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AMA: No Evidence that Abstinence Sex Ed Works

The American Medical Association says the federal government should not spend money on community-based sex education programs unless it has solid scientific evidence that the programs work, a position that would eliminate many abstinence-only programs.

The new AMA policy puts the doctor group at odds with the Bush administration, which just last week reaffirmed its support of abstinence-only based programs. But AMA president-elect J. Edward Hill, MD, a family physician from Tupelo, Miss., tells WebMD that the issue is too important to back any sex education curriculum that is not evidence-based.

“The cost of teenage pregnancy — from the cost of prenatal care to the cost of caring for babies born to teens — is outrageous, not to mention the public health consequences of sexually transmitted diseases. Given those facts the AMA is compelled to take a stand on this issue,” Hill says.

The evidence shows that abstinence-only programs don’t work for all adolescents and these programs don’t work in all settings, says Hill. He says that the AMA wants the federal government to fund only programs that have evidence of solid results.

Christopher DeRienzo, a medical student from Duke University School of Medicine in Durham, N.C., who represents the nation’s medical students in the AMA’s House of Delegates, brought the community-based sex education issue to the AMA. The AMA already is on record supporting broad-based sex education programs that include information about contraception as well as information about abstinence. But DeRienzo says that community-based programs often have an abstinence-only curriculum that includes not only errors but also sexual stereotypes, such as teaching that girls are unable to “focus” when sexually aroused.

The medical students asked the AMA to make a flat statement that it was opposed “federal funding of community-based abstinence-only sex education programs and instead support federal funding of comprehensive sex education programs that teach about contraceptive choices and safe sex while also stressing the importance of abstinence in preventing unwanted pregnancy and sexually transmitted diseases.”

But the AMA delegates, who represent state medical societies as well as medical specialty societies, softened the language. Rather than saying the AMA is opposed to abstinence-only sex education programs, the new policy states that the AMA only supports programs that are evidence-based.

The change in wording was brokered by Billie Jackson, MD, a Macon, Ga., dermatologist who describes herself as a mother of teens. She says that there is evidence that an abstinence-only program in Jessup, Ga., “is effective and there is also evidence that an abstinence-based program in Washington, D.C., is effective. So, I think that in some communities, abstinence-based programs do work and so children should be told that they can just say no. And as physicians we should support programs that work.”

By Peggy Peck, reviewed by Brunilda Nazario, MD

SOURCES: American Medical Association House of Delegates Interim Meeting. J. Edward Hill, MD, Tupelo, Miss. Christopher DeRienzo, Duke University School of Medicine, Durham, N.C.Billie Jackson, MD, Macon, Ga.