Department of Obstetrics, Gynecology and Reproductive Sciences, School of Medicine, University of California, San Francisco, USA.
Perspect Sex Reprod Health. 2010 Jun;42(2):125-32. doi: 10.1363/4212510.
Abstinence-only education has had little demonstrable impact on teenagers' sexual behaviors, despite significant policy and funding efforts. Given the struggle over resources to improve teenagers' reproductive health outcomes, the views of clinicians serving teenagers at high risk for unintended pregnancy and STDs merit particular attention.
In 2005, a qualitative study with 31 clinicians serving low-income, at-risk patients was conducted. A semistructured interview guide was used to ask clinicians about adolescent pregnancy, HIV and STD prevention counseling, and when they include abstinence. Thematic content analysis was used to examine the content of the counseling and the techniques used in different situations.
Providers reported offering comprehensive counseling, presenting abstinence as a choice for teenagers, along with information about contraceptives and condoms. Several providers mentioned that with young, sexually inexperienced teenagers, they discuss delaying sexual activity and suggest other ways to be affectionate, while giving information on condoms. Providers explained how they assess whether teenagers feel ready to be sexually active and try to impart skills for healthy relationships. Some described abstinence as giving teenagers a way to opt out of unwanted sexual activity. Many support abstinence if that is the patient's desire, but routinely dispense condoms and contraceptives.
Overall, providers did not give abstinence counseling as a rigid categorical concept in their preventive practices, but as a health tool to give agency to teenagers within a harm reduction framework. Their approach may be informative for adolescent policies and programs in the future.
尽管政策和资金投入巨大，但禁欲教育对青少年的性行为几乎没有产生明显影响。鉴于改善青少年生殖健康结果的资源竞争激烈，为青少年提供服务的临床医生的观点特别值得关注，这些青少年面临意外怀孕和性传播疾病的高风险。
2005 年，对 31 名为低收入、高危患者服务的临床医生进行了一项定性研究。使用半结构化访谈指南询问临床医生关于青少年怀孕、艾滋病毒和性传播疾病预防咨询的问题，以及他们何时包括禁欲。使用主题内容分析来检查咨询的内容和在不同情况下使用的技术。
提供者报告提供全面的咨询，向青少年提出禁欲是一种选择，同时提供有关避孕药具和避孕套的信息。一些提供者提到，对于年轻、性经验不足的青少年，他们会讨论推迟性行为，并建议其他表达爱意的方式，同时提供有关避孕套的信息。提供者解释了他们如何评估青少年是否准备好进行性行为，并试图传授健康关系的技能。一些人将禁欲描述为青少年避免不必要的性行为的一种选择。如果这是患者的愿望，许多人支持禁欲，但通常会分发避孕套和避孕药具。
总体而言，提供者在预防实践中并没有将禁欲咨询作为一种严格的分类概念，而是将其作为一种健康工具，在减少伤害的框架内赋予青少年自主权。他们的方法可能对未来的青少年政策和计划具有启示意义。
