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Wednesday 23rd May 2018

Abstinence alone 'won't help' HIV

27th July 2007

Programmes that rely exclusively on promoting sexual abstinence show little effect on sexual behaviour or on the incidence of HIV infection in high-income countries, a recent study has shown.


Abstinence programmes, which are favoured by some groups for religious reasons, aim to teach the social, health and psychological benefits of abstaining from sex, with especial emphasis on the potential harms caused by extramarital sex.

The study used data from 13 separate trials involving 15,940 young people in the United States, and compared it with outcomes in comparable control groups.

Participants self reported the incidence of unprotected vaginal sex, number of partners, condom use and sexual initiation. Some data appeared to show a greater degree of protection a short time after the inception of the programme, but longer-term data cancelled out this effect, according to a team of researchers at Oxford University.

Abstinence-only interventions encourage both primary abstinence (delaying sexual debut) and secondary abstinence (returning to abstinence after sexual activity), mostly among adolescents. Settings can be schools, community centres, family homes or faith-based groups.

A higher level of safer sex education seemed to be associated with programmes which had HIV prevention as one of their stated aims. Such programmes warned of HIV risk attached to oral sex, anal sex, same-sex activity and non-sexual means of transmission.

The researchers said they chose a high-income setting so as to minimise other factors linked to HIV transmission, such as poverty. They were also interested in conducting an apolitical review which would rely on methodological rigour rather than political sentiment, which runs high around such topics, especially in the United States.

In conclusion, the authors said: "The most methodologically rigorous reviews have consistently documented no evidence that abstinence only programmes can reduce risky sexual behaviour." However, they added that their reviews were limited to youths and did not exclusively examine abstinence only programmes for HIV prevention.

The team extracted data for biological outcomes (for example, HIV incidence) and behavioural outcomes (for example, unprotected vaginal sex), as these are most directly related to the sexual acquisition of HIV. Outcomes for same sex sexual behaviour were included. Only programmes aimed exclusively at HIV positive people were excluded.


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