Sex Education: Needs, Programs and Policies: Sex Education: Needs, Programs and Policies The Guttmacher Institute © December 2006


Young People Need Help Making Healthy Decisions: Young People Need Help Making Healthy Decisions


Young people are at high risk of unintended pregnancy and STIs for many years: Young people are at high risk of unintended pregnancy and STIs for many years 26.7 16.9 28.5 33.2 12.6 17.4 25.1 26.0 30.9 10 15 20 25 30 35 Menarche Spermarche First intercourse First marriage First birth Intend no more children First intercourse First marriage First birth Intend no more children AGE 14.0 MEN WOMEN


Many teens experience pregnancy and STIs: Many teens experience pregnancy and STIs More than 750,000 women younger than 20 become pregnant each year 82% of these pregnancies are unintended Nine million teens and young adults acquire an STI each year


The teen pregnancy rate is going down: The teen pregnancy rate is going down


Both abstinence and contraceptive use are responsible for the decline in teen pregnancy: Both abstinence and contraceptive use are responsible for the decline in teen pregnancy 86% of the decline was due to more effective contraceptive use 14% of the decline was due to more teens choosing to delay sexual intercourse


The proportion of high school students who have had sex has declined : The proportion of high school students who have had sex has declined


The proportion of sexually active high school students who use condoms has risen : The proportion of sexually active high school students who use condoms has risen


U.S. teens have higher rates of pregnancy, birth and abortion than teens in most other developed countries: U.S. teens have higher rates of pregnancy, birth and abortion than teens in most other developed countries


Why Do U.S. Teens Fare Worse Than Teens in Other Developed Countries? : Why Do U.S. Teens Fare Worse Than Teens in Other Developed Countries?


Teen sexual activity is similar across developed countries…: Teen sexual activity is similar across developed countries…


…but U.S. teens have higher rates of unintended pregnancy and STIs because they: …but U.S. teens have higher rates of unintended pregnancy and STIs because they Are less likely to use contraceptives Have shorter relationships Have more sexual partners


What accounts for safer behavior in other countries? : What accounts for safer behavior in other countries? Clear and unambiguous prevention messages Expectation that childbearing will be delayed until adulthood Societal support for young people


What accounts for safer behavior in other countries?: What accounts for safer behavior in other countries? Greater access to contraceptive and reproductive health services Comprehensive sex education


Sex Education in U.S. Public Schools: Sex Education in U.S. Public Schools


The proportion of teens receiving any formal instruction about birth control declined….: The proportion of teens receiving any formal instruction about birth control declined….


…while the proportion receiving information only about abstinence increased: …while the proportion receiving information only about abstinence increased


Similarly, the number of teens receiving information about both abstinence and contraception declined: Similarly, the number of teens receiving information about both abstinence and contraception declined % of teens receiving information about both abstinence and contraception


Many teenage males do not receive sex education before first sex: Many teenage males do not receive sex education before first sex


Black and Hispanic teens are less likely than white teens to receive information about birth control before first sex: Black and Hispanic teens are less likely than white teens to receive information about birth control before first sex % of sexually experienced teens receiving birth control information before first sex


Students say they need more sex education in school than they currently receive: Students say they need more sex education in school than they currently receive


Most school district policies promote abstinence: Most school district policies promote abstinence Districts with a sex education policy, 1998


School district sex education policies vary widely by region: School district sex education policies vary widely by region


There is a large gap between what teachers believe should be covered in sex education and what they actually teach: There is a large gap between what teachers believe should be covered in sex education and what they actually teach


Many sex education teachers do not teach about contraception: Many sex education teachers do not teach about contraception One in four sex education teachers are prohibited from teaching about contraception Four in 10 either do not teach about contraceptive methods (including condoms) or teach that they are ineffective


Teachers who teach the effectiveness of contraception are more likely to cover key prevention topics: Teachers who teach the effectiveness of contraception are more likely to cover key prevention topics


Public and ProfessionalOpinion: Public and Professional Opinion


Americans overwhelmingly favor broader sex education: Americans overwhelmingly favor broader sex education 93% of parents reported their child has benefited from sex education 94% of parents say that sex education should cover contraception Only 15% of Americans want abstinence-only education taught in the classroom


Support for comprehensive sex education: Support for comprehensive sex education American Medical Association American Academy of Pediatrics American Nurses Association American College of Obstetricians and Gynecologists American Psychological Association American Public Health Association Institute of Medicine National Institutes of Health Society for Adolescent Medicine


The Big Disconnect: The Big Disconnect Teachers, parents, students and health organizations want young people to receive comprehensive sex education. Conservative groups and politicians are promoting education in U.S. schools that emphasizes abstinence and denies young people accurate information about contraception.


U.S. Government Support for Abstinence Education: U.S. Government Support for Abstinence Education


The federal definition of abstinence education: The federal definition of abstinence education 'Abstinence education…has as its exclusive purpose, teaching the social, psychological, and health gains to be realized by abstaining from sexual activity'


The federal definition of abstinence: The federal definition of abstinence Under the Bush administration, federally funded programs must now discourage all unmarried people from engaging in any behavior or activity that might be 'sexually stimulating'—including kissing. State-funded programs must now promote abstinence among people as old as 29.


Total federal funding for abstinence education, FY 2006: Total federal funding for abstinence education, FY 2006 State Grant Program: $50 million AFLA: $13 million CBAE: $113 million Total: $176 million


Funding for abstinence-only sex education has increased substantially: Funding for abstinence-only sex education has increased substantially $ in millions


Federally funded abstinence education programs mislead youth: Federally funded abstinence education programs mislead youth Contraceptive effectiveness Risks of abortion STI incidence and transmission Scientific facts Medical evidence


Effectiveness of Sex Education: Effectiveness of Sex Education


What do evaluations say about the effectiveness of sex education?: What do evaluations say about the effectiveness of sex education? No evidence shows that abstinence without contraceptive education effectively protects teens Contraceptive education does not encourage sexual activity


What do evaluations say about the effectiveness of sex education?: What do evaluations say about the effectiveness of sex education? Considerable evidence that certain programs that include abstinence and contraceptive education help teens delay sexual activity increase contraceptive use reduce number of partners


The potential for harm: The potential for harm Virginity pledges help some teens to delay sexual activity, BUT Most pledgers break their pledge, AND Pledge-breakers are less likely to use condoms or seek STI care, and more likely to engage in alternative sexual behavior


The potential for harm: The potential for harm HIV prevention messages that promote only abstinence and not condoms may result in more unprotected sex than do safer-sex messages.


In Conclusion…: In Conclusion…


A “risk reduction” approach to teenage sexual activity remains vital: Sex among young people is common in the United States and worldwide Undermining confidence in contraception threatens young people’s lives and health Providing teens with medically accurate information reduces their risk of STIs and unwanted pregnancies A 'risk reduction' approach to teenage sexual activity remains vital


Summary: Summary Many U.S. teens experience unintended pregnancy and STIs Teens in other developed countries fare better Abstinence education that omits accurate information about contraceptives is prevalent across the country Many sex education teachers believe they are not meeting students’ needs


Summary: Summary Current federal policy ignores public opinion and research on 'what works' Only a balanced and comprehensive approach will help teens to become sexually healthy adults


Major Sources: Major Sources National Surveys Youth Risk Behavior Survey–Centers for Disease Control and Prevention National Survey of Family Growth– National Center for Health Statistics Surveys of school superintendents and sex education teachers–Guttmacher Institute Survey of students and public opinion–Henry J. Kaiser Family Foundation National Survey of Adolescent Males–Urban Institute


Major Sources: Major Sources Other Sources Teenage pregnancy statistics–Guttmacher Institute International birth and abortion statistics–various sources Evaluation research–National Campaign to Prevent Teen Pregnancy Federal law and policy Statements on sex education from national organizations Policy analysis–Guttmacher Institute


Slide48: This presentation was developed with support from the Program on Reproductive Health and Rights of the Open Society Institute. For more information, visit www.guttmacher.org


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