AVERT puts record straight for Apause

I was recently intrigued to read that AVERT, the leading international HIV and sexual health charity, had created a webpage setting up a clear distinction of approaches between ‘Comprehensive Sex Education’ and ‘Abstinence-based Sex Education’.  My sense of alarm grew as I read that Apause had been described as an ‘Abstinence plus’ programme and thereby allying it with those American, religiously motivated, conservative programmes and distancing it from theory and evidence-based public health practice.   

Compelled to clarify our position I complained to AVERT and wrote:

‘In the UK the first school-based Sex and Relationships Education programme to achieve positive changes in risk taking behaviour was Apause[1]. Findings from a review of the literature ‘suggest that postponement of first intercourse would be likely to have medical and social benefit.’ As an evidence and theory based programme Apause took a pragmatic and ‘age appropriate’ approach to abstinence with a programme aim of reducing the rates of first intercourse by the age of 16 years. Part of the programme involved peer educators working with students aged 13 and 14 years enabling them to have more control in their relationships by practicing assertiveness skills and role plays. Apause achieved increased tolerance, thus contributing to the programme aim of decreasing stigmatization of those young people who were already sexually active.'

In 2004 Apause was evaluated by the NFER[2]

Apause was spun out of Exeter University in 2006 and is managed by the Health Behaviour Group charity as part of the SRE Project.’

Happily AVERT went to the trouble of re-writing that webpage, citing Apause as a UK example of comprehensive approaches which,  ‘Although ... [they]... do explain to young people the potential benefits of delaying having sex until they are emotionally and physically ready, they also make sure that they are taught how to protect themselves from infections and pregnancy when they do decide to have sex.’

Lindberg and Maddow-Zimet[3] make a strong case that abstinence programmes which include information on contraception and STIs have a positive impact on sexual health and relationships amongst late teens and young adults. In contrast to the AVERT webpage, their analysis suggests that there is no easy distinction between abstinence programmes that teach about contraception and those that don’t. This is because it is common practice amongst abstinence programmes to talk about contraception, albeit often in terms of their relative ineffectiveness.

We consider this an important revision by AVERT of their position and I hope an increasing recognition amongst professionals in the field that postponement does not automatically equate with ‘abstinence until married’ and that postponement can be an effective and healthful message to promote.