Abstinence-only education policies and programs: a position paper of the Society for Adolescent Medicine.

Abstinence from sexual intercourse represents a healthy hoice for teenagers, as teenagers face considerable risk to heir reproductive health from unintended pregnancy and exually transmitted infections (STIs) including infection ith the human immunodeficiency virus (HIV). Remaining bstinent, at least through high school, is strongly supported y parents and even by adolescents themselves. However, ew Americans remain abstinent until marriage, many do ot or cannot marry, and most initiate sexual intercourse and ther sexual behaviors as adolescents. Abstinence as a beavioral goal is not the same as abstinence-only education rograms. Abstinence from sexual intercourse, while theoetically fully protective, often fails to protect against pregancy and disease in actual practice because abstinence is ot maintained. Providing “abstinence only” or “abstinence until mariage” messages as a sole option for teenagers is flawed rom scientific and medical ethics viewpoints. Efforts to romote abstinence should be based on sound science. Alhough federal support of abstinence-only programs has rown rapidly since 1996, the evaluations of such programs nd little evidence of efficacy in delaying initiation of exual intercourse. Conversely, efforts to promote abstience, when offered as part of comprehensive reproductive ealth promotion programs that provide information about ontraceptive options and protection from STIs have sucessfully delayed initiation of sexual intercourse. Moreover, bstinence-only programs are ethically problematic, being nherently coercive and often providing misinformation and ithholding information needed to make informed choices. n many communities, abstinence-only education (AOE) as been replacing comprehensive sexuality education. In ome communities, AOE has become the basis for suppresion of free speech in schools. Abstinence-only education rograms provide incomplete and/or misleading informaion about contraceptives, or none at all, and are often nsensitive to sexually active teenagers. Federally funded bstinence-until-marriage programs discriminate against ay, lesbian, bisexual, transgender and questioning youth, w