What is Sexual Risk-Avoidance Education?
Sexual Risk-Avoidance (SRA) education is an approach to sex education that focuses on risk-avoidance instead of Sexual Risk-Reduction (SRR) or “comprehensive sex education” when it comes to sexual activity. The term “Sexual Risk-Avoidance” is now used more commonly than the older term “abstinence.” It communicates how this approach mirrors other public health models designed to encourage avoidance instead of reduction of risky behavior, such as underage drinking or the use of illegal drugs. SRA education teaches that avoiding sexual activity before marriage is the surest way to avoid its risks. It also encourages youth to pursue good decision-making skills.
Does Sexual Risk-Avoidance Education Work?
SRA education reduces teen sexual activity by approximately 50%. SRA education decreases sexual initiation, increases abstinent behavior among sexually experienced teens, and/or decreases the number of partners among sexually experienced teens.
A 2010 study demonstrated that SRA education intervention among sixth and seventh graders was by far the most effective type of sex education in reducing sexual initiation among young teens, had no deterrence on the use of condoms, and reduced numbers of sexual partners in contrast to other sex-ed interventions in the same study:
Only 33% of those in the SRA education self-reported to have initiated sexual activity in the 24 month follow-up period. In contrast, about 47% in the general health intervention, 51.8% in the “safer sex” intervention, and about 42% in the “comprehensive sex ed” interventions self-reported to have initiated sexual activity in the 24 month follow-up period.
A majority of young people aged 15 to 17 have not had sex-and the percentage of teens who are abstinent has been growing for at least two decades. Between 1988 and 2010, the percentage of girls in that age group who had never had sexual intercourse rose from 63% to 73%, while the percentage of boys who were abstinent rose from 50% to 72%. Additionally, about 70 percent of parents agreed that it is “against [their] values for [their] adolescents to have sexual intercourse before marriage” and over 60 percent of adolescents believe that sex should be reserved for marriage.
 “Abstinence Works 2010 – Abstinence-Centered Programs that Reduce Teen Sex,” National Abstinence Education Association, February 2010, accessed on March 31, 2014. http://www.abstinenceassociation.org/docs/naea_abstinence_works_2010_preview.pdf. “Abstinence Works” is a compilation of independent, peer-reviewed abstinence-centered research that details numerous studies showing positive behavioral impact among students who participate in abstinence education classes.
 John and Loretta Jemmott, and GT Fong, “Efficacy of a theory-based abstinence-only intervention over 24 months: a randomized controlled trial with young adolescents.” Archives of Pediatrics & Adolescent Medicine, 164 no.2 (2010): 152-9.
 Gladys Martinez, Casey E. Copen, Joyce C. Abma, “Teenagers in the United States: Sexual Activity, Contraceptive Use, and Childbearing, 2006-2010 National Survey of Family Growth,” National Center for Health Statistics. Vital and Health Statistics 23, no. 31 (Oct 2011): Table 1, p. 14. www.cdc.gov/nchs/data/series/sr_23/sr23_031.pdf.
 “National Survey of Adolescents and Their Parents: Attitudes and Opinions about Sex and Abstinence,” Administration for Children and Families, U.S. Department of Health and Human Services, February 26, 2009. http://www.acf.hhs.gov/sites/default/files/fysb/20090226_abstinence1.pdf.
Examples of SRA Education & Results
Best ChoiceSM is a program that teaches youth about Sexual Integrity. The program is generally presented in five 50-minute classes, but each presentation can be tailored to fit various classroom situations as well as larger assemblies. Best ChoiceSM presentations are fast-paced, fun, edgy, informative as well as interactive. The program is available across the entire St. Louis region including St. Charles County, Jefferson County, St. Louis County and St. Louis City schools.
Best ChoiceSM equips young people with the necessary tools to avoid the heartbreak of unplanned pregnancy, sexually transmitted diseases and emotional stress. Teachers have come to rely on our quality presentations that effectively challenge students with the Sexual Integrity message.
As defined by Section 510 of Title V of the Social Security Act, abstinence education is “an educational or motivational program which:
- Has as its exclusive purpose, teaching the social, psychological, and health gains to be realized by abstaining from sexual activity;
- Teaches abstinence from sexual activity outside marriage as the expected standard for all school age children;
- Teaches that abstinence from sexual activity is the only certain way to avoid out-of-wedlock pregnancy, sexually transmitted diseases, and other associated health problems;
- Teaches that a mutually faithful monogamous relationship in the context of marriage is the expected standard of human sexual activity;
- Teaches that sexual activity outside of the context of marriage is likely to have harmful psychological and physical effects;
- Teaches that bearing children out-of-wedlock is likely to have harmful consequences for the child, the child’s parents, and society;
- Teaches young people how to reject sexual advances and how alcohol and drug use increases vulnerability to sexual advances; and
- Teaches the importance of attaining self-sufficiency before engaging in sexual activity.”
New York City Sexuality Education Report. By Miriam Grossman, MD with support by the World Youth Alliance Foundation. August 2011. (pdf format). NYC Sexuality Education Report
Heritage Keepers: A year after receiving the program, students initiated sex at a rate 67 lower than well-matched comparison students. (Source: Weed, S. E., Birch, P. J., Ericksen, I. H., & Olsen, J.A. (2011). Testing a predictive model of youth sexual intercourse initiation. Submitted for publication.)
Choosing the Best: Virgin students who received the program were nearly 1.5 times more likely to delay the onset of sex than virgins in the control group at the post-test measurement at the end of ninth grade. (Source: Lieberman, L., Su, H.(2012). Impact of the Choosing the Best program in communities committed to abstinence education. Sage Open. http://www.choosingthebest.org/docs/CTB_ Published_Research-SAGE_Publications.pdf)
PEERS Project: Each year the SRA abstinence education program was presented, it was associated with a nearly 1.5 percent increase in standard achievement test pass rates. (Source: Ferraro, L.F., Pressler, K.A. (2011). Do abstinence education programs influence high school academic performance? Am. Journal of Health Studies. 26 (4): 230-235.)
WAIT Training: Middle school students who participated in the program were 3.5 times more likely to delay sexual activity and reported fewer multiple partners one year after receiving the program in their health classes as compared to average behaviors from a neighboring community without the program. (Source: Rue, L.A, Chandran, R., Pannu, A., Bruce, D., Singh, R., & Traxler, K. (2012). Evaluation of an abstinence based intervention for middle school students. Journal of Family and Consumer Sciences 104, (3), 32-40).
U. of Pennsylvania Study of Inner City Youth: Only the abstinence intervention significantly reduced sexual initiation:
- Of students in the control group, 46.6 percent initiated sex. Christian Medical Association www.cmda.org Page 9 of 17
- Of students who had received the abstinence intervention, 32.6 percent initiated sex.
- Of students who had received “comprehensive” sex education, 41.8 percent initiated sex.
- Of students who had received “safer sex” education, 51.8 percent initiated sex.
(Source: Jemmott, J. B., Jemmott, L. S., Fong, G. T. (2010). Efficacy of a theory-based abstinence-only intervention over 24 months. Arch Pediatr Adolesc Med. 2010;164(2):152-159.)
Reasons of the Heart: Youth who participated in the L.I. Teen Freedom program were nearly 3 1⁄2 times (OR) more likely than average to maintain sexual abstinence 12 months after participating in the program. (Source: Rue, L.A, Chandran, R., Pannu, A., Bruce, D., Singh, R.(2010). Estimate of Program Effects, L.I. Teen Freedom Program).
Game Plan/Aspire: After six months, program students were nearly four times more likely to remain abstinent than the control group who did not receive the program. (Source: Educational Evaluators, Inc. 2011. Tesoros de Esperanza. CBAE Evaluation Report during the 2008- 2009 project year).
Earle School District: Since the program began, incidence of teen pregnancy reduced in the senior class of the study school by 80 percent. (Source: Rue, L. A., Rogers, J., Kinder ,E. ,Bruce ,D.(2009). Summative Evaluation: Abstinence Education Program. -Impact Evaluation submitted to Department of Health and Human Services, Grant # 90AE0219).
Arkansas Title V Funded Programs: Sexually experienced teens who received the program were about twice as likely to be sexually abstinent one year later than those who did not receive the program. (Source: Birch P. and Weed S. (2008). Phase V Final Report: Delivered to the Arkansas Department of Health. July 16, 2008. Salt Lake City: The Institute for Research & Evaluation).
Best Friends: Best Friends girls were nearly 6.5 times more likely to abstain from sexual activity than Youth Risk Behavior Surveillance System (YRBSS) respondents. Additionally, they were:
- 2.4 times more likely to abstain from smoking
- 8.1 times more likely to abstain from illegal drug use, and
- 1.9 times more likely to abstain from drinking.
(Source: Lerner, R., (2004). Can abstinence work? An analysis of the Best Friends Program. Adolescent and Family Health, 3(4), 185-192).