This calls into question the continued use of public money to fund abstinence only programmes in the United States. At present, 33 per cent of HIV prevention funds from the US President’s Emergency Plan for AIDS Relief (PEPFAR) are used for abstinence only programmes. This limits the funding available for other safer sex strategies.
Researchers at the University of Oxford reviewed 13 trials involving over 15,000 US youths to assess the effects of abstinence only programmes on HIV infection rates in high income countries. They measured self reported biological and behavioural outcomes such as sexually transmitted infection, pregnancy, frequency of unprotected sex, number of partners, and sexual initiation.
Compared with various controls, no programme had a beneficial effect on incidence of unprotected vaginal sex, number of partners, condom use, sexual initiation, incidence of pregnancy, or incidence of sexually transmitted infection. The results also suggest that abstinence only programmes did not increase primary abstinence (prevention) or secondary abstinence (decreased incidence and frequency of recent sex).
Despite some study limitations, these conclusions are consistent with previous reviews that found no evidence of an effect of abstinence only programmes in developing countries or the United States, say the authors. They call for more rigorous evaluations of these programmes in the future.
In contrast to abstinence only programmes, programmes that promote the use of condoms greatly reduce the risk of acquiring HIV, especially when such programmes are culturally tailored behavioural interventions targeting people at highest risk of HIV infection, say researchers in an accompanying editorial in the British Medical Journal.
MEDICA.de; Source: BMJ-British Medical Journal