Prevention of HIV/AIDS, other STIs and Pregnancy: Group-Based Abstinence Education Interventions for Adolescents
Abstinence Education (AE) promotes abstinence from sexual activity (either delayed initiation or abstinence until marriage) and mentions condoms or other birth control methods only to highlight their failure rates if at all. These interventions usually include messages about the psychological and health benefits of abstinence, and most adhere to eight federal guidelines required to obtain federal funding (the Federal A-H guidelines).
This review evaluated AE interventions delivered in school or community settings to groups of adolescents (10–19 years old). These interventions could also include other components, such as media campaigns and community service events.
Summary of Task Force Recommendations & Findings
The Community Preventive Services Task Force finds insufficient evidence to determine the effectiveness of group-based abstinence education delivered to adolescents to prevent pregnancy, HIV and other sexually transmitted infections (STIs). Evidence is considered insufficient because of inconsistent results across studies.
Task Force Finding and Rationale Statement
About the Intervention
Interventions may be:
- Targeted to adolescents:
- Girls only
- Boys only
- Girls and boys together
- Delivered in group settings in schools or communities
- Led by adult or peer educators
- Implemented as single or multicomponent programs
- Tailored to groups or individuals
Content of these interventions may address prevention of:
- HIV and STIs
- Pregnancy
Results from the Systematic Reviews
Twenty-one studies with 23 study arms qualified for analysis in this review. The meta-analyses found the following results for primary outcomes:
- Sexual activity: decrease of approximately 16% (OR=0.81, 95% CI 0.70, 0.94; 21 study arms)
- This decrease is statistically significant, however, effect estimates differed by study design with larger effects for nonrandomized controlled trials compared to randomized controlled trials.
- Studies with both designs had problems such as differences in follow-up time and multiple studies conducted by the same investigators.
- Frequency of sex OR=0.77, 95% CI 0.57, 1.04 ( 5 study arms)
- This result, although in the favorable direction (decrease in frequency), is statistically nonsignificant. Also, effect estimates differed by study design with larger effects for nonrandomized controlled trials compared to randomized controlled trials.
- STIs: increase of approximately 8% that was statistically nonsignificant (OR=1.08, 95% CI 0.90, 1.29; 9 study arms)
- Pregnancy: increase of approximately 12% (OR=1.15, 1.00, 1.32; 10 study arms)
- Although this increase is statistically significant, sensitivity analyses suggest that the effect estimate is unreliable.
- AE had no meaningful effect on any of the following secondary outcomes:
- Number of sexual partners
- Use of protection
- Unprotected sexual activity
- In two of the studies, at least one relevant outcome was reported that could not be included in the meta-analysis because of too little information to calculate an odds ratio. The results for these studies were consistent with the results of the meta-analysis.
These reviews were based on a systematic review of all available studies, conducted on behalf of the Task Force by a team of specialists in systematic review methods, and in research, practice and policy related to adolescent sexual behavior.
Economic Review
An economic review was not conducted because the Task Force found insufficient evidence to support the intervention.
Supporting Materials
- Research gaps
- Summary evidence table
[PDF - 106KB] - Included studies
- Search strategy
Publications
More Community Guide publications about Prevention of HIV/AIDS, other STIs and Pregnancy
Disclaimer
The findings and conclusions on this page are those of the Community Preventive Services Task Force and do not necessarily represent those of CDC.
Sample Citation
The content of publications of the Guide to Community Preventive Services is in the public domain. Citation as to source, however, is appreciated. Sample citation: Guide to Community Preventive Services. Prevention of HIV/AIDS, other STIs and pregnancy: group-based abstinence education interventions for adolescents. www.thecommunityguide.org/hiv/abstinence_ed.html. Last updated: MM/DD/YYYY.
Review completed: June 2009
- Page last reviewed: January 31, 2011
- Page last updated: December 22, 2011
- Content source: The Guide to Community Preventive Services
Get email updates
To receive email updates about Prevention of HIV/AIDS, other STIs and Pregnancy, enter your email address:
Contact Us:
- Community Guide Branch
Epidemiology and Analysis Program Office (EAPO)
Office of Surveillance, Epidemiology, and Laboratory Services (OSELS)
Centers for Disease Control and Prevention
1600 Clifton Road NE
Mailstop E-69
Atlanta, GA 30333 - Community Guide
