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Date: May 20, 1998
Princeton Researcher Finds ‘Safer Sex’ Message Alters Behavior Longer Than ‘Abstinence’
In this week’s Journal of the American Medical Association, Princeton University psychology professor John Jemmott reports results of the first HIV prevention study to compare the effects of educating teenagers about safe sex with the effects of educating them on abstinence. The results suggest that while both approaches affect sexual behavior in the short term, over the long term the safer-sex program not only increases condom use but may decrease the frequency of sexual contact in some groups. This, Jemmott et al. write, provides evidence "contrary to the common belief that sex education increases sexual activity."
The study followed 659 inner-city African-American sixth- and seventh-graders for one year. The adolescents, 53 percent of whom were girls, volunteered for the "Spruce Adolescent Health Promotion Project," an eight-hour program held on two consecutive Saturdays. Designed by psychologist Jemmott, professor of nursing Loretta Sweet Jemmott of the University of Pennsylvania, and psychologist Geoffrey T. Fong of the University of Waterloo, the "interventions," as they are called, combined group discussions, videos, games, brainstorming, experiential exercises, and skill-building exercises. The interventions were designed to be educational, entertaining, and culturally sensitive.
A control group received interventions on health issues unrelated to sexual behavior, such as cardiovascular disease and stroke. Groups comprised six to eight students, randomly assigned; some were led by adults, others by pairs of peer leaders. The students were asked to report on their behavior at three, six, and twelve months. The follow-up rate was an unusually high 92.5 percent.
After three months, both strategies seemed equally effective: teenagers in the abstinence group reported having sex less often than members of the control group, and teens in the safe-sex group were having less unprotected sex than control group members. But at the six-month and one-year follow-ups, adolescents in the safer-sex group were using condoms more often when they had sexual intercourse than were the teenagers in the control group. Among children who were already sexually active at the start of the program, those in the safer sex group reported having sex less often than did the teenagers who had been told about the benefits of abstinence or those in the control group. In addition, they had fewer unprotected sexual contacts than did teenagers in the control group.
"If the goal [of HIV prevention efforts] is reduction of unprotected sexual intercourse," the authors conclude, "the safer sex strategy may hold the most promise, particularly with those adolescents who are already sexually experienced. Moreover, safer sex interventions may have longer lasting effects than abstinence interventions."
Professor Jemmott, who has been on the Princeton faculty since 1981, teaches health psychology and quantitative methods. He is married to co-author Loretta Sweet Jemmott.