A in "ABC" Approach: Systematic Review of Sexual Abstinence education in adolescents

Background: Abstinence is one of the most important aspects of “ABC” approach to prevent the spread of HIV through changing sexual behavior. The purpose of this study was to review the studies conducted in the field of sexual abstinence education.   Methods:We investigated the published experimental or quasi-experimental studies from 1998 to 2018 on the impact of sexual abstinence education in the Web of Sciences, PubMed, Scopus, Springer, PsycNET and Sience direct databases. Inclusion criteria were: Randomized Controlled Trials on adolescents receiving abstinence education programs in both English and Persian languages. The outcome measure was sexual behaviors. Of the 1195 articles, 10 papers were evaluated and analyzed by two researchers separately. The quality of the studies was evaluated by Critical Appraisal Skills Program and judged by Cochrane Risk of Bias Tool and divided into three levels of low, high and unclear risk of bias. Results: Seven of the ten included studies in this review reported positive results of abstinence education on sexual behaviors in adolescents. Conclusion: Some evidence supports the efficacy of any particular abstinence education on different aspects of sexual behaviors in adolescents. But, unfortunately, there is no strong evidence in this area. Evaluations of sexual abstinence education using behavioral indicators and long-term follow-up are needed to truly assess its impacts.