Experts Challenge Sex Report

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Experts Challenge Sex Report

Special Report - November 16, 2009
A Centers for Disease Control and Prevention (CDC) task force report that recommends contraceptive-based sex education programs for adolescents is misleading and based on flawed data, according to two members of a consultant panel charged with analyzing the available research on group-based sex education programs for the task force. Their dissenting opinion was issued in response to recommendations from the CDC’s Task Force on Community Preventative Services, which were published November 6, and concluded that group-based comprehensive risk reduction (CRR) programs, which promote contraceptive use, are sufficiently effective at reducing the someof the negative consequences of teen sexual activity. The CDC Task Force recommends, “group-based CRR delivered to adolescents to promote behaviors that prevent or reduce the risk of pregnancy, HIV, and other sexually transmitted infections (STIs).” At the same time, the Task Force concludes that there is “insufficient evidence to determine the effectiveness of group-based abstinence education” to reduce teen pregnancy and STDs, “due to inconsistent results across studies.”

However, two members of the expert panel that reviewed the studies for the CDC disagree with the Task Force’s recommendations. On November 7, Irene Ericksen and Danielle Ruedt, who served on the CDC’s “Adolescent Sex Behavior Coordination Team External Partners” panel, issued a 9-page “Minority Report” in response to the Task Force’s findings. Published by the Institute for Research and Evaluation (IRE), the report details Erickson’s and Ruedt’s concerns about what they consider “serious limitations” in the meta-analysis upon which the Task Force based its recommendations. One of the five points of concern raised by Ericksen and Ruedt is that the report “combined widely divergent types of sex ed programs into a single analysis, and then attempted to draw across-the-board conclusions.”

“The resulting internal inconsistency in the results indicates there are many types of CSE programs that don’t work, yet the study concludes that CSE programs are broadly effective,” said Ericksen in a statement. “This, along with the lack of evidence for school-based programs, makes the study’s recommendations potentially misleading to policy-makers who want to implement evidence-based programs, especially in schools.”

Ericksen and Ruedt also argue that:

While the Task Force recommends CRR programs over Abstinence Education (AE) programs, “the study did not produce statistical evidence that CSE programs offer a real advantage over effective AE programs.”
School-based comprehensive sex education programs failed “to demonstrate effectiveness on three critical outcomes—teen condom use, teen pregnancy or the spread of STDs.”
Although the analysis found no evidence that abstinence education programs decrease condom use among teens that become sexual active, this finding was not included in the Task Force’s final recommendations.

“These limitations lead us to conclude that the statements about the general effectiveness of the comprehensive risk reduction (CRR) strategy are not warranted by the data,” write Ericksen and Ruedt. “They overstate the likelihood that any single CRR program will be effective at protecting the sexual health of adolescents, especially the school-based programs, which are the focus of the public policy debate about sex education and impact the future health of millions of adolescents across the country.” According to Erickson and Ruedt, the Task Force recommendations “also fail to acknowledge the evidence for the effectiveness of abstinence education (AE) programs at reducing teen sexual activity, and invite conclusions that CRR is a superior approach to AE, which is not supported by the evidence.”