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Why Teen STAR Is Uniquely Successful in Motivating Abstinence Among Teens


UN Photo Marco Dormino

Susan E. Wills - published on 08/28/14

Offered in 27 countries, Teen STAR is by far the best sexuality education program you've never heard about.

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What would you call a “sex ed” program for teens that achieves results like this: 96.4% of the students responding to a 2-year post-graduation behavioral questionnaire reported that they remained abstinent?

Too good to be true? A fluke? No. It’s called Teen STAR: “Sexuality Teaching in the context of Adult Responsibility.”

The questionnaire was a follow-up to a Teen STAR initiative that trained hundreds of volunteers to teach over 55,000 Ugandan and Ethiopian teens the 14-session, year-long  school-based program, made possible through a grant from USAID under the President’s Emergency Program for AIDS Relief (PEPFAR). Funds were awarded Teen STAR as a means of reducing HIV/AIDS transmission.

Despite this remarkable success and despite tremendous support from the parents and community, Teen STAR is no longer being funded by USAID in countries experiencing an AIDS epidemic because this Administration now supports the use of long-acting reversible contraceptives (LARCs) and condoms to reduce pregnancy, HIV/AIDS transmission and the population. This is the same failed strategy that the Bill and Melinda Gates Foundation has recently embarked on.

Thankfully, Teen STAR will continue to be offered in the Diocese of Meki, Ethiopia because the Director of Education just announced his plan to train more instructors and have Teen STAR offered in every school—government-run and religious—under his jurisdiction. In addition, the government’s district education officer in Asella, Ethiopia intends to offer Teen STAR in his school district, based in part on the remarkable changes he observed in his son who was in the local Teen STAR program. Instead of hanging out with friends in the evening drinking beer, his son began inviting his buddies to their home to study and do their homework together.  

Today, Teen STAR is being taught in 27 countries and on five continents.

Two rigorous randomized, prospective studies of Chilean teens also demonstrated Teen STAR’s success. Among  freshmen girls at a public high school in 1997, the Teen STAR group averaged 1.5 pregnancies per year and the control group (receiving the general health curriculum only) averaged almost six times more pregnancies per year—8.75%.

The second study, which included students aged 12 to 18, from ten schools, found that Teen STAR “reduced sexual activity, delayed sexual onset, and increased positive attitudes toward abstinence.” Nine percent of students in the Teen STAR group were currently sexually active, compared to 20%  in the control group. Fewer Teen STAR students initiated sexual activity (3.4% of females and 8.8% of males), compared to the control group (12.4% of females and 17.6% of males).

Generally speaking and across the globe, Teen STAR results in over 90% of female and male virgins remaining abstinent, while 40-50% of previously sexually-active females and 30-50% of previously sexually active males discontinued sexual activity. This level of success with respect to secondary abstinence (a return to abstinent behavior) may be unique to Teen STAR.

Before discussing the program’s rationale and content, I want to introduce readers to Teen STAR’s founder and leader since its inception in 1980: Hanna Klaus, MD, FACOG, Diplomate of the American Board of Obstetrics & Gynecology (also known as Sr. Miriam Paul, and a member of the Medical Mission Sisters).

One year after Nazi troops invaded Austria, Dr. Klaus was sent to a foster family in England, at the age of 11. Her parents were able to get to New York the following year, where she then joined them. At 14, she was baptized in the Lutheran Church 
and went on to earn a BA and MD at the University of Louisville, graduating from its medical school in 1950. During her first year of residency at Mass General, she entered the Catholic Church and from then to October 1957 when she joined the Medical Mission Sisters, Dr. Klaus completed additional resdiencies at the Washington University School of Medicine, Peter Bent Brigham Hospital and Harvard Medical School.

Her service as a Medical Mission Sister began as Chief of OB-GYNS and Acting Medical Director at the Holy Family Hospital in Rawalpindi, Pakistan (1961 – 1966), followed by two years as OB department director in Dhaka, Pakistan (now Bangladesh).

Returning to the United States in 1969, she became an instructor, then assistant professor, supervisor of patients and residents and faculty practitioner at various St. Louis hospitals before becoming OB Department Director at St. Francis Hospital (Wichita, KS) and later, assistant professor, followed by associate professor of OB-GYN at George Washington University Medical School and Director, OB-GYN education at Holy Cross Hospital. She has published over 70 scholarly articles and scores of popular articles.

With the onset of the sexual revolution in the 1960s, Dr. Klaus was providing OB care to many young (13-16), pregnant teens in St. Louis. She tells a wonderful anecdote about how she learned that a program like Teen STAR could work. In 1973, she learned the Billings method of natural family planning (based on monitoring changes in cervical mucus during the fertility cycle). After giving birth, some of the girls continued to live with their  baby’s father. “I told them about the mucus in three sentences,” she explained.

“Two years later, one of ‘my’ girls came in. The baby was thriving and I asked her if she had been pregnant again. She said no. When I asked her how she was avoiding it, she looked surprised and said ‘You told me about the mucus.’ “

With a grant from the Joseph P. Kennedy Jr. Foundation, Dr. Klaus developed a medical outline of how to teach the Billings method to teens, but her colleague—also a Billings instructor—tossed that aside and asked a classroom full of girls: “Y’all want to talk woman talk?” Using the Socratic method, the curriculum followed the sequence of the girls’ Q&A, beginning with what they can see–the mucus. Where does it come from and why? What are the implications? What hormones and moods do they elicit. Behavior. The nature of the human person. Men and their sexuality. Decision-making. Conception and embryonic/fetal development. Dating—its purpose, boundaries and how to establish them. Responsibility. Methods of NFP and artificial family planning (and their limitations). Girls would chart their cycles with the Billings method and after only three months, would “own” their fertility.   

A curriculum for boys was written at the request of parents, by Fr. Don Heet, OSFS, then the principal of a Catholic HS in northern Virginia (appropriately, Paul VI). The Teen STAR curriculum has also been adapted for Catholic schools, adding a religious component (mainly the theology of the body), and for younger teens in early adolescence, for young adults and for teenage mothers.

Teachers attend a five-day, 40-hour training workshop and must live the values of Humanae Vitae.

Parental permission is required and parents are invited to three meetings—before, during and after the program, to inform them of what will be covered, answer questions they might have and, in the later meetings, to learn how they perceive the program and what changes they’ve observed in their child.

Why is Teen STAR more successful than straight abstinence/chastity programs? Some of them wrongly teach a negative view of sexuality, stressing risks of pregnancy and disease, and many of the programs are essentially short-term, top-down lectures that remain external to the individual teens. Teen STAR, on the other hand, is experiential, personal and internalized. Girls learn to understand and value their sexuality, as well as their fertility, by experiencing and identifying the hormonal shifts and symptoms that occur throughout their cycle. They come to “own” their fertility and begin to have control over their moods and, importantly, their relationships.

Comprehensive sex ed and our culture separate sex from procreation and relationships. Many abstinence curricula also separate sexuality from the context of relationships. But Teen STAR allows students to explore, through guided discussion, the emotional, social, intellectual, spiritual and behavioral aspects of possessing fertility, allowing them to make their own mature decision to abstain from sexual activity until marriage.

A Diocesan Family Life Director,who strongly endorses Teen STAR once wrote a letter to the New Oxford Review, pointing out that, “Sexual intercourse in a Judeo-Christian value system is … a symbol of vulnerability and surrender, of total, mutual self-giving, in a covenant of self-emptying love.” You will not learn that in a comprehensive sex ed or abstinence-only program.

Teen STAR is approved by all bishops in whose dioceses it is offered, and by the Pontifical Council for the Family. The demand for the program is great, but funding remains inadequate. For more information about Teen STAR, please visit their website.

Susan E. Wills is Spirituality Director for Aleteia’s English edition.

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