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Example 4 - Promotion of Abstinence-Based Sex Education

"Abstinence" is the new federal mantra. Whether the question relates to protecting against unintended pregnancy or to HIV infection, the answer is always the same:" Just say no" to sex. Those of us here understand that abstinence is not the answer or not the only answer. If it were, our species would die out in a few generations. However, some political leaders hold the view that, like that notorious gay icon SpongeBob Squarepants, our species should reproduce asexually like sponges. Or, as a teenager in a David Sipress cartoon asks, "Dad, can I go to Bobby's house to abstain from having sex?"

What has prompted the missionary zeal for abstinence-only education programs in the United States? Like big oil and Enron, it comes from Texas. When the President was Governor of Texas, his pet abstinence-only education project had a notable record. Notable in that of all 50 states, Texas had the least decline in pregnancy rate among women aged 15 to 17 years. On the basis of this stunning success story, the President now is spending nearly quarter of a billion tax dollars annually promoting the abstinence education.[18]

Public health policy should be based on evidence. In 2002, DiCenso and colleagues published in the British Medical Journal a systematic review of the evidence about abstinence-only programs.[19] Although most teen pregnancy prevention programs were ineffective, abstinence-only programs did have a statistically significant effect -- in the wrong direction. The risk of pregnancy was 54% higher among those exposed to this faith-based promulgation of chastity.

Here, in graphic format, is the world's literature summarized. The effect of abstinence-only education and its 95% confidence intervals fall entirely within the zone of harm. The evidence is incontrovertible. Nevertheless, this administration prefers to base policy on revelation, rather than reality; ideology, rather than evidence; and political gain, rather than medical benefit. Think what good we could do with a quarter billion dollars spent on contraception, immunization, cervical cancer screening, and other programs that work?


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