Adolescent abstinence and condom use: are we sure we are really teaching what is safe?

This article reviews existing research on condom and abstinence method- and user-failure rates, and the use of this research in determining sexuality education curricula. Latex condoms effectively prevent pregnancies and most sexually transmitted diseases or infections (STIs), with method-failure rates between 0.5% and 7%, but with user-failure rates between 12% and 70%. Total abstinence presumably has a method-failure rate of zero, but research on periodic abstinence indicates user-failure rates between 26% and 86%. No researchers have attempted to establish total abstinence user-failure rates. Abstinence-only curricula evaluations have demonstrated changes in adolescents' attitudes but little change in sexual behaviors. Comprehensive sexuality education curricula have demonstrated attitudinal changes and delays in adolescents' sexual activity. Since inconsistent use of either condoms or abstinence threatens adolescents' health, this article urges more scientific research on total abstinence user-failure rates, better and clearer dissemination of research findings, and encourages funders to require educators to show thorough knowledge of research findings.