"Three Decades of Research:" A New Sex Ed Agenda and the Veneer of Science.

The research review, "Three Decades of Research: The Case for Comprehensive Sex Education," by Goldfarb and Lieberman (2021), purports to show "strong support" for the effectiveness of school-based comprehensive sex education (CSE) at producing many benefits beyond its original goals of preventing teen pregnancy and STDs. We reviewed the evidence the study cites in support of these claims, item by item, and found that 1) 80% of the sources cited as supporting evidence for CSE are not studies of CSE programs and 2) of the few cited studies of actual CSE programs, roughly 90% do not meet recommended scientific standards for evidence of program effectiveness. Important to note, contrary to its claims, the study does not show scientific evidence that comprehensive sex education helps prevent child sex abuse, reduces dating/intimate partner violence or homophobic bullying, or that it should be taught to young children in the early grades. Rather than making "the case for CSE," Goldfarb and Lieberman's review gives the appearance of scientific support to a new CSE agenda that the authors articulate and endorse, which includes early sex education, gender ideology, and social justice theory. However, they do not present scientifically reliable confirmatory evidence for that agenda.

Re-Examining the Evidence for School-Based Comprehensive Sex Education: A Global Research Review.

PURPOSE: To evaluate the global research on school-based comprehensive sex education (CSE) by applying rigorous and meaningful criteria to outcomes of credible studies in order to identify evidence of real program effectiveness. METHODS: We examined 120 studies of school-based sex education contained in the reviews of research sponsored by three authoritative agencies: the United Nations Educational, Scientific and Cultural Organization, the U.S. federal Teen Pregnancy Prevention Program, and the Centers for Disease Control and Prevention. Their reviews screened more than 600 hundred studies and accepted only those that reached a threshold of adequate scientific rigor. These included 60 U.S. studies and 43 non-U.S. studies of school-based CSE plus 17 U.S. studies of school-based abstinence education (AE). We evaluated these studies for evidence of effectiveness using criteria grounded in the science of prevention research: sustained positive impact (at least 12 months post-program), on a key protective indicator (abstinence, condom use-especially consistent use, pregnancy, or STDs), for the main (targeted) teenage population, and without negative/harmful program effects. RESULTS: Worldwide, six out of 103 school-based CSE studies (U.S. and non-U.S. combined) showed main effects on a key protective indicator, sustained at least 12 months post-program, excluding programs that also had negative effects. Sixteen studies found harmful CSE impacts. Looking just at the U.S., of the 60 school-based CSE studies, three found sustained main effects on a key protective indicator (excluding programs with negative effects) and seven studies found harmful impact. For the 17 AE studies in the U.S., seven showed sustained protective main effects and one study showed harmful effects. CONCLUSIONS: Some of the strongest, most current school-based CSE studies worldwide show very little evidence of real program effectiveness. In the U.S., the evidence, though limited, appeared somewhat better for abstinence education.

An abstinence program's impact on cognitive mediators and sexual initiation.

OBJECTIVES: To evaluate the impact of an abstinence education program on sexual intercourse initiation and on possible cognitive mediators of sexual initiation for virgin seventh graders in suburban Virginia. METHODS: Measures of sexual behavior and 6 mediating variables were compared at 3 time periods for program participants and a matched comparison group (n=550), controlling for pretest differences. RESULTS: At posttest, program students scored significantly better on 4 of the 6 mediators. After one year, program students had a substantially lower risk of sexual initiation than did comparison students (RR=.457, P=.008). CONCLUSION: The program achieved a significant reduction in teen sexual initiation, and the role of the cognitive mediators was supported.

The effectiveness of group-based comprehensive risk-reduction and abstinence education interventions to prevent or reduce the risk of adolescent pregnancy, human immunodeficiency virus, and sexually transmitted infections: two systematic reviews for the Guide to Community Preventive Services.

CONTEXT: Adolescent pregnancy, HIV, and other sexually transmitted infections (STIs) are major public health problems in the U.S. Implementing group-based interventions that address the sexual behavior of adolescents may reduce the incidence of pregnancy, HIV, and other STIs in this group. EVIDENCE ACQUISITION: Methods for conducting systematic reviews from the Guide to Community Preventive Services were used to synthesize scientific evidence on the effectiveness of two strategies for group-based behavioral interventions for adolescents: (1) comprehensive risk reduction and (2) abstinence education on preventing pregnancy, HIV, and other STIs. Effectiveness of these interventions was determined by reductions in sexual risk behaviors, pregnancy, HIV, and other STIs and increases in protective sexual behaviors. The literature search identified 6579 citations for comprehensive risk reduction and abstinence education. Of these, 66 studies of comprehensive risk reduction and 23 studies of abstinence education assessed the effects of group-based interventions that address the sexual behavior of adolescents, and were included in the respective reviews. EVIDENCE SYNTHESIS: Meta-analyses were conducted for each strategy on the seven key outcomes identified by the coordination team-current sexual activity; frequency of sexual activity; number of sex partners; frequency of unprotected sexual activity; use of protection (condoms and/or hormonal contraception); pregnancy; and STIs. The results of these meta-analyses for comprehensive risk reduction showed favorable effects for all of the outcomes reviewed. For abstinence education, the meta-analysis showed a small number of studies, with inconsistent findings across studies that varied by study design and follow-up time, leading to considerable uncertainty around effect estimates. CONCLUSIONS: Based on these findings, group-based comprehensive risk reduction was found to be an effective strategy to reduce adolescent pregnancy, HIV, and STIs. No conclusions could be drawn on the effectiveness of group-based abstinence education.