none-dare-call-it.html I Drew This: "None dare call it education"]

==Notes==
{{reflist|group=note}}

==References==
{{reflist|2|80%}}

==Appendix I: A-H Definition of Abstinence Education for Title V, Section 510 Programs==
:A: Have as its exclusive purpose teaching the social, psychological, and health gains to be realized by abstaining from sexual activity
:B: Teach abstinence from sexual activity outside marriage as the expected standard for all school-age children
:C: Teach that abstinence from sexual activity is the only certain way to avoid out-of-wedlock pregnancy, sexually transmitted diseases, and other associated health problems
:D: Teach that a mutually faithful, monogamous relationship in the context of marriage is the expected standard of sexual activity
:E: Teach that sexual activity outside the context of marriage is likely to have harmful psychological and physical effects
:F: Teach that bearing children out of wedlock is likely to have harmful consequences for the child, the child’s parents, and society
:G: Teach young people how to reject sexual advances and how alcohol and drug use increases vulnerability to sexual advances
:H: Teach the importance of attaining self-sufficiency before engaging in sexual activity

[[Category:Abstinence|Programs]]
[[Category:Conservative deceit]]
[[Category:Government incompetence]]
[[Category:Moral absolutism]]
[[Category:Purity culture]]
[[Category:Woo]]
[[Category:United States politics]]

Categories: Abstinence, Conservative deceit, Government incompetence, Moral absolutism, Purity culture, Woo, United States politics