Abstinence-Only-Until-Marriage: An Updated Review of U.S. Policies and Programs and Their Impact

Abstract

Adolescence is marked by the emergence of human sexuality, sexual identity, and the initiation of intimate relations; within this context, abstinence from sexual intercourse can be a healthy choice. However, programs that promote abstinence-only-until-marriage (AOUM) or sexual risk avoidance are scientifically and ethically problematic and-as such-have been widely rejected by medical and public health professionals. Although abstinence is theoretically effective, in actual practice, intentions to abstain from sexual activity often fail. Given a rising age at first marriage around the world, a rapidly declining percentage of young people remain abstinent until marriage. Promotion of AOUM policies by the U.S. government has undermined sexuality education in the United States and in U.S. foreign aid programs; funding for AOUM continues in the United States. The weight of scientific evidence finds that AOUM programs are not effective in delaying initiation of sexual intercourse or changing other sexual risk behaviors. AOUM programs, as defined by U.S. federal funding requirements, inherently withhold information about human sexuality and may provide medically inaccurate and stigmatizing information. Thus, AOUM programs threaten fundamental human rights to health, information, and life. Young people need access to accurate and comprehensive sexual health information to protect their health and lives.

Sex Education in America: Abstaining from Comprehensive Facts

“…Santelli and colleagues conducted a comprehensive review of outcomes associated with increasing abstinence‐only education funding. They determined that AOUM education goals to delay sexual intercourse until marriage do not support US demographic trends . The median age at first sexual activity for both men and women has remained stable between 17 and 19 years since 1960 .…”

“…They determined that AOUM education goals to delay sexual intercourse until marriage do not support US demographic trends . The median age at first sexual activity for both men and women has remained stable between 17 and 19 years since 1960 . However, the span from onset of sexual activity to marriage has risen from 1.5 years in the 1960s to 8.7 years for women and 11.7 years for men .…”

“…Abstinence is the only 100% effective method to prevent pregnancy and STI; however, adherence to abstinence until marriage is low across the life span. Santelli and colleagues conclude that “in actual practice the efficacy of AOUM interventions may approach zero.” (p276) The attempt to deter sexually physical aspects of adolescent relationships has led to an education system that misses out on a key concept—how to be physically safe. In a rapidly diverse and transformative age, AOUM education has failed to evolve.…”

“…Aside from failing to prevent pregnancy and delay onset of intercourse, most AOUM education programs “violate adolescent rights, stigmatize or exclude many youths, and reinforce harmful gender stereotypes.” (p1) The AOUM education model is heteronormative. Guidelines for abstinence programming include teaching that “a mutually faithful monogamous relationship in the context of marriage is the expected standard of human sexual activity” and “sexual activity outside the context of marriage is likely to have harmful psychological and physical effects.” (p1) AOUM education teaches that sex outside of heterosexual marriage is not normal or expected .…”

The Risk of Remaining Silent: Addressing the Current Threats to Women's Health

“…DHHS, n.d.). The administration has indicated the desire to eliminate the Office of Adolescent Health altogether, even though data support its programmatic outcomes, in contrast to negative findings associated with the majority of abstinence-only education programs (Santelli, Kantor & Grilo, 2017).…”