A theory-based, abstinence-only intervention appears to be associated with a lower rate of sexual involvement among African American sixth- and seventh-graders and can be combined with other strategies to help reduce the risk of sexually transmitted infections, according to a report in the February issue of Archives of Pediatrics and Adolescent Medicine.

Researchers conducted a randomized controlled trial to evaluate one intervention, an eight-hour abstinence-only program targeting reduced sexual intercourse. A total of 662 African American students (average age 12.2, 53.5 percent girls) were randomly assigned to participate either in the abstinence-only intervention, an eight-hour safer sex–only intervention targeting increased condom use; eight-hour and 12-hour comprehensive interventions targeting both sexual intercourse and condom use; or an eight-hour health-promotion control intervention focusing on issues not related to sexual behavior. Some participants were then randomly selected to receive an intervention maintenance program designed to extend the efficacy of each program.

After 24 months, 84.4 percent of the students were still enrolled in the program. The probability of ever having sexual intercourse by the 24-month follow-up was 33.5 percent in the abstinence-only program and 48.5 percent in the control group attending health promotion courses. Rates in the safer sex and comprehensive programs did not differ significantly from the control group.

In addition, fewer students in the abstinence-only group (20.6 percent) vs. those in the control group (29 percent) reported having sex in the previous three months during the follow-up period. The abstinence-only intervention did not appear to change rates of condom use. The eight-hour and 12-hour comprehensive programs appeared to be associated with reduced reports of having multiple partners when compared with the control group.

"Adolescents risk the deleterious consequences of early sexual involvement including human immunodeficiency virus (HIV), other sexually transmitted infections (STIs) and unintended pregnancies. In the United States, these risks are especially great among African American adolescents," the authors write as background information in the article.

 "Although considerable research suggests that behavioral interventions can reduce sexual behaviors related to risk of STI among adolescents, including younger adolescents aged 11 to 15 years, a public policy debate has revolved around the appropriateness and efficacy of different sexual risk–reduction interventions."

The findings do not indicate that this intervention is the best approach or that other programs should be abandoned, the authors note. "Tackling the problem of STIs among young people requires an array of approaches implemented in a variety of venues," they conclude. "What the present results suggest is that theory-based abstinence-only interventions can be part of this mix. Using theory-based abstinence-only interventions selectively might contribute to the overall goal of curbing the spread of STIs in both the United States and other countries."

Citation: John B. Jemmott III, Loretta S. Jemmott, Geoffrey T. Fong, Arch Pediatr Adolesc Med, February 2010, 164(2),152-159