Although refraining from having sexual intercourse is a sure-fire way to prevent pregnancies and sexually transmitted infections, a recent report
published in the journal Pediatrics concluded that abstinence-only programs are ineffective in delaying the initiation of sex. The federal government has invested more than $100 million into abstinence-only sexuality education since an eight-point definition
of abstinence education was enacted in 1996 under the Social Security Act.
Dr. Cora Breuner of Seattle Children's Hospital, one of the report's lead authors, says the main element to consider when talking about sexual education is that the conversation should be about health first.
"This isn't a religious or cultural discussion at all. It's about safety, health and the future of our children," Breuner said. "Then you layer onto it and say, 'this is not what people in our culture or religion approve of, but this is what it is.' It's an open dialogue."
Abstinence-only sexual education is taught in some public schools and other community outlets. "The most effective means of birth control is to wait, but this curriculum is not the best way to disseminate that," Breuner said. "Teaching kids about healthy sex prevents a lot of significant problems. It doesn't promote being sexually active."
This study looked at a survey of 1,200 high school seniors by the National Campaign to Prevent Teen and Unplanned Pregnancy. The students reported mixed feelings about their first time having sex, with more than three-fourths acknowledging that they'd change the way the experience occurred if they could.
In the classroom
Sex ed varies widely across schools. The delivery of sexual education to children and adolescents is shaped by factors such as state and school district guidelines and how comfortable teachers are about addressing the topic. Fewer than half of public schools in the United States require sexual education, and the few that do aren't required to have standards in place to make sure the information is medically accurate.
The Pediatrics publication outlines a comprehensive evidence-based curriculum that research shows is more effective. That approach is medically factual, researchers say, and "recognizes the diversity of values and beliefs represented in the community, and complements and augments the sexuality education children receive from their families, religious and community groups, and health care professionals."
A systematic government review
showed that comprehensive sexuality education programs effectively delay the initiation of sexual intercourse while promoting mindful sexual behavior such as condom use.
Parents are another key component to sexual education.
(PDF) conducted by the Centers for Disease Control and Prevention found that girls between the ages of 15 and 17 were more likely to talk to their parents about sex than their male counterparts, 80% to 68% respectively. Discussions of sexuality are also unequal between mother and fathers. Information collected from 1980 to 2010 reveals that most mothers conduct conversations about sex. In a review, fathers have self-reported that they recognize that this disparity exists.
The new publication recommends programs to coach parents through delivering sexuality education to their kid such as Talking Parents, Healthy Teens,
which aims to improve parents' communication and monitoring of their teens' sexual activity.
At the doctor's office
Pediatricians have a unique incentive to have a dialogue with their patients, the study also says. However, one in three adolescents reports not receiving information on sexuality from their doctors. And if they did, the conversation lasted an average of 40 seconds
, one study reported.
Pediatricians are in an ideal position to give advice to individual patients in a controlled setting, with parents monitoring the conversation. Subsequent exams give pediatricians opportunities for followup conversations as well. Unlike in a school setting, information from a clinician or other health care professional is confidential.
The new report suggests a pre-visit questionnaire administered by doctors to personalize the advice they can provide.