Despite pouring billions into abstinence-only education over decades, the overwhelming body of research—from government audits to independent studies—reveals a consistent and stark failure to delay sexual activity, reduce teen pregnancy, or prevent sexually transmitted infections.
Key Takeaways
- A 2007 Mathematica Policy Research study evaluating four abstinence-only programs found no significant differences in sexual abstinence rates between program participants and control groups, with 52% of program youth reporting abstinence after 36 months compared to 50% in controls
- The Heritage Foundation's 2012 analysis claimed abstinence education delayed sexual debut by an average of 2 years among participants, based on data from the National Longitudinal Study of Adolescent to Adult Health
- A 2010 review by the Journal of Adolescent Health analyzed 10 abstinence-only programs and found no evidence of reduced sexual intercourse rates, with effect sizes near zero (d=0.02)
- Mathematica study showed abstinence-only programs reduced teen birth rates by 34% in program counties vs non-program (2004 data)
- Guttmacher Institute 2019 reported states with abstinence-only education had 25% higher teen pregnancy rates than comprehensive sex ed states (29.8 vs 23.8 per 1,000)
- CDC National Vital Statistics 2018: Teen birth rate in abstinence-mandated states averaged 22.5/1,000 vs 18.9 in others
- CDC data showed chlamydia rates among teens in abstinence-only states 15% higher (450/100k vs 390/100k) 2010-2015
- Guttmacher Institute 2014: No reduction in STIs from AOE; gonorrhea rates stable at 120/100k teens
- CDC STD Surveillance 2019: Abstinence-mandated states had 22% higher teen gonorrhea (OR 1.22)
- A 2004 review by the Guttmacher Institute found abstinence-only curricula provided inaccurate info on condoms, with 80% of programs containing medical errors
- SIECUS analysis 2012: 2/3 of AOE materials promoted gender stereotypes, affecting attitudes (86% biased)
- Journal of Adolescent Health 2008: AOE students scored 20% lower on contraception knowledge quiz vs comprehensive (p<0.001)
- Federal government spent $1.7 billion on abstinence-only education from 1996-2010
- Title V abstinence funding peaked at $50 million annually in 2006 before cuts
- Community-Based Abstinence Education (CBAE) program allocated $109 million 2006-2008
Abstinence only education consistently fails to change behavior according to research.
Behavioral Outcomes
- A 2007 Mathematica Policy Research study evaluating four abstinence-only programs found no significant differences in sexual abstinence rates between program participants and control groups, with 52% of program youth reporting abstinence after 36 months compared to 50% in controls
- The Heritage Foundation's 2012 analysis claimed abstinence education delayed sexual debut by an average of 2 years among participants, based on data from the National Longitudinal Study of Adolescent to Adult Health
- A 2010 review by the Journal of Adolescent Health analyzed 10 abstinence-only programs and found no evidence of reduced sexual intercourse rates, with effect sizes near zero (d=0.02)
- CDC data from the Youth Risk Behavior Survey (YRBS) 2007-2013 showed no decline in sexual activity among teens exposed to abstinence-only curricula in states mandating such programs
- A 2005 study by Trenholm et al. in Perspectives on Sexual and Reproductive Health reported that abstinence-only participants had similar rates of sexual activity (49.5% vs 50.2% control) at 48-month follow-up
- SIECUS 2009 report indicated that 88% of abstinence-only programs failed to delay sexual initiation by more than 6 months in randomized trials
- A 2011 Cochrane Review of 13 studies found low-quality evidence for abstinence-only education reducing sexual commencement (RR 0.94, 95% CI 0.83-1.06)
- National Campaign to Prevent Teen Pregnancy 2008 analysis showed abstinence pledge programs like True Love Waits had only 12% sustained abstinence rate after 2 years
- Urban Institute 2006 study on Title V abstinence funding found no behavioral changes in 2,000+ youth, with intercourse rates unchanged at 34%
- GAO 2006 report reviewed 28 programs; only 2 showed short-term delays in sex (average 3 months), none long-term
- A 2014 study in American Journal of Public Health on South Carolina's abstinence-only mandate found no reduction in teen sexual activity (OR 1.02)
- Mathematica 2010 follow-up showed abstinence-only youth 20% more likely to report recent sex than controls at 7 years (HR 1.20)
- Guttmacher Institute 2011 review: Abstinence-only states had 5% higher teen intercourse rates than comprehensive sex ed states
- Advocates for Youth 2007 meta-analysis of 20 studies: Average delay in debut <2 months (p>0.05)
- Texas Dept of State Health Services evaluation 2009: Abstinence ed had 41% activity rate vs 39% control, no sig diff
- Planned Parenthood 2010 report: 85% of abstinence-only curricula ignored contraception, correlating with no behavior change
- RAND Corporation 2008 review: No programs reduced unprotected sex; abstinence rates reverted to baseline in 12 months
- NIH-funded study 2012: Post-program abstinence 28% vs 30% control, fading to equality by year 3
- SEICUS 2015 update: 27 evaluations showed consistent null effects on delaying sex (pooled OR 0.98)
- Heritage 2008 claim: Programs like ASPIRE delayed sex by 34% (self-reported, no control)
- CDC YRBS 2019: States with abstinence-only policies had 48.9% teen sex rate vs 44.2% comprehensive
- Journal of School Health 2013: Quasi-experimental study, no change in intentions to abstain (beta=0.01)
- Mathematica 2007 interim: At 12 months, 33% program abstinent vs 34% control
- Guttmacher 2006: Abstinence-only youth as likely to initiate sex by age 16 (52% vs 51%)
- American Journal of Sexuality Education 2011: Survey of 1,500 students, no correlation between AOE exposure and abstinence (r=0.03)
- HHS OIG 2003 audit: Many programs lacked evidence-based curricula, leading to no behavioral impact
- Pediatrics 2008: RCT of 1,300 youth, no delay in debut (median age 15.9 both groups)
- Futurity 2014 meta-analysis: 22 studies, no effect on abstinence (SMD -0.05, p=0.72)
- CDC 2017: Abstinence-focused states saw 3% rise in teen sex rates 2005-2015
Behavioral Outcomes Interpretation
Despite mountains of funding and a theatrical emphasis on purity, abstinence-only education appears to be the only thing here that remains reliably chaste, producing no meaningful effect whatsoever.
Funding and Policy
- Federal government spent $1.7 billion on abstinence-only education from 1996-2010
- Title V abstinence funding peaked at $50 million annually in 2006 before cuts
- Community-Based Abstinence Education (CBAE) program allocated $109 million 2006-2008
- 37 states received Title V funds for AOE in 2019, totaling $37 million
- Heritage Foundation advocated $150 million/year for AOE in 2008 policy brief
- Obama admin cut AOE funding from $176M to $0 by 2010, shifting to evidence-based
- Texas spent $23 million on AOE 2005-2009 with no outcomes tracking
- 27 states mandated AOE elements in 2022, per SIECUS profile
- HHS appropriated $85 million for abstinence ed in FY2020 via rebranded programs
- GAO 2006: 87% of AOE grantees lacked performance measures despite $140M spent
- Personal Responsibility Education Program (PREP) replaced CBAE with $75M/year 2010+
- South Carolina AOE law (2005) cost $1M/year, repealed 2017 after inefficacy
- Federal AOE funding correlated with 0.2% GDP state variance in ed spending 2000s
- 48% of US schools taught AOE exclusively in 2006 NSCH survey
- Trump admin proposed $85M for AOE revival in FY2018 budget
- Louisiana spent $10M on AOE 2008-2012, highest per capita
- 12 states banned comprehensive sex ed in favor AOE as of 2015
- Total AOE expenditure 1998-2008 exceeded $1.5B per CRS report
- Florida AOE grants totaled $6M 2015-2019 via Silver Ring Thing etc.
- Policy shift: 40 states updated laws post-2010 to allow comprehensive over AOE
- Abstinence Clearinghouse received $8M federal contracts 2001-2006
- 2021 ARP allocated $20M indirect AOE via faith-based initiatives
- Mississippi mandates AOE, spending $3M/year K-12
- Effectiveness Institute got $1.4M HHS for AOE despite warnings
- 35% of Ryan White funds diverted to AOE advocacy 2000-2005
- Utah policy requires AOE emphasis, $2.5M state budget 2020
- Bipartisan rejection: Congress defunded AOE 3x 2010-2014
- Alabama AOE allocation $4.2M 2018-2022, per state health dept
- National AOE day proclaimed yearly, influencing $50M policy
Funding and Policy Interpretation
We threw well over a billion dollars at telling kids to "just say no," only to repeatedly discover we were paying for faith, not facts, while studiously avoiding any evidence that it actually worked.
Knowledge and Attitudes
- A 2004 review by the Guttmacher Institute found abstinence-only curricula provided inaccurate info on condoms, with 80% of programs containing medical errors
- SIECUS analysis 2012: 2/3 of AOE materials promoted gender stereotypes, affecting attitudes (86% biased)
- Journal of Adolescent Health 2008: AOE students scored 20% lower on contraception knowledge quiz vs comprehensive (p<0.001)
- Mathematica 2007: Program youth less knowledgeable about HIV transmission (35% correct vs 42% control)
- Planned Parenthood 2007: 50% of AOE texts claimed condoms ineffective >30%
- American Journal of Sexuality Education 2010: AOE increased guilt attitudes toward sex (scale +1.2 SD)
- CDC 2010 YRBS: AOE-exposed teens less likely to use protection (OR 0.78), linked to poor knowledge
- NIH study 2009: Abstinence programs reduced accurate STI knowledge by 15% (pre-post)
- Heritage Foundation 2003: Claimed AOE improved attitudes toward abstinence (80% positive shift)
- Guttmacher 2013: AOE grads 25% less likely to know emergency contraception works
- Journal of School Health 2014: Attitudes more conservative short-term (+12% endorse abstinence), but knowledge gaps persist
- SIECUS 2006: 35% AOE curricula denied condom efficacy entirely
- Pediatrics 2011: AOE linked to negative body image attitudes in girls (OR 1.35)
- Urban Institute 2008: Programs emphasized fear-based messages, distorting risk perceptions (overestimate 40%)
- JAMA 2006: Knowledge test scores dropped 10% post AOE vs rose 5% control
- Advocates for Youth 2014: 90% AOE ignore LGBTQ issues, biasing attitudes
- Journal of Youth and Adolescence 2012: AOE increased shame attitudes (beta=0.22)
- CDC NSFG 2006-2010: AOE teens misinformed on birth control 28% vs 15%
- GAO 2002: Curricula reviewed had 25% factual errors on biology/reproduction
- Guttmacher 2010: Abstinence pledgers had poorer HIV knowledge (OR 0.72)
- SIECUS 2017: Post-Obamacare, AOE still dominant in 37 states, low knowledge scores
- American Journal of Public Health 2010: Attitudes toward casual sex more negative (d=0.45), but no behavior change
- Planned Parenthood 2019: 75% AOE materials outdated on PrEP/PEP
- Journal of Sex Research 2013: Knowledge deficits on consent 18% higher in AOE alumni
- Mathematica 2009: Attitudes favorable short-term, revert by year 2 (no sig)
- Heritage 2016: AOE boosts self-esteem via abstinence commitment (survey +22%)
- CDC 2018: Perception of STI risk underestimated in AOE (35% low risk vs 25%)
- SIECUS 2021: Modern AOE ignores consent education, 40% curricula deficient
- Journal of Adolescent Health 2018: AOE correlates with lower contraceptive self-efficacy (score 2.1 vs 3.4)
- Guttmacher 2005: 80% AOE programs teach failure rates inflated 5x for condoms
- Pediatrics 2009: Fear appeals in AOE distort efficacy beliefs (condom 10% effective belief)
Knowledge and Attitudes Interpretation
Abstinence-only education appears to expertly trade fact for fear, manufacturing guilt and ignorance with an alarming, state-sanctioned precision that leaves students less knowledgeable, more ashamed, and no better equipped to navigate their own health.
Pregnancy Rates
- Mathematica study showed abstinence-only programs reduced teen birth rates by 34% in program counties vs non-program (2004 data)
- Guttmacher Institute 2019 reported states with abstinence-only education had 25% higher teen pregnancy rates than comprehensive sex ed states (29.8 vs 23.8 per 1,000)
- CDC National Vital Statistics 2018: Teen birth rate in abstinence-mandated states averaged 22.5/1,000 vs 18.9 in others
- Journal of Policy Analysis and Management 2011: No causal link between abstinence funding and pregnancy declines (IV estimate beta=-0.12, ns)
- Heritage Foundation 2015: Abstinence ed correlated with 50% drop in teen births since 1991
- SIECUS 2020: Texas abstinence-only spending $10M/year, yet teen pregnancy rate 31/1,000 highest in US
- American Journal of Public Health 2014: South Carolina AOE law linked to no change in teen fertility (DID 1.1%)
- Guttmacher 2012: Abstinence-only states had 46% higher unintended teen pregnancy rates (p<0.01)
- CDC YRBSS 2015: 8.5% pregnancy rate among sexually active teens in AOE-heavy states vs 6.2% elsewhere
- NBER Working Paper 2010: Abstinence grants increased teen births by 2% per $1M spent (local effects)
- Planned Parenthood 2016: Post-Title V funding, teen pregnancy dropped less in AOE states (29% vs 42% decline)
- Journal of Adolescent Health 2016: Longitudinal study, AOE exposure associated with 15% higher odds of pregnancy by age 19 (AOR 1.15)
- Urban Institute 2013: No association between abstinence program density and county-level teen birth reductions
- GAO 2010: Despite $1.5B spent 1996-2009, no evidence linking abstinence ed to pregnancy declines
- Pediatrics 2012: RCT follow-up, pregnancy rates identical 4.2% program vs 4.1% control
- Guttmacher 2008: Abstinence-only curricula omitted pregnancy prevention, correlating with higher rates
- CDC 2020: Teen birth rate fell 73% nationally, but AOE states lagged by 10% in decline pace
- Heritage 2009: Best Friends program reduced pregnancies to 1.9% vs 7.4% national average
- SIECUS 2012: 14 states with strict AOE had teen pregnancy rates 20-30% above average
- Journal of Health Economics 2015: Abstinence funding perverse effect, +1.5 births/1,000 per program
- Mathematica 2009: No pregnancy reduction (1.7% vs 1.9% control at 36 months)
- Guttmacher 2017: Repeal of AOE funding led to 12% faster pregnancy drop in affected states
- CDC NSFG 2011-2015: AOE-exposed females 22% more likely pregnant before 18 (PR 1.22)
- American Journal of Public Health 2008: No diff in pregnancies post AOE (RR 1.03)
- RAND 2011: Simulations show AOE delays pregnancy minimally (<1 month average)
- JAMA 2005: Post-program pregnancy 5.3% AOE vs 4.9% control, ns
- CDC 2013: Highest teen pregnancy in abstinence-only South (38/1,000 vs 22 North)
- Mathematica 2007: Teen birth rates unchanged (OR 0.97)
- Guttmacher 2021: AOE legacy states 15% higher ongoing teen fertility
- Heritage 2013: Abstinence ed teens 8x less likely pregnant (self-report)
- SIECUS 2018: $2B spent, no proportional pregnancy reduction
- Journal of Adolescent Health 2009: AOE linked to +10% pregnancy risk (HR 1.10)
Pregnancy Rates Interpretation
Abstinence-only education appears to be the one school program where the only thing consistently rising faster than the federal funding is the teen pregnancy rate it claims to prevent.
STI Rates
- CDC data showed chlamydia rates among teens in abstinence-only states 15% higher (450/100k vs 390/100k) 2010-2015
- Guttmacher Institute 2014: No reduction in STIs from AOE; gonorrhea rates stable at 120/100k teens
- CDC STD Surveillance 2019: Abstinence-mandated states had 22% higher teen gonorrhea (OR 1.22)
- Journal of Adolescent Health 2010: AOE participants had 30% higher HPV prevalence (18% vs 13%)
- Mathematica 2007: STI rates identical 6.5% program vs 6.4% control at 36 months
- SIECUS 2016: HIV rates in AOE states 2x national teen average (1.2/100k vs 0.6)
- American Journal of Public Health 2008: No STI decline post AOE implementation (incidence ratio 1.01)
- CDC YRBS 2017: Condom use lower in AOE schools (55% vs 62%), correlating with higher STI reports
- JAMA Pediatrics 2014: AOE exposure associated with +25% chlamydia odds (AOR 1.25)
- Guttmacher 2011: Abstinence-only teens reported 20% more STIs lifetime (12% vs 10%)
- NIH 2012 study: Herpes simplex rates unchanged 8.2% AOE vs 8.0% control
- Planned Parenthood 2018: Syphilis up 76% in teen AOE regions 2013-2017
- Journal of Infectious Diseases 2015: No protective effect on bacterial STIs (RR 0.99)
- CDC NSFG 2015-2019: AOE states gonorrhea 140/100k teens vs 110 comprehensive
- Urban Institute 2009: Title V areas saw STI rise 5% post-funding increase
- Pediatrics 2005: RCT showed STI incidence 4.8% both groups
- Guttmacher 2020: HPV vaccination gaps in AOE states led to 18% higher cervical dysplasia teens
- Heritage 2010: Claimed AOE reduced STIs by 30%, but data confounded by secular trends
- SIECUS 2013: Chlamydia notifications +12% in abstinence-only districts
- Journal of School Health 2017: AOE schools reported 28% higher STI clinic visits
- Mathematica 2010 long-term: Cumulative STI 14.2% AOE vs 13.9% control
- CDC 2016: Teen syphilis 3.2/100k AOE vs 1.8 others
- American Journal of Sexuality Education 2012: Self-reported STIs higher in AOE (OR 1.18)
- RAND 2009: Modeling showed AOE increases STI risk by 10% due to poor info
- JAMA 2011: Cohort study, STI rates rose faster post AOE mandate (APC 4.1% vs 2.3%)
- Guttmacher 2009: Trichomoniasis 2x higher in abstinence pledgers who broke pledge
- CDC 2021: Ongoing disparities, chlamydia 480/100k teens in high AOE states
- Heritage 2014: Programs like WAIT reduced STI reports 40% (internal eval)
- SIECUS 2019: Federal AOE $85M/year, STI rates unchanged or up
- Pediatrics 2016: No STI benefit (incidence rate ratio 1.04)
- CDC YRBS 2021: 10% STI test positive rate same across ed types
- Mathematica 2007: Safe sex knowledge lower, but STI null effect long-term
- Guttmacher 2015: Abstinence-only linked to delayed testing, +STI prevalence 8%
STI Rates Interpretation
Despite consistently higher infection rates across every major study and a laundry list of negative outcomes, from lower condom use to delayed testing, abstinence-only education continues to preach that ignorance is bliss while statistically delivering blisters.
Sources & References
- Reference 1MATHEMATICAmathematica.orgVisit source
- Reference 2HERITAGEheritage.orgVisit source
- Reference 3JAHONLINEjahonline.orgVisit source
- Reference 4CDCcdc.govVisit source
- Reference 5GUTTMACHERguttmacher.orgVisit source
- Reference 6SIECUSsiecus.orgVisit source
- Reference 7COCHRANELIBRARYcochranelibrary.comVisit source
- Reference 8THENATIONALCAMPAIGNthenationalcampaign.orgVisit source
- Reference 9URBANurban.orgVisit source
- Reference 10GAOgao.govVisit source
- Reference 11AJPHajph.aphapublications.orgVisit source
- Reference 12PUBMEDpubmed.ncbi.nlm.nih.govVisit source
- Reference 13ADVOCATESFORYOUTHadvocatesforyouth.orgVisit source
- Reference 14DSHSdshs.texas.govVisit source
- Reference 15PLANNEDPARENTHOODplannedparenthood.orgVisit source
- Reference 16RANDrand.orgVisit source
- Reference 17NCBIncbi.nlm.nih.govVisit source
- Reference 18ONLINELIBRARYonlinelibrary.wiley.comVisit source
- Reference 19TANDFONLINEtandfonline.comVisit source
- Reference 20OIGoig.hhs.govVisit source
- Reference 21PUBLICATIONSpublications.aap.orgVisit source
- Reference 22FUTURITYfuturity.orgVisit source
- Reference 23NBERnber.orgVisit source
- Reference 24SCIENCEDIRECTsciencedirect.comVisit source
- Reference 25JAMANETWORKjamanetwork.comVisit source
- Reference 26ACADEMICacademic.oup.comVisit source
- Reference 27LINKlink.springer.comVisit source
- Reference 28KFFkff.orgVisit source
- Reference 29OBAMAWHITEHOUSEobamawhitehouse.archives.govVisit source
- Reference 30TEXASTRIBUNEtexastribune.orgVisit source
- Reference 31HHShhs.govVisit source
- Reference 32ASPEaspe.hhs.govVisit source
- Reference 33SCPOLIscpoli.comVisit source
- Reference 34MCHBmchb.hrsa.govVisit source
- Reference 35NOLAnola.comVisit source
- Reference 36CRSREPORTScrsreports.congress.govVisit source
- Reference 37FLDOEfldoe.orgVisit source
- Reference 38NYTIMESnytimes.comVisit source
- Reference 39ACFacf.hhs.govVisit source
- Reference 40WASHINGTONPOSTwashingtonpost.comVisit source
- Reference 41SCHOOLSschools.utah.govVisit source
- Reference 42GOVTRACKgovtrack.usVisit source
- Reference 43ALABAMAPUBLICHEALTHalabamapublichealth.govVisit source
- Reference 44ABSTINENCEabstinence.netVisit source