Promoting abstinence and fidelity does nothing to reduce teen pregnancies or HIV

Preface. One of the goals of Christian evangelists and fundamentalists is to get enough Supreme Court justices who will stop sex education and ban contraceptives. Bad timing, free birth control and abortion are desperately needed to get the human population down to a carrying capacity of a civilization without fossil fuels, roughly a billion or so people world-wide and 100 million or less in the United States.  That would greatly minimize the death toll and suffering on the other side of the net energy cliff.

Not only that, but spending money on programs to promote abstinence has now been shown to be totally ineffective and a waste of money.

Alice Friedemann  author of “When Trucks Stop Running: Energy and the Future of Transportation”, 2015, Springer and “Crunch! Whole Grain Artisan Chips and Crackers”. Podcasts: Practical Prepping, KunstlerCast 253, KunstlerCast278, Peak Prosperity , XX2 report ]

Richter, R. May 2, 2016. Promoting abstinence, fidelity for HIV prevention is ineffective. Stanford University.

Since 2004, the U.S. President’s Emergency Fund for AIDS Relief, known as PEPFAR, has supported local initiatives that encourage men and women to limit their number of sexual partners and delay their first sexual experience and, in the process, help to reduce the number of teen pregnancies. However, in a study of nearly 500,000 individuals in 22 countries, the researchers could not find any evidence that these initiatives had an impact on changing individual behavior.

“Overall we were not able to detect any population-level benefit from this program,” said Nathan Lo, a Stanford MD/PhD student and lead author of the study. “We did not detect any effect of PEPFAR funding on the number of sexual partners or upon the age of sexual intercourse. And we did not detect any effect on the proportion of teen pregnancy.

“We believe funding should be considered for programs that have a stronger evidence basis,” he added.

PEPFAR was launched in 2004 by President George W. Bush with a 5-year, $15 billion investment in global AIDS treatment and prevention in 15 countries. However, the program’s initial requirement that one-third of the prevention funds be dedicated to abstinence and “be faithful” programs has been highly controversial. Critics questioned whether this approach could work and argued that focusing only on these methods would deprive people of information on other potentially lifesaving options.

Abstinence, faithfulness funding continues

In 2008, the one-third requirement was eliminated, but U.S. funds continued to flow to abstinence and “be faithful” programs, albeit at lower levels. In 2008, $260 million was committed to these programs, but by 2013 by that figure had fallen to $45 million.

“Spending money and having no effect is a pretty costly thing because the money could be used elsewhere to save lives.

Although PEPFAR continues to fund abstinence and faithfulness programs as part of its broader behavior-based prevention efforts, there is no routine evaluation of the success of these programs. “We hope our work will emphasize the difficulty in changing sexual behavior and the need to measure the impact of these programs if they are going to continue to be funded,” Lo said.

Teenage pregnancy rates among a total of 27,000 women in both PEPFAR-funded and nonfunded countries and found no difference in rates between the two.

Bendavid noted that, in any setting, it is difficult to change sexual behavior. For instance, a 2012 federal Centers for Disease Control analysis of U.S.-based abstinence programs found they had little impact in altering high-risk sexual practices in this country.

“Changing sexual behavior is not an easy thing,” Bendavid said. “These are very personal decisions. When individuals make decisions about sex, they are not typically thinking about the billboard they may have seen or the guy who came by the village and said they should wait until marriage. Behavioral change is much more complicated than that.

The one factor that the researchers found to be clearly related to sexual behavior, particularly in women, was education level. Women with at least a primary school education had much lower rates of high-risk sexual behavior than those with no formal education, they found.

“One would expect that women who are educated have more agency and the means to know what behaviors are high-risk,” Bendavid said. “We found a pretty strong association.

See the full press release here.



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