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No Time to Lose: Getting More from HIV Prevention
(Kirby, 2000; IOM, 1997b; IOM, 1995a; Kirby, 1995). In addition, these reviews and expert panels conclude that school-based sex education and condom availability programs do not increase sexual activity among adolescents.
National surveys show strong public support for comprehensive sex education policies and condom availability programs. A 1998 poll found that 81 percent of adults supported schools teaching information about abstinence as well as about contraception and prevention of STDs (Kaiser Family Foundation, 1998). A 1991 poll showed that 64 percent of adults favored making condoms available in high schools (Roper Organization, 1991), and a 1999 poll found that 53 percent of adults thought school personnel should make condoms available to sexually active youth (Haffner and Wagoner, 1999). Condom availability programs are also endorsed by the American Academy of Pediatrics (AAP, 1995).
In contrast, two recent reviews of the literature on abstinence-only education programs concluded that the evidence was insufficient to determine whether abstinence programs decrease sexual activity (Kirby, 2000; Maynard, 2000). One of these reviews concluded that the weight of the evidence indicated that abstinence programs do not delay the onset of intercourse, but significant methodological limitations could have obscured the impact of these interventions (Kirby, 2000). Public support for abstinence-only education programs is also limited. In a 1998 poll, only 18 percent of adults thought abstinence should be the only topic of discussion (Kaiser Family Foundation, 1998).
Still, many school districts do not provide comprehensive programs. A 1998 national survey found that of school districts with a policy to teach sex education, only two-thirds permitted positive discussions of contraception (Landry et al., 1999). In addition, a 1995 survey found that only 2.2 percent of all public high schools and 0.3 percent of school districts made condoms available to students (Kirby and Brown, 1996).
In contrast, abstinence-only programs have proliferated. A 1998 survey found that one-third of all school districts with a policy to teach sex education used abstinence-only education that prohibited dissemination of any positive information about contraception (Landry et al., 1999). This study found that every region of the country had a significant proportion of districts with abstinence-only policies; however, districts in the South were five times as likely as those in the Northeast to have an abstinence-only policy. The survey also found that among those districts that changed their sex education policies, twice as many adopted a more abstinence-focused policy than vice versa (Landry et al., 1999).
While federal involvement in sex education has historically been limited, two federal programs provide sizeable amounts of funding for abstinence-only sex education programs: the 1981 Adolescent Family Life Act