Let’s not judge sex-ed effectiveness on teen pregnancy alone.

Tom at Family Scholars Blog writes:

Given that everyone wants to reduce teen pregnancy, why can’t we just agree to go with what has been shown to work? Increasingly, I see earmarked funds for abstinence-only education as financial handouts to the Bush Administration’s social conservative base. To be sure, I don’t support throwing condoms at kids. Comprehensive sex-ed programs that don’t work should not be supported, either. But there has been a fair amount of research as to what works. We should use this knowledge. Believe me, if there was any convincing evidence that abstinence-only programs worked, I’d support them.

With the caveat that parents should be able to expect transparency and some degree of control over the curriculum presented to their own children, public policy should definitely throw its weight behind programs that are proven to further public goals.  And reducing teenage pregnancy is indeed a laudable public-health goal.

I have two questions for Tom about the specific programs that are shown to reduce teenage pregnancy:

1. Are these same programs also proven to reduce rates of sexually transmitted infections among teenagers? Surely this is an equally laudable public-health goal.
2. How do these programs affect the age of onset of sexual behavior, compared to other programs? Surely delaying the onset of sexual behavior is also a laudable goal, if perhaps not as urgent (from a public health standpoint) as reducing teen pregnancies and STIs.

It isn’t self-evident that the programs that best reduce teenage pregnancy are the same programs that best reduce STI rates, because these different results are produced by different behavior sets.   A decrease in teen pregnancy could be caused by increased use of oral or injectable contraceptives, neither of which offers any protection whatsoever against STIs.  And even condoms are not very effective against the transmission of human papilloma virus (HPV) or herpes, both of which have lifelong consequences.

Nor is it self-evident that declines in teen pregnancy correspond to children waiting longer before becoming sexually active.  Perhaps they are substituting oral and anal intercourse for vaginal intercourse.  Perhaps they are using contraceptives more frequently.  These do not protect against emotional entanglements too complex for their maturity level.

So I’m curious if one class of programs is effective in all three of these areas. Teen pregnancy isn’t the only measure worth studying.