Abstinence study finds risk reduction
Health care reform bill includes abstinence funding
As HIV researchers, clinicians, and public health officials continue to wait for an evidence-based biomedical prevention intervention, there remains a need for proven HIV prevention interventions targeting adolescents and young adults.
The Centers for Disease Control and Prevention (CDC) has some evidence-based prevention interventions that might work or be adapted for minority youth and young men who have sex with men (MSM).
But for HIV clinics and community-based organizations (CBOs) short of funds, funding might be an obstacle.
One unexpected area of new funds can be found in a provision (section 2953) inserted in the new Patient Protection and Affordable Care Act: $75 million per year through Fiscal Year 2014 for personal responsibility education grants to states for programs that focus on abstinence and contraception to prevent pregnancy, HIV, and other sexually-transmitted diseases (STDs). Also, the bill's section 2954 restores $50 million per year through FY 2014 for abstinence education.
The bill requires the personal responsibility education programs to be evidence-based, medically-accurate, and age appropriate.
Finding evidence-based abstinence-only programs might be difficult, but not impossible. There is at least one new risk reduction intervention focusing on abstinence education that recently was found to be effective.
The study found that teens receiving the abstinence education delayed sexual contact in comparison to a control group, says John Barton Jemmott III, PhD, a professor of communication in psychiatry in the University of Pennsylvania School of Medicine in Philadelphia, PA.
"We had a small group intervention, led by an adult who was specially trained to implement the curriculum, which was divided into eight one-hour modules," Jemmott says.
Researchers randomly assigned adolescents to one of five different groups, including the following:
- Abstinence only, the intervention group;
- Safer sex only, a condom use group;
- A combined abstinence and safer sex intervention that included a total of 12 hours of intervention;
- A reduced version of the combined abstinence and safer sex intervention that included a total of eight hours;
- A health promotion control group that didn't have messages that focused on sex, but discussed other health behaviors, including diet, avoiding cigarette smoking, physical activity, and avoiding alcohol consumption.
"What we found was the abstinence only intervention was effective in reducing the percentage of people who were virgins at baseline who initiated sex in a 24-month follow-up to the study when compared with the control group," Jemmott says.
Targeting African American teens, Jemmott's research also has found that HIV/STD-intervention participants, who were African Americans in the 13-18 years age group, were more likely to report consistent condom use than were control-intervention participants.1
"People definitely are going to be using this intervention because it's really the first one shown in a randomized controlled trial to be efficacious," Jemmott says. "We need more research on abstinence-only interventions to see if these results are replicated."
The behavioral intervention was tailored to the population and did not include a moralistic or religious basis, he notes.
"The facilitator is not preaching, just shaping the discussion," he explains. "An example is one type of brainstorming activity where we might ask the young people to say what the benefits of sex are and what are the benefits of practicing abstinence."
Often the youth would find their list in favor of abstinence was longer, and this fit in with other exercises they had done on thinking about their future and what they wanted to be doing in five years or 10 years, Jemmott adds.
"They think about that in the context of what they want to accomplish in their lives, and how having sex might slow them down and prevent them from reaching their goals," he says.
Reference
- Jemmott JB 3rd, Jemmott LS, Fong GT, et al. Effectiveness of an HIV/STD risk-reduction intervention for adolescents when implemented by community-based organizations: a cluster-randomized controlled trial. Am J Pub Health. 2010;100(4):720-726.
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