Comprehensive Sex Education: The Most Effective Way to Reduce Teen Pregnancy Rates

A hot topic in our society is SEX EDUCATION because the United States has one of the highest rates of teen pregnancy among the Western industrialized nations. Due to the rise in HIV diagnoses starting in the 1970s, much research has been done on preventing the spread of STD and HIV/AIDS, but more research is needed in the area of teen pregnancy.

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Bristol Palin, with her son, in an ad to bring awareness to teen pregnancy from the Candie’s Foundation

QUICK FACTS

  • By the end of high school, almost 2/3 of American adolescents are sexually active
  • 1 in 5 has had more than 1 sexual partner
  • The CDC reports 31.3 births per 1,000 adolescent women aged 15-19 in 2011(42.5 in 2007)
  • The teen pregnancy rate is highest among minority females
  • In 2011, 329,797 teen girls (ages 15-19) had a baby
  • Over 50% of teen mothers do not graduate high school
  • An adolescent who is sexually active and does not use any form of contraception has a 90% chance of becoming pregnant within a year

http://media.nationaljournal.com/?controllerName=image&action=get&id=7076

Teen Birth Rate from 2005 to 2009

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Teen Birth Rate divided by age group

Clearly, the United States needs to intervene and implement effective sex education programs that reduce teen pregnancy rates across the nation.

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Abstinence-Only Education – Does It Work?

The short answer is NO. While many public interest groups, such as Focus on the Family, advocate teaching children to abstain from sexual intercourse until marriage, unbiased psychological research has demonstrated that this method is ineffective at decreasing teen pregnancy or STD rates. Those who go through an abstinence-only sex education program are 50% more likely to become pregnant than those who go through comprehensive sex education. Abstinence-only education may even increase negative behaviors!

“There is little evidence that abstinence-only programs are successful in encouraging teenagers from delaying sexual activity until marriage, and consequently, avoiding pregnancy, or STD or HIV infection. Comprehensive sex education, which emphasizes the benefits of abstinence while also teaching about contraception has been proven to reduce rates of teen pregnancy and STD infection.” -Starkman & Rajani (2002, p. 313)

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A media portrayal of abstinence-only sex education (from the movie “Mean Girls”)

What is Comprehensive Sex Education?

Comprehensive sex education, also referred to as abstinence-plus, emphasizes abstinence as the safest behavior, but also promotes the use of contraceptives and condoms for teens who are or become sexually active. Arguments against comprehensive sex education claim that it encourages teens to have sex, but this is not true. Research has shown that adolescents who go through comprehensive sex education are NOT more likely to have sex than those who do not. In fact, comprehensive sex education programs can help adolescents delay sexual debut, reduce the frequency of sexual activity, reduce the number of sexual partners, increase condom use, increase contraceptive use, decrease teen pregnancy rates, and decrease STD/HIV/AIDS rates. Sex education matters and is important for the overall health of adolescents.

What Makes Comprehensive Sex Education Effective?

Here are some key components that work together to elicit positive safe sex behavior:

  1. Knowledge on contraception, such as condoms or the birth control pill
  2. community-based (such as Planned Parenthood) or school-based (such as health class in high school)
  3. Distribution of contraceptives in class, such as condoms
  4. Identify the health goals and focus on them
  5. Program created by psychologists or other health professionals who are experts in social theory, research, and sex education
  6. Give clear messages about good safe sex behaviors (abstinence or contraceptive use)
  7. Address knowledge, perceived risks, values, attitudes, perceived norms, and self-efficacy
  8. Activities and methods should be culturally, sexually, and age appropriate

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My Intervention: Comprehensive Sex Education in Schools with Condom Distribution

We already know that abstinence-only education is ineffective, so my focus is on comprehensive sex education versus no sex education. The goal of my proposed intervention is to reduce teen pregnancy rates and increase self-efficacy regarding condom use. Self-efficacy is the strength of one’s belief in their ability to complete tasks and accomplish goals. When applied to condom use, it means a person’s self-confidence in their ability to discuss and advocate condom use during sexual intercourse. This intervention will be implemented in high schools across America and the subjects will be ninth graders enrolled in a mandatory freshman year health class. To decrease teen pregnancy rates, my intervention would implement a comprehensive sex education program based off of the Reducing the Risk curriculum and include condom distribution in class and access to oral contraceptives in the student health center.

Hypotheses:

  1. The teen birth rate (accessed by public health records) will be significantly lower in the experimental group (comprehensive sex education) than the control group (no sex education)
  2. The experimental group will have a higher self-efficacy in regards to negotiating condom use than the control group, thus more likely to use condoms or other forms of contraception during sexual intercourse

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Independent Variable

My independent variable is the type of education that the students receive: either comprehensive sex education (this is the experimental group) or a substance abuse education program such as DARE (this is the control group).

I will base my comprehensive sex education curriculum off of Reducing the Risk, which is a theory-based, research-proven sex education program that focuses on the development of attitudes and skills that will help teens prevent pregnancy and STD transmission. Students will gain interpersonal and social skills, such as refusal skills, delay tactics, alternative actions to sex, decision-making skills, and assertive communication skills after going through the Reducing the Risk program. This program consists of 16 hour-long classes, which would be implemented in mandatory freshman year health class for ninth graders in the experimental group. In one of the classes, the teacher will hand out condoms to the students. Also, the students in the experimental group will have access to oral contraceptives at the high school’s student health center.

The control condition will receive 16 hour-long lessons on substance abuse education and no sex education.

Dependent Variables

The first dependent variable is teen birth rate (which is different than teen pregnancy rate). The teen birth rate for each experimental condition (experimental group versus control group) will be assessed by looking at public birth records. Ideally, the experimental group will have a lower birth rate than the control group.

The second dependent variable is the Self-Efficacy for Negotiating Condom Use Scale, which measures a teen’s self-efficacy/self-confidence in their ability to discuss and implement condom use with a partner. The higher the score on the scale, the higher the self-efficacy of the individual, and the more likely they will use condoms during sex and prevent pregnancy. Ideally, the experimental group will score higher on these self-efficacy measures than the control group.

These dependent variables will be measured almost 3 years post-intervention, around the time of the subjects’ graduation. The delay in measuring the dependent variables will hopefully reflect long-term change in behavior that results in positive safe sex choices.

Why Will My Intervention (hopefully) Work?

My intervention will work by giving teens the knowledge, skill sets, and contraception needed to prevent teen pregnancy. Comprehensive sex education is the way to go as it has many positive health and well-being benefits and reduces risky sexual behavior. Statistics show that adolescents will have sex despite abstinence messages, therefore teens need to know the truth about sex so that they will know how to keep themselves healthy and prevent pregnancy.

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References

Advocates for Youth (2009, September). Comprehensive sex education: research and results. advocatesforyouth.org. Retrieved November 11, 2013 from http://www.advocatesforyouth.org/publications/1487

Davis, E., & Friel, L. V. (2001). Adolescent sexuality: Disentangling the effects of family structure and family context. Journal Of Marriage And Family, 63(3), 669-681.

Franklin, C., & Corcoran, J. (2000). Preventing adolescent pregnancy: A review of programs and practices. Social Work, 45(1), 40-52.

Kirby, D. (2007). Emerging answers 2007: Research findings on programs to reduce teen pregnancy. Washington DC: National Campaign to Prevent Teen Pregnancy.

Kirby, D. (2008). The impact of abstinence and comprehensive sex and STD/HIV education programs on adolescent sexual behavior. Sexuality Research & Social Policy, 5(3), 18-27.

Poobalan, A.S., Pitchforth, E., Imamura, M., Tucker, J.S., Philip, K., Spratt, J., … Van Teijlingen, E. (2009). Characteristics of effective interventions in improving young people’s sexual health: a review of reviews. Sex Education, 9(3), 319-336.

Raskin, J. D. (2011). The science and politics of sex education. Psyccritiques, 56(1).

Reducing the Risk (1989). Reducing the risk executive summary. ETR Associates. Retrieved December 9, 2013 from http://pub.etr.org/upfiles/ReducingTheRisk_execSummary.pdf

Self-Efficacy for Negotiating Condom Use Scale (1996). Center for HIV Identification, Prevention and Treatment Services. Retrieved December 10, 2013 from http://    chipts.ucla.edu/resources/?did=200

Starkman, N., & Rajani, N. (2002). The case for comprehensive sex education. AIDS Patient Care And Stds, 16(7), 313-318.

Walcott, C. M., Chenneville, T., & Tarquini, S. (2011). Relationship between recall of sex education and college students’ sexual attitudes and behavior. Psychology In The Schools, 48(8), 828-842.

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