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State's abstinence-only sex education doesn't work any better, report says
By Josephine Marcotty
startribune.com

01/04/2004 - The state's $5 million abstinence-only sex education program isn't working, according to an independent study commissioned by the Minnesota Department of Health. The study found that sexual activity among junior high kids at three schools where the program was taught doubled between 2001 and 2002 -- a pattern similar to that exhibited by kids statewide -- and that the number who said they would probably have sex during high school nearly doubled, as well. The state's five-year-old abstinence-only initiative has been taught to 45,000 Minnesota kids and is funded by state and federal dollars.

ENABL (Education Now and Babies Later) teaches the view embraced by social conservatives -- that abstinence is the only sure way to avoid pregnancy and sexually transmitted diseases, and that teaching kids about birth control or safer sex practices simply encourages them to have sex. In fact, federal rules tied to the funding forbid any mention of the effectiveness of contraception or safer sexual practices that reduce the risk of disease.

The 91-page report, posted last week with little fanfare on the Health Department's Web site, recommends broadening the program to include more information about contraception. Critics of the ENABL program questioned why the agency waited until six months after the report was completed to release what they said might be a politically controversial finding. State health officials said the release was not delayed.

The Minnesota researchers surveyed 413 kids who were taught the abstinence-only curriculum at one school in each of three counties. They found over the course of the year that the rate of those who said they were sexually active increased from 5.8 to 12.4 percent, and that the rate of those who said they would probably have sex before finishing high school increased from 9.5 to 17 percent. That is still lower than the average rate of sexually active adolescents in those counties, researchers said. But the abstinence-only message would have been viewed as a success if the rates of sexual activity and sexual intentions among the ENABL group had remained about the same in each year, researchers said.

"Given how much money is being spent, it seems like a really weak intervention," said Connie Schmitz, the outside consultant with Professional Evaluation Services of Minneapolis. Schmitz, who headed the study, said it raises serious questions about whether sexually active kids are getting the information they need to avoid pregnancy and infectious diseases.

Few surprised
Carol Woolverton, assistant commissioner of health, said Health Department officials were not surprised by the results. "We take it very seriously," she said. "And we recognize that there might be more efficient ways to approach this." But it's too early to say whether the Health Department will try to find a way to reach sexually active kids with information about contraceptives, she said. The state risks losing the federal funding that pays for most of the program if it changes from abstinence-only. However, advocates of contraceptive education said the findings clearly show it's time for state health officials to advocate a change in direction. "They have to take these results seriously, be accountable to the citizens of the state and make an appropriate change so we get better results," said Nancy Nelson, executive director of the Minnesota Organization on Adolescent Pregnancy, Prevention and Parenting. "We should do what works."

Tom Prichard, president of the Minnesota Family Council, which supports abstinence-only education, said he wasn't surprised by the findings, either. However, he said ENABL isn't working because it doesn't go far enough in its abstinence message. Kids should be told not just to abstain until they are adults, but rather to wait until they are married to have sex. He also said the program is not long enough or clear enough in its message that kids should also abstain from any physical or sexual contact.

The Minnesota report adds to a very small body of research on the effectiveness of abstinence-only education. Prichard said the Heritage Foundation, a conservative think tank, lists a number of effective abstinence-only programs on its Web site. Some experts, however, say that none has been effective in reducing pregnancy and sexual activity. "So far all of the programs that have been demonstrated to have a positive impact . . . have been comprehensive sex education that emphasize abstinence and talk about condoms and contraception and encourage their use for young people who are sexually active," said Douglas Kirby, a researcher on sex education for the National Campaign to End Teen Pregnancy. He added, "the jury is still out" on abstinence-only education. The federal government has funded a major nationwide review of such programs and will be completed in 2005.

In Minnesota, most parents want both kinds of information provided to their kids, according to the ENABL study. It surveyed 2,500 Minnesota parents and found that only one-fifth wanted abstinence-only education and that 77 percent wanted their kids to know about contraception, too, the researchers said.

ENABL is a community-based program coordinated by schools, local organizations and parents. It relies on public-service advertising and community events to advocate abstinence. But the primary piece consists of a five-hour educational curriculum taught in schools or at community centers and includes statistics, reasons why kids should wait until they are either adults or married to have sex and suggestions on how to avoid sex and risky situations where sex might occur. It also encourages them to talk to their parents about sex. The program also includes information on the failure rates of contraceptives but nothing on their effectiveness in preventing pregnancy and disease.

In Minnesota the teen birth rate was 27.5 per 1,000, one of the lowest in the nation and down by a fourth since 1991, according to the CDC. But that number masks what state health officials have acknowledged is a significant problem in Minnesota -- it has some of the highest teen birth rates in the nation among some minority groups, blacks in particular. In 2000, the birth rate among blacks in Minnesota was 162 per 1,000, compared with 30 for whites. However, birth rates among minority groups have been declining, as well.

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