In fact, the study found that participating in an abstinence program and taking a formal pledge of virginity were by far the most significant factors in a youth's delaying early sexual activity. The study compared students who had taken a formal pledge of virginity with students who had not taken a pledge but were otherwise identical in terms of race, income, school performance, degree of religiousness, and other social and demographic factors. Based on this analysis, the authors discovered that the level of sexual activity among students who had taken a formal pledge of virginity was one-fourth the level of that of their counterparts who had not taken a pledge. Overall, nearly 16 percent of girls and 10 percent of boys were found to have taken a virginity pledge.
We recruited community-dwelling adult volunteers who were criminal justice offenders and who had a history of opioid dependence. Eligibility criteria were current (within the previous 12 months) or lifetime (any previous) opioid dependence (as defined by the Diagnostic and Statistical Manual of Mental Disorders, 4th edition [DSM-IV]); a stated goal of opiate-free treatment rather than opioid-agonist or partial-agonist maintenance therapy; an opioid-free status as confirmed by negative urine toxicologic screening for all opioids before randomization; residence in the community and receipt of an adjudicated sentence that included supervision (e.g., parole, probation, outpatient drug-court programs, or other court-mandated treatment) or, in the previous 12 months, release from jail or prison, a plea-bargain arrangement, or any community supervision as above; general good health as determined by history and physical examination; an age of 18 to 60 years; and the ability to provide written informed consent.
In addition, early sexual activity can negatively affect the ability of young people to form stable and healthy relationships in a later marriage. Sexual relationships among teenagers are fleeting and unstable, and broken intimate relationships can have serious long-term developmental effects. A series of broken intimate relationships can undermine an individual's capacity to enter into a committed, loving marital relationship. In general, individuals who engage in premarital sexual activity are 50 percent more likely to divorce later in life than those who do not. Divorce, in turn, leads to sharp reductions in adult happiness and child well-being.
Sex education is the transmission of information regarding the sexuality. Often a preference is given for the more general term “relationships and sexuality education,” including sex education is a part and which in addition to the transfer of information has also a great emphasis on the aspect of the formation. In some schools, this subject is included in the curriculum of the school in a subject like biology or religion.
Teenage sexual activity is a major problem confronting the nation and has led to a rising incidence of sexually transmitted diseases (STDs), emotional and psychological injuries, and out-of-wedlock childbearing. Abstinence education programs for youth have been proven to be effective in reducing early sexual activity. Abstinence programs also can provide the foundation for personal responsibility and enduring marital commitment. Therefore, they are vitally important to efforts aimed at reducing out-of-wedlock childbearing among young adult women, improving child well-being, and increasing adult happiness over the long term.
This U.S. multisite, randomized, controlled trial showed that extended-release naltrexone resulted in a lower rate of opioid relapse than the rate with usual treatment in a predominantly male and minority population of outpatient, voluntary participants with criminal justice involvement and opioid abstinence at baseline. During a 24-week treatment phase, the percentage of participants with a relapse event was lower among participants assigned to extended-release naltrexone than among those assigned to usual treatment (43% vs. 64%), corresponding to an absolute difference in risk of 21 percentage points and a number needed to treat of 5. The prevention of opioid use by extended-release naltrexone did not persist through follow-up at week 52 and week 78, approximately 6 months and 12 months, respectively, after the treatment phase had ended. In addition, we did not detect a benefit of extended-release naltrexone on several important secondary outcomes, including rates of cocaine, heavy alcohol, and injection-drug use. Rates of self-reported reincarceration and days of incarceration through week 27 were also not significantly lower in the extended-release naltrexone group than in the usual-treatment group.
At the week 52 and week 78 visits, participants provided 6 months of self-reports on opioid use and a single urine sample. We analyzed the percentage of opioid-negative (vs. opioid-positive or missing) urine samples at both visits using mixed-effects logistic models. We used a logistic mixed-effects model for repeated measures to analyze self-reported opioid use from week 1 to week 78 and to test for differences in the treatment groups over time with the use of an interaction term between group and time.
The primary outcome was the time (in weeks) to an opioid-relapse event during the 24-week treatment phase. A relapse event was defined as 10 or more days of opioid use in a 28-day (4-week) period as assessed by self-report or by testing of urine samples obtained every 2 weeks; a positive or missing sample was computed as 5 days of opioid use. Relapse was considered to be a one-time event and corresponded to the loss of persistent opioid abstinence after randomization, when all participants had been opioid-free and had endorsed a goal of opioid abstinence. Related opioid-use outcomes were rates of opioid-negative (vs. opioid-positive or missing) urine samples, the percentage of 2-week intervals with no opioid use as assessed by self-report or by testing of urine samples (confirmed abstinence), the percentage of days with self-reported opioid use, and post-treatment rates of opioid use as assessed by self-report (percentage of 2-week intervals with any opioid use vs. no opioid use) and by testing of single urine samples at weeks 52 and 78. The primary relapse outcome used during the treatment phase, defined by assessments performed every 2 weeks, self-report, and testing of urine samples, was not available during long-term follow-up because visits were scheduled only at weeks 52 and 78. Secondary outcomes of interest were rates of alcohol and nonopioid drug use, HIV risk behaviors, rearrests and reincarcerations, and adverse events including opioid overdose.
The trial groups did not differ significantly at baseline in terms of demographic characteristics and criminal justice status, and results were not modified by site, missed visits, or missing data. Main relapse-prevention effects were similar to those in the placebo-controlled pivotal efficacy trial, in which the median percentage of weeks of confirmed abstinence was 90% in the extended-release naltrexone group, as compared with 35% in the placebo group. On the basis of self-reports and a single urine sample at week 52 and week 78, months after extended-release naltrexone therapy had ended, the relapse-prevention effects had waned. As is the case with any chronic illness, symptoms of opioid-use disorder are more likely to recur with the discontinuation of effective pharmacotherapy. Future research would be needed to determine whether long-term or continuous treatment with extended-release naltrexone — similar to buprenorphine or methadone maintenance therapy — could help maintain the short-term benefits observed in this trial and improve longer-term outcomes.
Critics of abstinence education often assert that while abstinence education that exclusively promotes abstaining from premarital sex is a good idea in theory, there is no evidence that such education can actually reduce sexual activity among young people. Such criticism is erroneous. There are currently 10 scientific evaluations (described below) that demonstrate the effectiveness of abstinence programs in altering sexual behavior. Each of the programs evaluated is a real abstinence (or what is conventionally termed an "abstinence only") program; that is, the program does not provide contraceptives or encourage their use.
Arthur Robin Williams, Vincent Barbieri, Kaitlyn Mishlen, Frances R. Levin, Edward V. Nunes, John J. Mariani, Adam Bisaga. . (2017) Long-term follow-up study of community-based patients receiving XR-NTX for opioid use disorders. 26:4, 319-325.