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National Data Shows Comprehensive Sex Education Better at Reducing Teen Pregnancy than Abstinence-Only Programs


Researchers at the University of Washington set out to compare the sexual health risk of adolescents who have received various types of sexuality education.  Though a number of recent studies have evaluated specific programs, little research has been done on the adolescent population as a whole.

This study used data collected in 2002–03 through the National Survey of Family Growth (NSFG), a nationwide survey conducted by the Centers for Disease Control and Prevention’s (CDC) National Center for Health Statistics. 

The researchers analyzed data from 1,719 heterosexual respondents to the NSFG who were 15–19.1  The median age of respondents was 17.  The authors focused on young people’s answers to two questions: whether they had received “any formal instruction at school, church, a community center, or some other place about how to say no to sex” before the age of 18 and whether they had received any formal education about birth control.  Young people who reported only receiving information on how to say no to sex were classified as participants in abstinence-only programs and young people who reported getting both messages were classified as having received comprehensive sex education.  These two groups were also compared to young people who reported receiving no formal sex education. 

To assess sexual risk researchers looked at whether respondents reported ever having engaged in vaginal intercourse, been involved in a pregnancy, or been diagnosed with a sexually transmitted disease (STD).


Pamela Kohler, et al., “Abstinence-Only and Comprehensive Sex Education and the Initiation of Sexual Activity and Teen Pregnancy,” Journal of Adolescent Health 42.4 (March 2008); 344–351.

Key Findings:

  • Young people who received comprehensive sex education were significantly less likely to report a teen pregnancy compared to those who received no sex education.
  • Abstinence-only programs were not significantly associated with a risk reduction for teen pregnancy when compared with no sex education.
  • In comparing abstinence-only programs with comprehensive sex education, comprehensive sex education was associated with a 50% lower risk of teen pregnancy.
  • After adjusting for demographics, abstinence-only programs were not significantly associated with a delay in the initiation of vaginal intercourse.
  • Comprehensive sex education was marginally associated with reduced reports of vaginal intercourse.
  • Neither abstinence-only programs nor comprehensive sex education were significantly associated with risk for an STD when compared to no sex education.


Demographic Findings

  • Young people who received no sex education tended to be black, from low-income non-intact2 families, and rural areas.
  • Young people who received abstinence-only programs tended to be younger and from low-to-moderate-income intact families.
  • Young people who received comprehensive sex education tended to be slightly older, white, and from higher-income families in more urban areas.
  • The strongest predictor for an STD diagnosis was a non-intact family.  Adolescents in these families were four times more likely to report having been diagnosed with an STD.

SIECUS Analysis:
This study adds to the growing body of research in support of a comprehensive approach to sexuality education. First, it confirms that abstinence-only-until-marriage programs are not effective in changing young people’s sexual behavior or preventing negative outcomes such as teen pregnancy.  More importantly, however, it confirms that programs that teach young people about both abstinence and contraception/disease prevention are, in fact, effective. 

In particular, the authors found that receiving information about birth control in formal sex education was associated with a 50% lower risk of teen pregnancy when compared to receiving information only on abstinence.  It also confirmed that talking to young people about birth control does not lead to increased sexual activity or higher STD rates as many critics of comprehensive sexuality education continue to claim. 

This study is a welcome addition to the research on sexuality education and youth sexual behavior; however, there are some limitations to the data.  The NSFG does not ask detailed questions about sex education. Instead, researcher categorized respondents by their answer to two basic questions.  By this narrow definition they found that 66.8% of respondents reported receiving comprehensive sex education, 23.8% reported abstinence-only, and 9.4% reported no sex education. However, no information was available about the quality, context, or duration of either the abstinence-only or comprehensive sex education programs. 

SIECUS defines comprehensive sexuality education as programs that start in kindergarten and continue through 12th grade. These programs include age-appropriate, medically accurate information on a broad set of topics related to sexuality, including human development, relationships, decision-making, abstinence, contraception, and disease prevention. They provide students with opportunities for developing skills as well as learning information. 

There is a good chance that many of the students grouped as having received comprehensive sex education did not receive such a thorough program.  In fact, very few students do.  However, it’s encouraging that even programs that simply cover birth control and abstinence can reduce young people’s risk of teen pregnancy.  And, though we know little about the abstinence-only programs that these students were exposed to, we do know that they withheld information about contraception and we know that this approach has failed to reduce sexual activity, teen pregnancy, or STDs. 

The stated goals of federally funded abstinence-only-until-marriage programs are to delay sexual activity and prevent teen pregnancy and, yet, this research shows again that programs that discuss birth control as well as abstinence do a better job at both of these tasks. This research should encourage policymakers to end funding for failed abstinence-only-until-marriage programs and begin funding programs that work.

In addition, this study also reveals some disturbing disparities in what young people are learning.  For example, it found that a plurality, 36.9%, of young people who received no sex education live in households that made less than $20,000.  Moreover, the authors note that “generally individuals receiving no sex education tended to be from low-income, nonintact families, black, and from rural areas.”  We know that young people of color and young people from low-income communities are disproportionately affected by teen pregnancy and sexually transmitted diseases.  In order to overcome these health disparities, we must ensure that these young people, in particular, receive high quality sexuality education.   


  1. Respondents who reported a sexual orientation other than heterosexual were excluded from the analysis because the programs do not address same-sex behavior.   
  2. “Intact families” were defined as those where the children resided with the same two biological or adoptive parents since birth.