Most US adults in favor of more balanced approach to sex education in schools

The majority of U.S. adults, regardless of political affiliation, support a more balanced approach to sex education in schools, including teaching children about both abstinence and other methods of preventing pregnancy and sexually transmitted diseases, according to the results of a national survey published in the November issue of Archives of Pediatrics & Adolescent Medicine, one of the JAMA/Archives journals.

Young adults age 15 to 24 account for one-fourth of all sexually active individuals, according to background information in the article. However, they acquire about half of the new sexually transmitted disease (STD) infections--a total of 9 million infections, at a cost of $6.5 billion annually. One-fourth of youth have had sex by age 15, 37.5 by age 16 and 46.9 percent by age 17. "These data underscore the relevance of timely and informative sex education in middle and high schools as an important component to the public health goal of promoting safe behaviors and preventing additional infections and unintended pregnancies," the authors write.

Amy Bleakley, Ph.D., M.P.H., and colleagues at the Annenberg Public Policy Center, Annenberg School for Communication, University of Pennsylvania, Philadelphia, analyzed data from 1,096 adults (average age 46.8, 46 percent men) who participated in the Annenberg National Health Communication Survey between July 2005 and January 2006. Respondents were asked about their support of three different types of sex education: abstinence-only, comprehensive and comprehensive that includes condom instruction. Participants also provided their political ideology on a seven-point scale from "extremely liberal" to "extremely conservative" as well as information about how often they attended religious services. Among the participants, 78.7 percent were white, 9.6 percent were black and 7.6 percent were Hispanic; 39.5 percent identified themselves as politically moderate, 35.5 percent as conservative and 25 percent as liberal.

Overall, 80.4 percent of participants said they believed comprehensive programs were an effective way to prevent unplanned pregnancies, compared with 39 percent who said they believed abstinence-only programs were effective. Eighty-two percent of participants said they supported comprehensive sex education programs and 10 percent opposed them; 68.5 percent supported and 21 percent opposed condom instruction; and 36 percent supported and 50 percent opposed abstinence-only programs. The researchers further broke down results by political affiliation and religious behavior and found the following:

• 91.6 percent of liberals, 86.4 percent of moderates and 70 percent of conservatives supported comprehensive (also known as abstinence plus) programs, while 19 percent of conservatives, 5.3 percent of moderates and 3.7 percent of liberals opposed them

• 47 percent of conservatives supported abstinence-only education, while 67 percent of liberals, 50.4 percent of moderates and 39.9 percent of conservatives opposed it

• 37.5 percent of conservatives, 13.4 percent of moderates and 9.1 percent of liberals opposed condom instruction, while 51.2 percent of conservatives supported it; among all respondents, 57 percent disagreed that condom instruction encourages teens to have sex

• 87.4 percent of those who never attend religious services support comprehensive programs

• Among those who attend religious services more than once per week, 60.3 percent supported abstinence-only and 60.3 percent supported abstinence plus programs; 52.6 percent opposed and 37.9 percent supported condom instruction

• 31.3 percent of those who attend religious services more than once per week and 57.9 percent of those who never attend services oppose abstinence-only education

"The federal government's support of abstinence-only education is in contrast to the broad public and scientific support for comprehensive sex education demonstrated by our research review and study results. This discrepancy in the realm of sex education highlights a gap between science and policy. Sex education in schools is clearly a politically charged issue, but public opinion in this instance offers an opportunity to diffuse some of the inherent tension between science and policymaking," the authors conclude. "With such high support for comprehensive sex education among the public from liberals, conservatives and moderates alike, political leaders could capitalize on this rare occasion to enact public policy that is supported by both sound scientific evidence as well as public opinion."

(Arch Pediatr Adolesc Med. 2006;160:1151-1156. Available pre-embargo to the media at www.jamamedia.org.)

Editor's Note: Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

Editorial: Current Evidence Supports Comprehensive Sex Education

Abstinence-only sex education programs have received a large amount of federal funding in recent years, despite the lack of research supporting their effectiveness, writes Douglas Kirby, Ph.D., ETR Associates, Scotts Valley, Calif., in an accompanying editorial.

"To the extent that unproven abstinence-only programs have displaced effective comprehensive programs, the abstinence-only funding may have had much less effect on the behavior of youth than its supporters have hoped," Dr. Kirby writes. "In fact, it is even possible that by making the funds so restrictive, they had the opposite effect intended."

That does not mean that abstinence-only programs could not be effective, he continues. Such programs deserve further study, and all forms of sex education that succeed in delaying sex and increasing condom and other contraceptive use among young people should be considered for funding.

(Arch Pediatr Adolesc Med. 2006;160:1182-1184. Available pre-embargo to the media at www.jamamedia.org.)

Editor's Note: Please see the article for additional information, including author contributions and affiliations, financial disclosures, funding and support, etc.

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