Sexual activity among adolescents is a controversial topic. There is a lot of debate about how and when adolescents should be sexually active with particular concern about sexual intercourse. The important point, however, is that regardless of one's conviction about the appropriateness of sexual activity in general, and sexual intercourse in particular, the fact is that many adolescents are having sexual intercourse. There are associated health outcomes that can be detrimental to some of the adolescents who are sexually active, and can negatively impact society (Rosenthal et al. S280-S287).
For instance, unintended pregnancies and sexually transmitted diseases resulting from lack of condom and contraceptive use have a significant economic impact (Sharma Stano Hass 335-351). The more early youth engage in sexual intercourse, the more likely they are able to experience these consequences. There are factors that explain the reasons behind early initiation of sexual intercourse, and there exist intervention programs that address these factors, and have, to some extent, delayed coital debut among participants who have not engaged in sexual intercourse. These programs share a common set of characteristics: (1) they are based on well-tested theories, (2) they focus on reducing one or more sexual behaviors, (3) they employ variety of teaching methods, and (4) they provide accurate information on both abstinence and contraception.
Cost of Intervention
The costs of these programs are difficult to determine. This is due to the fact that they can vary depending on the implementation strategy. The direct program costs of one school-based program, Safer Choices, amounted to $102,852; at a cost per intervention student of $54 (Wang Crossett Lowry Sussman Dent 1043-1050). The cost of another program, Teen Outreach Project, was $96,625 at $644 per student. In contrast, most government spending on sex education has supported other programs.
In 2004, the federal government committed $137 million to abstinence education through three programs: Welfare ($50 million), Adolescent Family Life Act ($12 million), and Special Projects of Regional and National Significance ($75 million) (Weiss et al 19-26). These programs that lack evidence of effectiveness consume significant amount of resources that can probably be justifiably spent on more cost-effective program.
Intervention programs involve the consumption of resources. It takes money to implement and sustain these programs. The costs associated with intervention programs are the direct and indirect resources consumed when conducting them. In other words, the cost of a health promotion program is the value of its forgone alternative. In economic terms this is referred to as opportunity costs (Tuner 221-238). Committing resources to a particular sex education program effectively means less or no resources for other programs. This is due to the basic tenets of economics: scarcity and choice.
Resources are not unlimited; therefore, not all possible interventions can be pursued. Choices among alternatives have to be made within the realm of available resources. Therefore, choosing one intervention strategy instead of another requires that the cost of the forgone intervention be taken into consideration when conducting an economic evaluation (Shaw Debbie 311-316). It should be noted, however, that some of the costs that should be included in an analysis might not be measurable in monetary terms. This is due to the different definitions of cost. Costs are usually defined at four different levels of precision: dollar expenditures, costs evaluated in dollars, costs that can be quantified and non-quantifiable costs (Rosenthal et al. S280-S287). Dollar expenditures are the easiest in ...