Impacts of Four Title V, Section 510 Abstinence Education Programs. Perceptions of Condom and Birth Control Pill Effectiveness

04/13/2007

  • Most study youth reported that condoms were at least sometimes effective at preventing pregnancy.  Programs had no impact on this perception.

About half of program and control group youth responded that, when used correctly, condoms usually prevent pregnancy (Figure V.1).  Most of the remainder, 38 percent, reported that condoms sometimes prevent pregnancy.  Only three percent of youth thought that condoms never prevent pregnancy, while seven percent reported being unsure.

Figure V.1.
Estimated Impacts on Perceived Effectiveness of Condoms for Preventing Pregnancy

Estimated Impacts on Perceived Effectiveness of Condoms for Preventing Pregnancy. See text for explanation.

Source:  Wave 4 Survey of Teen Activities and Attitudes (Mathematica Policy Research, Inc., 2005), administered to youth 42 to 78 months after enrolling in the Title V, Section 510 Abstinence Education Program study sample.

Note:  All estimates are based on weighted regression models.  For details on the covariates, see Appendix Table A.1.  Sample sizes and R-square statistics are in Appendix Tables A.2 and A.3, respectively.  Findings by site, as well as F-tests of the difference in the distribution of the outcome measure between control and program groups, are in Appendix Table A.10.

***p-value (of program-control difference) < 0.01; **p-value < 0.05; *p-value < 0.10, two-tailed test.

  • Many study youth reported being unsure about whether condoms prevent STDs.  Overall, program group youth were less likely than control group youth to perceive condoms as effective at preventing STDs.

Roughly one-quarter of youth in both the program and control groups reported being unsure about how effective condoms are at preventing chlamydia and gonorrhea or at preventing herpes and HPV (Figure V.2).  In addition, a sizeable fraction in both groups, about one in seven, reported being unsure about condoms effectiveness for preventing HIV.  These findings are in sharp contrast to those for pregnancy (above), for which very few youth in either group reported being unsure about their effectiveness.

Youth in the program group were significantly less likely to report that condoms usually prevent STDs than those in the control group.  And, for each STD type, this difference was offset by a significantly higher proportion of program group youth reporting that condoms are never effective at prevention.[2]  Specifically, programs raised the proportion of youth who reported that condoms never prevent HIV from an estimated 17 to 21 percent; the proportion who reported that condoms never prevent chlamydia and gonorrhea from an estimated 14 to 20 percent; and the proportion who reported that condoms never prevent herpes and HPV from an estimated 15 to 23 percent.

Findings at the site level, detailed in Appendix Tables A.11 through A.13, indicate that two programs, My Choice, My Future! and Teens in Control, are largely responsible for the impacts seen overall.  The My Choice, My Future! findings mirror the overall results most closely  for all STDs examined, youth in the program group were significantly less likely than those in the control group to report that condoms are usually preventive, and they were significantly more likely to report that condoms are never preventive.  For Teens in Control, the same pattern of results holds, though the differences are less often statistically significant.  FUPTP also displayed some statistically significant differences between program and control group youth.  Most notably, program group youth in this site were more likely to report that condoms usually prevent HIV while also more likely to report that condoms never prevent herpes and HPV.

Figure V.2.
Estimated Impacts on Perceived Effectiveness of Condoms for Preventing Sexually Transmitted Diseases:

Prevention of Chlamydia and Gonorrhea

Estimated Impacts on Perceived Effectiveness of Condoms for Prevention of Chlamydia and Gonorrhea. See text for explanation.

Prevention of HIV

Estimated Impacts on Perceived Effectiveness of Condoms for Prevention of HIV. See text for explanation.

Prevention of Herpes and HPV

Estimated Impacts on Perceived Effectiveness of Condoms for Prevention of Herpes and HPV. See text for explanation.

Source:  Wave 4 Survey of Teen Activities and Attitudes (Mathematica Policy Research, Inc., 2005), administered to youth 42 to 78 months after enrolling in the Title V, Section 510 Abstinence Education Program study sample.

Note:  All estimates are based on weighted regression models.  For details on the covariates, see Appendix Table A.1.  Sample sizes and R-square statistics are in Appendix Tables A.2 and A.3, respectively.  Findings by site, as well as F-tests of the difference in the distribution of the outcome measure between control and program groups, are in Appendix Tables A.11 through A.13.

***p-value (of program-control difference) < 0.01; **p-value < 0.05; *p-value < 0.10, two-tailed test.

  • Most study youth reported that birth control pills were usually or sometimes effective at preventing pregnancy.  Program and control group youth shared similar perceptions.

Just over half of the youth in both the program and control groups reported that, when used properly, birth control pills usually prevent pregnancy (Figure V.3).  Only three percent of youth in each group reported that birth control pills never prevent pregnancy, and seven percent were unsure about their effectiveness.  At the site level, shown in Appendix Table A.14, program group youth in FUPTP were significantly more likely than control group youth to report birth control pills usually prevent pregnancy.  This difference is not evident in the overall findings because it is offset by small, negative differences in the other three program sites (none are statistically significant).

Figure V.3.
Estimated Impacts on Perceived Effectiveness of Birth Control Pills for Preventing Pregnancy

Estimated Impacts on Perceived Effectiveness of Birth Control Pills for Preventing Pregnancy. See text for explanation.

Source:  Wave 4 Survey of Teen Activities and Attitudes (Mathematica Policy Research, Inc., 2005), administered to youth 42 to 78 months after enrolling in the Title V, Section 510 Abstinence Education Program study sample.

Note:  All estimates are based on weighted regression models.  For details on the covariates, see Appendix Table A.1.  Sample sizes and R-square statistics are in Appendix Tables A.2 and A.3, respectively.  Findings by site, as well as F-tests of the difference in the distribution of the outcome measure between control and program groups, are in Appendix Table A.14.

***p-value (of program-control difference) < 0.01; **p-value < 0.05; *p-value < 0.10, two-tailed test.

 

  • Program group youth were less likely than control group youth to perceive birth control pills as effective at preventing STDs.

More than two out of three study participants reported, correctly, that birth control pills do not prevent STDs.  For each STD investigated, a significantly higher proportion of youth in the program group than the control group reported this was the case (Figure V.4).  For example, 73 percent of program group youth correctly reported that birth control pills never prevent HIV compared to 69 percent of control group youth, a statistically significant difference of four percentage points.

As with several previous measures, My Choice, My Future! is the main source for the difference seen overall in these perceptions (see Appendix Tables A.15 through A.17).  For each STD type, the proportion of program group youth in My Choice, My Future! who reported that birth control pills never prevent STDs was significantly higher than that of the control group.  Differences ranged from 8 to 11 percentage points.  In contrast, the other three program sites display no statistically significant differences between the two groups for any of the STDs examined.

Figure V.4.
Estimated Impacts on Perceived Effectiveness of Birth Control Pills for Preventing Sexually Transmitted Diseases:

Prevention of HIV

Estimated Impacts on Perceived Effectiveness of Birth Control Pills for Preventing Sexually Transmitted Diseases: Prevention of HIV. See text for explanation.

Prevention of Chlamydia and Gonorrhea

Estimated Impacts on Perceived Effectiveness of Birth Control Pills for Preventing Sexually Transmitted Diseases: Prevention of Chlamydia and Gonorrhea. See text for explanation.

Prevention of Herpes and HPV

Estimated Impacts on Perceived Effectiveness of Birth Control Pills for Preventing Sexually Transmitted Diseases: Prevention of Herpes and HPV. See text for explanation.

Source:  Wave 4 Survey of Teen Activities and Attitudes (Mathematica Policy Research, Inc., 2005), administered to youth 42 to 78 months after enrolling in the Title V, Section 510 Abstinence Education Program study sample.

Note:  All estimates are based on weighted regression models.  For details on the covariates, see Appendix Table A.1.  Sample sizes and R-square statistics are in Appendix Tables A.2 and A.3, respectively.  Findings by site, as well as F-tests of the difference in the distribution of the outcome measure between control and program groups, are in Appendix Tables A.15 through A.17.

***p-value (of program-control difference) < 0.01; **p-value < 0.05; *p-value < 0.10, two-tailed test.

Endnotes

[1] These potential mediators of sexual abstinence (knowledge and perceptions) were not measured until the final follow-up survey.  Therefore, this is the first report to examine them.  For updated impact findings on other potential mediators of sexual abstinence  all of which were examined in a prior DHHS study report by Maynard et al. (2005)  see Appendix E.

[2] For each STD category, youth who reported in the never effective category were significantly more likely to have remained abstinent than those who reported into one of the other categories.  This difference merely reflects an association, not evidence of a causal relationship.  Indeed, it is evident among both program and control group youth, suggesting it is related to factors other than program participation.

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