Effectiveness of Abstinence-Only Education and Comprehensive Sexual Education in Reducing Teenage Pregnancy in the U.S.

Purpose:  Although the United States is considered one of the developed countries, the high incidence of teenage pregnancy in this country continues to remain a significant health concern.  Although formal sex education has been incorporated into the United States school system, the method by which such a program is being presented continues to be a topic of debate. Abstinence-only sex education and comprehensive sex education are the two predominant methods of delivering sexual health education to US teens. However, it is not known which of these methods are associated with reduced teen pregnancy. Using the PICO (Problem, Intervention, Comparison, Outcome) framework, we examined which of the above delivery methods of sex health education are associated with reduced teenage pregnancy.  

Methods:  A search of the literature using the CINAHL, MEDLINE and PUBMED databases was conducted. Specific keywords such as “teenage pregnancy”, “adolescent pregnancy”, “teenage girls”, “abstinence education”, “abstinence counseling”, “sexual education”, “comprehensive sex education”, “sexual health”, “birth control”, “U.S. schools”,  and “school role” were used in the search of the literature. Studies that were conducted among US teenagers between ages 13 and 19, and were published between the years 2004 and 2014 were included in the review. The initial search yielded 252 research articles. Articles that did not meet the inclusion criteria were excluded.  

Results:  The comprehensive sex education method was found effective in reducing teenage pregnancies.  Such teaching method was found to provide more complete and accurate information to teenagers on sexual health.

Conclusion:  The comprehensive sexual education method was found most effective in reducing teenage pregnancies in the US when compared to abstinence-only sex education method. Such methods designed to cover all topics of sexual health including various forms of contraception, awareness and education related to the transmission of sexually transmitted infections, and abstinence as a choice rather than the only option available to adolescents was associated with reduced teenage pregnancy rates. For such programs to be effective, it is recommended that these be delivered by trained school nurses.