Perhaps one of the best examples of ideology impeding sound public-health policy is the current US administration's insistence that both US and international sex education programmes promote the view that the only sensible approach to avoiding unwanted pregnancy and sexually transmitted infections is abstinence until marriage, followed by life-long monogamy. Since the mid-1990s the USA has poured hundreds of millions of dollars into such programmes, and many cash-strapped public schools have adopted abstinence-only curricula in order to obtain these much needed federal funds. As a result, more candid and frank programmes have been dropped. To qualify for abstinence-only funding, programmes must teach “that a mutually faithful monogamous relationship in the context of marriage is the expected standard of human sexual activity” and “that sexual activity outside of marriage is likely to have harmful psychological and physical effects”. The law severely restricts what teachers can say about same-sex relationships, for example, and encourages them to promote a fear of sex that is far from healthy. In addition, the discussion of contraception in many of these abstinence-only courses often ignores the benefits of different contraceptive methods, emphasising instead their failure rates and side-effects. While sexual abstinence—at least until one is old enough and mature enough to engage in healthy sexual relationships—might be advisable, there is little evidence that the abstinence-only approach is effective. Such is the conclusion of several reviews including one conducted by the US Surgeon General in 2001 and another conducted by the Committee on HIV Prevention Strategies in the United States, an expert panel convened by the US Institute of Medicine. In their report No time to lose: getting more from HIV prevention, the Committee urged US policymakers to “eliminate requirements that public funds be used for abstinence-only education, and that states and local school districts implement and continue to support age-appropriate comprehensive sex education and condom availability programs”. Comprehensive sex-education programmes—sometimes called abstinence-plus—promote abstinence but also recognise that many teenagers are or will soon become sexually active no matter what they are told. Indeed, surveys indicate that half of those aged 15–19 have already had sexual intercourse. These sexually active young people clearly need to be supplied with accurate information about contraception, condom use, abortion, and sexually transmitted infections. In addition, realistic programmes must also address the fact that some young people will have same sex relationships and are especially in need of frank instruction in measures they can take to prevent infection, especially against HIV. For these and other reasons, comprehensive sex education programmes have been endorsed by almost every major American medical association, including the American Medical Association, the American Pediatric Association, the American College of Obstetrics and Gynecologists, the American Public Health Association, and the American Psychological Association. It is understandable why so many groups, in particular conservative religious groups, wish to promote values that they feel are under assault in modern society. One US abstinence-only group, Concerned Women of America, goes so far on its website to contend that modern sexual mores are at the root cause of many of society's most difficult social problems, arguing “The problems that have become so entrenched in our country, such as AIDS, illegitimate births, poverty, increasing crime and the breakdown of the nuclear family, can all be attributed to the debilitating effects of a public policy that condones sex without love or responsibility”. But the origins of these and other problems of society are much more complex, and denying young people full and accurate information about sex, contraception, and prevention of sexually transmitted diseases not only puts them at needless risk, but also threatens to undermine their trust and respect of some of society's most important institutions: its schools, health system, and government officials. Young people today are exposed to a myriad of influences ranging from their parents and peers to music, film, video, and the internet. Only if they are provided with all the information they need to make their own decisions will they be able to decide wisely.