Abstract
Based on a review of 3 purposively selected curricula used in federally funded programs, the authors identified the types of scientific errors about condoms present in abstinence-only education. These curricula explicitly and implicitly convey the message that condoms fail to provide protection against HIV and commonly use out-of-date references. In addition, the curricula often misrepresent cited research, such as by reporting only the highest condom failure rates from study findings. The curricula do not explain differences between typical-use and perfect-use contraceptive failure associated with condom use and often incorrectly compare HIV transmission risk with pregnancy risk. Finally, these curricula use faulty reasoning to explain risk and promote misinformation about condoms (such as condom permeability) that has been repudiated by scientific consensus. The information these curricula present about condoms does not represent complete, current, or accurate medical knowledge about the effectiveness of condoms in preventing sexually transmitted infections, including HIV.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Administration for Children and Families, U. S. Department of Health and Human Services. (2007, March 12). Grants notice: Community-based abstinence education program, funding opportunity number: HHS-2007-ACF-ACYF-AE-0099. Retrieved May 21, 2007, from http://www.acf.hhs.gov/grants/open/ HHS-2007-ACF-ACYF-AE-0099.html
American Academy of Pediatrics, Committee on Psychosocial Aspects of Child and Family Health and Committee on Adolescence. (2001). Sexuality education for children and adolescents. Pediatrics, 108, 498–502.
American Medical Association. (2004). H-170.968 Sexuality education, abstinence, and distribution of condoms in schools. Retrieved July 11, 2007, from http://www.ama-assn.org/apps/pf new/pf online? f n=browse& doc=policyfiles/HnE/H-170.968.HTM
Aral, S., & Holmes, K. (1999). Social and behavioral determinants of the epidemiology of STDs: Industrialized and developing countries. In K. Holmes, P. F. Sparling, P.-A. Mardh, S. M. Lemon, W. E. Stamm, P. Piot, et al., Sexually transmitted diseases (pp. 39–76). New York: McGraw-Hill.
Bethards, B. (2003). Condom availability for adolescents. In American College of Obstetricians and Gynecologists (Ed.), Health care for adolescents (pp. 53–57). Atlanta, GA: Author.
Blake, S. M., Ledsky, R., Goodenow, C., Sawyer, R., Lohrmann, D., & Windsor, R. (2003). Condom availability programs in Massachusetts high schools: Relationships with condom use and sexual behavior. American Journal of Public Health, 93, 955–962.
Casper, C., & Wald, A. (2002). Condom use and the prevention of genital herpes acquisition. Herpes, 9, 10–14.
Dailard, C. (2002). Abstinence promotion and teen family planning: The misguided drive for equal funding. The Guttmacher Report on Public Policy, 5(1), 1–3.
Davis, K. R., & Weller, S. C. (1999). The effectiveness of condoms in reducing heterosexual transmission of HIV. Family Planning Perspectives, 31, 272–279.
Eaton, D. K., Kann, L., Kinchen, S., Ross, J., Hawkins, J., Harris, W. A., et al. (2006). Youth risk behavior surveillance—United States, 2005. MMWR Surveillance Summaries, 55(5), 1–108.
Finer, L. (2007). Trends in premarital sex in the United States, 1954–2003. Public Health Reports, 122, 73–78.
Fischl, M. A., Dickinson, G. M., Scott, G. B., Klimas, M. A., & Parks, W. (1987). Evaluation of heterosexual partners, children, and household contacts of adults with AIDS. Journal of the American Medical Association, 257, 640–644.
Frainie, K. (2002). Why kNOw Abstinence Education programs: Curriculum for sixth grade through high school, teacher’s manual. Chattanooga, TN: AAA Women’s Services.
Frainie, K., & Ritterbush, D. (2006). Why kNOw Abstinence Education programs: Curriculum for sixth grade through high school, teacher’s manual. Chattanooga, TN: Why Know Abstinence Education.
Fu, H. S., Darroch, J. E., Haas, T., & Ranjit, N. (1999). Contraceptive failure rates: New estimates from the 1995 National Survey of Family Growth. Family Planning Perspectives, 31, 56–63.
Furstenberg F. F., Jr., Getz, L. M., Teitler, J. O., & Weiss, C. C. (1997). Does condom availability make a difference? An evaluation of Philadelphia’s health resource centers. Family Planning Perspectives, 29, 123–127.
Haskins, R., & Bevan, C. S. (1997). Abstinence education under welfare reform. Children and Youth Services Review, 19, 465–484.
Hatcher, R. A., Trussell, J., Stewart, F., Nelson, A. L., Cates, W., Jr., Guest, F., et al. (2004). Contraceptive technology. New York: Ardent Media.
Holmes, K., Levine, R., & Weaver, M. (2004). Effectiveness of condoms in preventing sexually transmitted infections. Bulletin of the World Health Organization, 82, 454–461.
Huberman, A. M., & Miles, M. (2002). The qualitative researcher’s companion. Thousand Oaks, CA: Sage.
Jones E. F., & Forrest, J. D. (1989). Contraceptive failure in the United States: Revised estimates from the 1982 National Survey of Family Growth. Family Planning Perspectives, 21, 103–109.
Kantor, L. M., Santelli, J. S., Teitler, J., & Balmer, R. (2008). Abstinence-only policies and programs: An overview. Sexuality Research & Social Policy, 5(3), 6–17.
Kirby, D. B. (2008). The impact of abstinence and comprehensive sex and STD/HIV education programs on adolescent sexual behavior. Sexuality Research & Social Policy, 5(3), 18–27.
Kirby, D., Brener, N. D., Brown, N. L., Peterfreund, N., Hillard, P., & Harrist, R. (1999). The impact of condom distribution in Seattle schools on sexual behavior and condom use. American Journal of Public Health, 89, 182–187.
Kirby, D., Laris, B., & Rolleri, L. A. (2007). Sex and HIV education programs: Their impact on sexual behaviors of young people throughout the world. Journal of Adolescent Health, 40, 206–217.
Miller, A. M., & Schleifer, R. A. (2008). Through the looking glass: Abstinence-only-until-marriage programs and their impact on adolescent human rights. Sexuality Research & Social Policy, 5(3), 28–43.
Morris, M., Handcock, M. S., Miller, W. C., Ford, C. A., Schmitz, J. L., Hobbs, M. M., et al. (2006). Prevalence of HIV infection among young adults in the United States: Results from the Add Health Study. American Journal of Public Health, 96, 1091–1097.
National Institute of Allergy and Infectious Diseases. (2001). Workshop summary: Scientific evidence on condom effectivenessfor sexually transmitted disease (STD) prevention. Bethesda, MD: National Institutes of Health, Department of Health and Human Services.
Potter, S., & Roach, N. (1998). Sexuality, commitment & family: Teacher’s manual. Spokane, WA: Teen-Aid.
Ranjit, N., Bankole, A., Darroch, J. E., & Singh, S. (2001). Contraceptive failure in the first two years of use: Differences across socioeconomic subgroups. Family Planning Perspectives, 33, 19–27.
Roach, N., & Benn, L. (1998). Me, my world, my future: Teacher’s manual. Spokane, WA: Teen-Aid.
Santelli, J. S. (2007). Declaration of John S. Santelli, M.D., M.P.H. Retrieved July 11, 2007, from http://www. aclu.org/reproductiverights/sexed/29486lgl200704 26.html
Santelli, J. S. (in press). Medical accuracy in sexuality education: Ideology and the scientific process. American Journal of Public Health.
Smoak, N. D., Scott-Sheldon, L. A., Johnson, B. T., & Carey, M. P. (2006). Sexual risk reduction interventions do not inadvertently increase the overall frequency of sexual behavior: A meta-analysis of 174 studies with 116,735 participants. Journal of Acquired Immune Deficiency Syndromes, 41, 374–384.
Trenholm, C., Devaney, B., Fortson, K., Quay, L., Wheeler, J., & Clark, M. (2007). Impacts of four Title V, Section 510 abstinence education programs: Final report. Trenton, NJ: Mathematica Policy Research.
Trussell, J. (2004). Contraceptive efficacy. In R. A. Hatcher, J. Trussell, F. Stewart, A. L. Nelson, W. Cates, Jr., F. Guest, et al., Contraceptive technology (pp. 773–846). New York: Ardent Media.
United States House of Representatives Committee on Government Reform—Minority Staff Special Investigations Division. (2004, December). The content of federally funded abstinence-only educationprograms. Retrieved July 11, 2007, from http:// oversight.house.gov/documents/20041201102153-50247.pdf
U.S. Government Accountability Office. (2006a). Abstinence education: Applicability of section 317P of the Public Health Service Act. Washington, DC: Author.
U.S. Government Accountability Office. (2006b). Abstinence education: Efforts to assess the accuracy and effectiveness of federally funded programs. Washington, DC: Author.
Weller, S. C. (1993). A meta-analysis of condom effectiveness in reducing sexually-transmitted HIV. Social Science and Medicine, 36, 1635–1644.
Weller, S., & Davis, K. (2002). Condom effectiveness in reducing heterosexual HIV transmission. The Cochrane Library, 2003(4). Chichester, UK: John Wiley & Sons.
Winer, R. L., Hughes, J. P., Feng, Q., O’Reilly, S., Kiviat, N., Holmes, K. K., et al. (2006). Condom use and the risk of genital human papillomavirus infection in young women. New England Journal of Medicine, 354, 2645–2654.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Lin, A.J., Santelli, J.S. The accuracy of condom information in three selected abstinence-only education curricula. Sex Res Soc Policy 5, 56 (2008). https://doi.org/10.1525/srsp.2008.5.3.56
DOI: https://doi.org/10.1525/srsp.2008.5.3.56