Abstinence Education and Comprehensive Risk Reduction for Teens

The Community Preventive Services Task Force (Task Force) has published its findings on two types of interventions to prevent teen pregnancy, HIV, and other sexually transmitted infections. The interventions are delivered to groups of teens in school or community settings. The Task Force recommended comprehensive risk reduction education; however they were unable to determine if abstinence education is effective for this purpose. These findings and the Community Guide evidence reviews on which they are based are published in the March 2012 American Journal of Preventive Medicine.

And the Task Force found .?

Based on a systematic review of scientific evidence, the Task Force recommends comprehensive risk reduction interventions, because they found sufficient evidence that it:

• Reduced several self-reported risk behaviors, including:
  • Engagement in any sexual activity
  • Frequency of sexual activity
  • Number of partners, and
  • Frequency of unprotected sex
• Increased self-reported use of protection against pregnancy and sexually transmitted infections (STIs)
• Reduced the incidence of self-reported or clinically-documented sexually STIs
• A related review looked at group-based abstinence education to prevent pregnancy, HIV and other STIs among adolescents. Due to inconsistent results among reviewed studies, the Task Force found insufficient evidence to support this intervention. This finding means that more research is needed to determine whether or not the intervention works.

How do “comprehensive risk reduction” and “abstinence education” differ?

As defined by this review, comprehensive risk reduction interventions promote various behaviors to prevent or reduce the risk of pregnancy, HIV, and other STIs. Abstinence education interventions, however, promote only abstinence from sexual activity.

Comprehensive risk reduction interventions may:

• Identify abstinence as the best method, but also provides information about other sexual risk reduction strategies
• Promote abstinence and sexual risk reduction without placing one approach above another; or
• Primarily or solely promote sexual risk reduction strategies

Some comprehensive risk reduction interventions include providing condoms or offering STI testing.

Abstinence education interventions:

• Promote abstinence from sexual activity (either delayed initiation or abstinence until marriage)
• Mention condoms or other birth control methods only to highlight their failure rates if at all
• Usually include messages about the psychological and health benefits of abstinence

Some abstinence education interventions are combined with media campaigns or community service events.

Why prevent teen pregnancy, HIV, and other sexually transmitted infections?

The Task Force addressed this subject because pregnancy, HIV, and other sexually transmitted infections (STIs) are major health problems among U.S. teenagers:

• Teen pregnancy — While the national birth rate among women aged 15-19 years dropped 37% from 1991 to 2009, the teen birth rate is still high. In 2009 approximately 410,000 teens aged 15-19 years gave birth. Teen pregnancy also costs an estimated $9.1 billion a year.
• HIV — In 2006, 34% of the estimated 54,230 new HIV infections in the U.S. occurred in those aged 13 29 years. Among male teens and young adults, the rate of infection per 100,000 was seven times higher among African Americans than among whites, and three times higher among African Americans than Hispanics.
• Other STIs — Although people aged 15 24 years account for only one quarter of the sexually experienced population, they contract nearly half of the 19 million new STIs diagnosed each year.

The Task Force and The Community Guide

The Community Preventive Services Task Force (Task Force) is an independent, nonfederal, unpaid group whose members are appointed by the Director of the Centers for Disease Control and Prevention (CDC). The Task Force bases its findings and recommendation on systematic reviews of the scientific literature. These reviews are conducted, with oversight from the Task Force, by scientists and subject matter experts from the Centers for Disease Control and Prevention in collaboration with a wide range of government, academic, policy, and practice-based partners. The reviews and the Task Force findings and recommendations are compiled in the Guide to Community Preventive Services (Community Guide)

Visit All Community Guide Topics to learn about Community Guide systematic reviews and resulting Task Force findings on 20 topics.

For More Information

Click on the following links to learn more about this topic.

• The Community Guide reviews and Task Force findings for comprehensive risk reduction interventions and abstinence education interventions
• Centers for Disease Control and Prevention information on HIV/AIDS prevention