A study published in the Archives of Pediatrics and Adolescent Medicine in early February 2012 examined the effects of sexuality education on adolescent birthrates.  Researchers at Washington University in St. Louis (WUSL) utilized a longitudinal and multi-state design to examine the effect of sexuality education on adolescent birthrates from 1997 to 2005 among girls ages 15–17 in 24 states.[1] The WUSL researchers found that states with a more conservative political climate and a higher degree of religiosity had higher adolescent birthrates in spite of sexuality education.[2] The study controlled for demographic characteristics of the state, as well as religiosity and degree of conservatism.

 

States included in the analysis were those that participated in the School Health Profiles developed by the Centers for Disease Control and Prevention (CDC) for at least three of the years examined in the study. The School Health Profiles document school health practices, and data are collected from questionnaires that the principal and lead health education teacher complete every two years.[3] Sexuality education was measured in the study as the average percentage of 13 sexual health topics taught in each state as reported through the School Health Profiles questionnaire.[4] Demographic measures included state-level poverty rate, race/ethnicity, and violent crime rates for each state. Additionally, variables that reflect the state’s religious and political climate were included. Finally, the adolescent abortion laws of each state were included.

 

The birthrate for adolescent girls ages 15–17 has steadily decreased since 1997, with the exception of an uptick in 2006.[5] Nonetheless, variations in adolescent birthrates among states persist. One of the central aims of this research was to examine the association between birthrates and state-level sexuality education topics that are presumed to influence behavior. Findings revealed an important association between the amount of sexuality education provided in schools in a particular state and its respective adolescent birthrate. One key finding was that states with a higher average number of topics taught in school are associated with lower adolescent birthrates. Additionally, results showed that eight individual topics are found to be associated with lower adolescent birthrates in a given state and include, HIV infection prevention, pregnancy prevention, sexually transmitted disease prevention, abstinence as the most effective method to avoid HIV, how HIV is transmitted, condom efficacy, how to correctly use a condom, and human sexuality.

 

Of all the surveyed topics taught, how to use a condom was taught to a much lower degree than other topics. Researchers found a significant inverse relationship over time between the state’s religiosity and the percentage of schools that taught condom efficacy or how to use a condom correctly.[6] Conversely, researchers found that the more liberal a state is the more sexuality education topics were taught.[7] Changes in the topics taught within a state over time were not found to have a significant effect on birthrates with the exception of teaching HIV infection prevention. As evidenced by the results, teaching HIV infection prevention within a state is associated with lower birthrates.[8]

 

However, once researchers included demographic characteristics, religiosity, and degree of conservatism of the state into their analysis virtually all effects of sexuality education disappear.  Though there is a strong correlation between teaching sexuality education and a lower teen birthrate, the poverty rate, race/ethnicity, and violent crime rates of each state in fact provide a better explanation of adolescent birthrates. Specifically, a higher proportion of whites, a lower average poverty level, and higher religiosity are all associated with lower adolescent birthrates.[9] These findings indicate that increased sexuality education is associated with lower adolescent birthrates; however, they are constrained by the political and religious structure of the state.

 

Notably, studies released in both 2007 and 2011 conclude that a significant reason for the decline in adolescent pregnancy rates and birthrates can be attributed to increased contraceptive use.[10] The most recent study, conducted by the CDC’s National Survey of Family Growth, reports that teens are increasing their contraceptive use in the following ways: use of any contraception, use of highly effective contraception, and increase of dual-use contraception.[11] These trends are promising, and “suggest a growing commitment among teens to protect themselves against both unintended pregnancy and STIs [sexually transmitted infections].”[12] The WUSL researchers urge policy makers and health care providers to “pragmatically identify methods to reduce the rate of adolescent births.”[13] Their findings provide useful insight into the ways that the social, political, and religious factors at the state level should be taken into consideration when considering the most comprehensive approach to reducing adolescent pregnancy rates and birthrates.

 

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