Medical Institute for Sexual Health P.O. Box 162306 Austin, TX 78716 512.328.6268 800.892.9484
Coming Events!
Coming April 2010: Building Family Connections Curriculum Training
Are you interested in providing a class for parents about sexual health and forming healthy relationships? Consider attending the next Building Family Connections (BFC) Curriculum Training event scheduled for April 20-22, 2010 in Chicago. The BFC curriculum was developed by MI to equip parents with the information necessary to improve parent-child communication about important topics of sexual health. After attending this dynamic, interactive 3-day BFC curriculum training, you will be prepared to go out into you own community and deliver this curriculum to parents and parenting adults, thereby making a difference in the lives of youth and the health of your community. For more information about the event or registration, please contact Melissa Steiner at msteiner@medinstitute.org.
Coming April 2010: Online Medical Accuracy training!
It is time to learn how to find the most current credible sexual health information on the Internet. This innovative online training demonstrates how to search PubMed databases and the Internet to find medically accurate health information. It also introduces strategies for evaluating the medical accuracy of information found in the media, medical journals, and Internet.
The training program is spread over two sessions and all participants who complete both training sessions receive a Medical Accuracy Training certificate. You will only need a computer with Internet connection and a phone to attend the training. You can get trained without any travel -- sitting right at your desk at home or in your office.
The dates of the next training are: Session 1: April 29, 2010 -- 11:30 AM - 1:30 PM Central Time Session 2: May 6, 2010 -- 11:30 AM - 1:30 PM Central Time
Plans are underway for a Clinical Intervention Seminar in Austin, TX on August 12, 2010. For further details and registration information, please call Austin LifeGuard at 512.374.0074.
Abstinence Ed Program Successfully Delays Sexual Debut
Early sexual involvement can lead to serious consequences in adolescents, such as sexually transmitted infections (STIs) and unintended pregnancies. According to the CDC, African American adolescents are a highly vulnerable population, representing only 17% of 13-19 year olds in the US but accounting for 72% of the HIV/AIDS cases in this age group in 2007.1 Understanding the severity of the problem, Drs. John and Loretta Jemmott designed a study to evaluate several different sexual health educational interventions with the primary objective of delaying sexual initiation in young adolescents.2 The randomized controlled trial included four different educational interventions: an 8-hour abstinence-only intervention, emphasizing risk avoidance; an 8-hour safer sex-only intervention, emphasizing condom use for reducing the risk of pregnancy and sexually transmitted infections (STIs); and two comprehensive interventions, one 8-hour and one 12-hour, emphasizing both abstinence and condom use. Additionally, the researchers included an 8-hour health-promotion class that emphasized health issues unrelated to sexual behavior to serve as a control.
Participants included 662 African American students in grades 6 and 7 from 4 public middle schools who agreed to attend the weekend educational sessions. The participants were randomly assigned to one of the intervention groups or the control group. Questionnaires were used to collect the self reported sexual behavior data of the adolescents several times up to 24 months after the intervention.
After 24 months, only the abstinence-only intervention was effective in preventing adolescents from engaging in sexual intercourse, with 33% fewer students initiating sexual intercourse in the abstinence intervention than in the health-promotion control group. None of the other interventions showed a significant decrease in the number of students initiating sexual intercourse when compared to the control students. A second important finding from the research study was that the abstinence-only intervention participants did not differ from the control group in the use of condoms when they did initiate sexual intercourse. And, lastly, several interventions were associated with a decrease in multiple partners. Both the 8- and 12-hour comprehensive interventions were associated with a significant reduction in reports of multiple partners compared with the control group. Also, students in the abstinence-only and 12-hour comprehensive interventions who received follow-up educational and counseling sessions were significantly less likely to have multiple partners compared to controls.
The researchers concluded that the abstinence-only intervention had the most dramatic effect on the prevention of adolescent sexual involvement. However, some limitations of the trial should be highlighted. The population that was targeted with these interventions was African-American middle school students in 4 public schools who were willing to attend educational classes on the weekend, limiting the generalizability of the findings to other populations, other age-groups, and even other students within this community. Also, the data were collected using self reports, which make it vulnerable to inaccuracy due to lack of memory or untruthful responses. However, the researchers took measures to encourage honest and accurate responses. They also performed a statistical analysis of the results for evidence of biased answers and found none.
Despite these limitations, this research has yielded some promising results that suggest abstinence-based education may play an important role in preventing early adolescent sexual involvement. Through rigorous design, implementation, and program evaluation, the researchers demonstrated that their "abstinence-only" intervention was the only intervention that significantly delayed sexual debut, outperforming both of the comprehensive education interventions. It is important to note, though, that the success of this educational intervention may not be representative of the outcomes in other abstinence programs. Since the abstinence education program used in the study was tailored to the target population, it was not designed to meet federal CBAE and Title V criteria for an abstinence education program,
Microsoft Word - NAKED GIRLSsuggesting that this intervention may have some inherent differences from other current abstinence education programs. Also, this sexual health program was not school-based. Like many other effective sexual health programs that have been detailed in scientific publications to date, this educational intervention took place outside of the typical classroom setting and used a format that may not be replicable in many schools.
However, these results do clearly emphasize the need for 1) rigorous evaluation of abstinence-based and comprehensive sexual health programs, 2) meticulous sexual health program planning tailored to the target population, and 3) maintenance programs that follow up and reinforce the primary messages of a sex education intervention, whether abstinence or comprehensive. As always, any sex education program for our youth should convey objective, scientifically accurate information. The Medical Institute's message remains unchanged that risk avoidance is the most effective option for preventing the emotional and physical consequences of risky sexual behavior. Providing our youth with evidence-based information can help them make the healthiest life choices.
References: 1. Centers for Disease Control and Prevention. HIV/AIDS Surveillance in Adolescents and Young Adults (through 2007) Slide Set. Available at: http://www.cdc.gov/hiv/topics/surveillance/resources/slides/adolescents/index.htm. Accessed 2010 Feb 4. 2. Jemmott JB, Jemott LS, Fong GT. Efficacy of a theory-based abstinence-only intervention over 24 months: a randomized controlled trial with young adolescents. Arch Pediatr Adolesc Med 2010;164(2):152-9.
HIV Module Updated!
The HIV module in the Optimal Sexual Health Slide Set has been updated and is now available for download by Gold and Platinum members.
The Optimal Sexual Health slide set is a collection of over 800 downloadable slides that provides information on sexually transmitted infections, nonmarital pregnancy, alternate sexual practices, abstinence, marriage and family, anatomy and physiology, parenting, contraceptives, and condoms. Designed for educators, health professionals, and other concerned individuals trying to make a difference in their community, the Optimal Sexual Health slide set facilitates sexual health presentations by providing up-to-date, scientifically accurate slides and speakers notes, all heavily referenced with reliable sources. By joining at the Gold level, members can enjoy use of the Optimal Sexual Health slides for their sexual health presentations. By joining at the Platinum level, members can download both the slides and the speaker's notes, a powerful combination of visual aids and thorough background information. Join now to immediately begin downloading and using this important educational resource.
For more information about the Optimal Sexual Health slide set or the benefits of membership, please visit our website at www.medinstitute.org and click on "Join Today."
Fast Fact of the Month
Over 730,000 people in the United States are living with HIV/AIDS, and about 56,000 new HIV infections occur every year.
Centers for Disease Control and Prevention. HIV/AIDS Surveillance Report, 2007. Vol. 19. Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention; 2009:1-63. Available at: http://www.cdc.gov/hiv/topics/surveillance/resources/reports/2007report/pdf/2007SurveillanceReport.pdf. Accessed 2010 Feb 12.
Message from the President/CEO
As the "abstinence" v. "comprehensive" sex education battle rages on, it's sometimes hard to make much sense of it all. The Jemmott and Jemmott studydiscussed in some detail elsewhere in this Advisory is obviously of great significance. Unfortunately, it is being, by some, heralded as being more than it truly is, while, by others, unfairly debunked as less than it is. Let's look at the facts.
On the one hand, the study is being criticized as involving only a two year follow up of sexual activity among younger teens. Not only does this criticism minimize the benefits of a 2 year follow up period, which is a substantial length that is uncommon in studies of this kind, but it also minimizes the true import of delaying initiation of sexual activity for two years. Incontrovertible data consistently affirm that a delay of two years in sexual debut greatly decreases the number of lifetime partners and, thereby, greatly decreases the risk of contracting numerous STIs.
Critics also argue that the self styled "abstinence-only" program tested by the Jemmott study was different than the federally funded "A-H" abstinence programs. The study itself confirms this to be true. There was no evaluation in the Jemmott study of any "A-H" intervention, so obviously no direct claim can be made either way regarding such programs. There are studies dealing directly with a number of "A-H" programs, some showing very positive results, and some not. Unfortunately, the discontinuance of funding for "A-H" programs just as many of them are becoming ripe for meaningful evaluation may well prevent obtaining the very data needed to draw conclusions regarding effectiveness.
But what is clear is that the "abstinence-only" program tested by Jemmott provided positive results. So isn't the obvious conclusion that significant efforts should be made to replicate this type of program or at least those of its elements which seem to yield positive results, and incorporating these elements into other programs? This does not mean, in and of itself, that all "A-H" programs or all "comprehensive sex" programs should be scratched. It only means that each must prove its value on its own, through appropriate and rigorous evaluation. But supporting a clear winner, such as the Jemmott "abstinence-only" initiative, seems like a no-brainer.
