Abstinence-Only-Until-Marriage: An Updated Review of U.S. Policies and Programs and Their Impact

Posted by Maria Codina on August 24, 2017 at 8:11 am

Adolescence is marked by the emergence of human sexuality, sexual identity, and the initiation of intimate relations; within this context, abstinence from sexual intercourse can be a healthy choice. However, programs that promote abstinence-only-until-marriage (AOUM) or sexual risk avoidance are scientifically and ethically problematic and—as such—have been widely rejected by medical and public health professionals. Although abstinence is theoretically effective, in actual practice, intentions to abstain from sexual activity often fail. Given a rising age at first marriage around the world, a rapidly declining percentage of young people remain abstinent until marriage. Promotion of AOUM policies by the U.S. government has undermined sexuality education in the United States and in U.S. foreign aid programs; funding for AOUM continues in the United States. The weight of scientific evidence finds that AOUM programs are not effective in delaying initiation of sexual intercourse or changing other sexual risk behaviors. AOUM programs, as defined by U.S. federal funding requirements, inherently withhold information about human sexuality and may provide medically inaccurate and stigmatizing information. Thus, AOUM programs threaten fundamental human rights to health, information, and life. Young people need access to accurate and comprehensive sexual health information to protect their health and lives.

This review article updates our 2006 review of abstinence-only-until-marriage (AOUM) policies and programs promoted by the U.S. government. We use the term AOUM to describe programs and policies that adhere to U.S. federal government funding requirements created in 1996. This update addresses the major changes in AOUM funding and programs, the accumulation of evaluation and observational research, and a better understanding of the impact of AOUM programs on other public health programs and specific groups of adolescents.