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END FUNDING FOR THE FAILED TITLE V ABSTINENCE-ONLY-UNTIL-MARRIAGE PROGRAM; SUPPORT COMPREHENSIVE SEX EDUCATION
 
SUPPORT THE REPEALING INEFFECTIVE AND INCOMPLETE
ABSTINENCE-ONLY PROGRAM FUNDING ACT(S. 578, H.R. 1085)
 
• Senator Frank Lautenberg (D-NJ) and Representative Barbara Lee (D-CA) introduced the Repealing Ineffective and Incomplete Abstinence-Only Program Funding Act, which would strike Title V, Section 510 of the Social Security Act from statute, thereby ending the Title V abstinence-only-until-marriage programs once and for all. It would transfer funding to the Personal Responsibility Education Program (PREP) state-grant program.
 
PREP-funded programs are required to provide information on both abstinence and contraception for the prevention of pregnancy and sexually transmitted diseases (STDs), including HIV, with a substantial emphasis on both abstinence and contraceptive use. Programs must also address adulthood preparation topics—such as healthy relationships, adolescent development, financial literacy, educational and career success, and healthy life skills—so that young people learn the skills they need to make healthy decisions.
 
• Since 1996, the United States has wasted more than $1.5 billion in federal funding on abstinence-only-until-marriage programs that fail to teach teens how to delay sexual initiation or prevent pregnancy or STDs, including HIV/AIDS. There is clear evidence that federally funded abstinence-only-until-marriage programs are not effective in stopping or even delaying adolescent sex.
 
• No study in a professional peer-reviewed journal has found abstinence-only-until-marriage programs to be broadly effective. Scientific evidence simply does not support an abstinence-only-until-marriage approach. In sharp contrast to abstinence-only-until-marriage programs, there is strong evidence that more comprehensive approaches help young people both to withstand the pressures to have sex too soon and to have healthy, responsible, and mutually protective relationships when they do become sexually active.
 
• The federal government should not continue funding the ineffective Title V abstinence-only-until-marriage program, but should instead listen to the overwhelming evidence that this massive federal expenditure has failed completely to achieve its stated goals. It should transfer the funding to PREP, which requires funded programs to be evidence-based or replicate elements of evidence-based programs that have been proven on the basis of rigorous scientific research to change behavior.
 
To cosponsor the Repealing Ineffective and Incomplete Abstinence-Only Program Funding Act (S. 578, H.R. 1085) or for more information, please contact: Christos Tsentas in Representative Barbara Lee’s office at 225-2661 or Julie Groeninger in Senator Frank Lautenberg’s office at 224-3224.
 
 
The Title V abstinence-only-until-marriage program expired on June 30, 2009, and, at that time, had been refused by nearly half of the states both because of its restrictive nature and the fact that overwhelming evidence has proven such programs to be ineffective and a waste of taxpayer dollars. The ideologically driven program was resurrected in recent health care reform legislation despite clear evidence that federally funded abstinence-only-until-marriage programs are not effective in stopping or even delaying adolescent sex—their entire supposed purpose. This extension equals $250 million for failed abstinence-only-until-marriage programs over the next five years (2010–2014). Health care reform should not have been used to fund programs that put young people’s health and lives at risk by denying them important information about contraception and condoms.
 
While the guidance issued for the Fiscal Year 2010 funding announcement makes the program more flexible than it has been in previous years, funded programs must continue to teach abstinence to the exclusion of other topics and may in no way contradict the A–H federal definition for “abstinence education.” They are prohibited from providing complete information about contraception or condoms for the prevention of unintended pregnancy, HIV, and other STIs. Despite its increased flexibility, only 30 states and Puerto Rico applied for Title V abstinence-only funding.
 
The Personal Responsibility Education Program (PREP), created through the recently passed health care reform legislation, will provide individual states with grants for comprehensive sex education that provides young people with complete, medically accurate, and age-appropriate sex education in order to help them reduce their risk of unintended pregnancy, HIV/AIDS, and other STDs. Programs would also address life skills so that young people can make responsible decisions and lead safe and healthy lives. Comparatively, 43 states, the District of Columbia, the Federated States of Micronesia, and Puerto Rico applied for PREP funding.                                 
 
 
 
TITLE V ABSTINENCE-ONLY PROGRAMS FAIL TO PROTECT YOUNG PEOPLE’S HEALTH
·         The United States has one of the highest teen pregnancy rates in the developed world. Each year in the U.S., more than 750,000 women aged 15-19 become pregnant, with more than 80 percent of these pregnancies unintended.[1]
·         While young people in the U.S., aged 15–25, make up only one-quarter of the sexually active population, they contract about half of the 19 million STDs annually. The Centers for Disease Control and Prevention (CDC) estimates that one in four young women ages 15-19 has an STD.[2]
·         Young people aged 13–29 account for over one-third of the estimated 56,300 new HIV infections each year, the largest share of any age group. Two young people every hour are infected with HIV.[3]
·         Teens need accurate, complete information to help them both postpone sexual activity and protect themselves if they become sexually active.
 
EVALUATIONS FIND ABSTINENCE-ONLY-UNTIL-MARRIAGE PROGRAMS INEFFECTIVE
·         A 10-year government study of programs funded by the Title V abstinence-only-until-marriage funding stream found that such programs did not delay sexual initiation—the entire purported purpose of the programs.[4] The evaluation found that the federally funded abstinence-only programs evaluated had no beneficial impact on young people’s sexual behavior. Individuals who participated in the programs were no more likely to abstain than those who did not.[5]
·         This report followed the findings from 13 states that have evaluated their own Title V abstinence-only-until-marriage programs with results ranging from finding the programs ineffective to finding them harmful.
·         Furthermore, in early November 2007, the National Campaign to Prevent Teen and Unplanned Pregnancy released Emerging Answers 2007, which discussed what programs work in preventing teen pregnancy and STDs, including HIV. The report found strong evidence that abstinence-only-until-marriage programs do not have any impact on teen sexual behavior.[6]Furthermore, the study found no evidence to support the continued investment of public funds in abstinence-only programs.
 
MORE COMPREHENSIVE SEX EDUCATION WORKS
·         More comprehensive sex education has been found to be effective in delaying sexual intercourse, increasing condom or contraceptive use, and reducing the number of partners among teens.[7]
·         Research has found that teens who report that they received comprehensive sex education are 50 percent less likely to experience an unintended pregnancy.[8]
·         Strong evidence indicates that sex education programs that promote abstinence as well as the use of condoms do not increase sexual behavior. Studies show that when teens are educated about, and have access to, condoms, levels of condom use at first intercourse increase while levels of sex stay the same.[9]
·         Teens who receive sex education that includes abstinence and contraception are more likely than those who receive abstinence-only-until-marriage messages to delay sexual activity and use contraception when they do become sexually active. Research shows that teens who practiced contraception consistently in their first sexual relationship are more likely to continue doing so than those who used no method or who used a method inconsistently.[10]
 
LEADING MEDICAL AND PUBLIC HEALTH PROFESSIONAL GROUPS OPPOSE ABSTINENCE-ONLY-UNTIL-MARRIAGE PROGRAMS, SUPPORT COMPREHENSIVE SEX EDUCATION
·         The Institute of Medicine of the National Academies has called for the termination of abstinence-only-until-marriage programs because they represent “poor fiscal and public health policy.”[11]
·         Leading medical and public health professional groups—including the American Medical Association, the American Academy of Pediatrics, the Society of Adolescent Health and Medicine, the American College of Obstetricians and Gynecologists, the American Nurses Association, the American Public Health Association, and the American Psychological Association—have raised serious ethical concerns about U.S. support for such programs. These organizations and many others do not support abstinence-only-until-marriage programs but support a comprehensive approach that includes messages about abstinence and provides young people with information about contraception for the prevention of teen pregnancy, HIV/AIDS, and other STDs.
·         “While good patient care is built upon notions of informed consent and free choice, [abstinence-only] programs are inherently coercive by withholding information needed to make informed choices,” notes the American Public Health Association in its policy statement on abstinence-only programs.[12]
 
THE DEFINITION OF ABSTINENCE-ONLY-UNTIL-MARRIAGE PROGRAMS LEAVES MANY YOUNG PEOPLE OSTRACIZED AND AT RISK
·         The federal definition of “abstinence education”[13]that is found in the Title V abstinence-only-until-marriage program statute promotes marriage as the only acceptable family structure; ostracizes lesbian, gay, bisexual, and transgender (LGBT) youth; stigmatizes youth who have been sexually abused; denies information to sexually active youth and HIV-positive youth; and, ensures that young people who have already engaged in sexual activity or those living in “nontraditional” households are presented with fear- and shame-based messages.
·         Though often presented to communities and school boards as programs designed to prevent pregnancy or STDs, including HIV/AIDS, abstinence-only-until-marriage programs focus on marriage promotion and consistently ignore many youth who are most in need of information, education, and skills training.
·         Many aspects of the definition and guidelines for this program oppose the goals and tenets of comprehensive sex education, which aims to help young people navigate adolescence and become healthy adults.
 
COMPREHENSIVE SEX EDUCATION IS SUPPORTED BY VAST MAJORITY OF AMERICANS
·         According to the results of a 2005–2006 nationally representative survey of U.S. adults published in Archives of Pediatric and Adolescent Medicine, more than eight in 10 polled support comprehensive sex education.[14]
·         A survey conducted by the Kennedy School of Government, Kaiser Family Foundation, and NPR found that over 90% of parents of middle school and high school students believe it is important to have sexuality education as part of the school curriculum. The vast majority polled support “comprehensive sex education programs” instead of programs that have “abstaining from sexual activity” as their only purpose.[15]
·         A majority of voters in nearly every demographic category, including Democrats, Republicans, and independents, as well as Catholics and evangelical Christians, support comprehensive sex education.[16]
 

Updated April 2011

 


[1]Lorrie Gavin, et al., “Sexual and Reproductive Health of Persons Aged 10–24 Years – United States, 2002–2007,” Surveillance Summaries, vol. 58, number SS-6 (Atlanta, GA: Centers for Disease Control and Prevention, 17 July 2009), accessed 8 December 2009, <http://www.cdc.gov/mmWR/PDF/ss/ss5806.pdf>, 47.
[2]“STDs in Adolescents and Young Adults,” Centers for Disease Control and Prevention, accessed 15 March 2010, <http://www.cdc.gov/std/stats09/adol.htm>.
[3]Hall HI, Song R, Rhodes P, et 1. al. Estimation of HIV incidence in the United States. JAMA. 2008;300:520–529.
[4]Christopher Trenholm , et. al., Impacts of Four Title V, Section 510 Abstinence Education Programs: Final Report (Trenton, NJ: Mathematica Policy Research April 2007); accessed 6 September 2007 at www.mathematica-mpr.com/publications/pdfs/impactabstinence.pdf.
[5]Christopher Trenholm, , et al., Impacts of Abstinence Education on Teen Sexual Activity, Risk of Pregnancy, and Risk of Sexually Transmitted Diseases, Journal of Policy Analysis and Management 27, no. 2 (2008): 255–76.
[6]Douglas Kirby , Emerging Answers 2007: Research Findings on Programs to Reduce Teen Pregnancy and Sexually Transmitted Diseases (Washington, DC: National Campaign to Prevent Teen and Unplanned Pregnancy, 2007), 15; accessed 5 February 2007, <http://www.thenationalcampaign.org/EA2007/EA2007_full.pdf.>
[7]Ibid.
[8]Pamela Kohler, et al. “Abstinence-only and Comprehensive Sex Education and the Initiation of Sexual Activity and Teen Pregnancy.” Journal of Adolescent Health, April 2008, 42(4): 344-351.
[9]Mark Schuster, et al. Impact of a high school condom availability program on sexual attitudes and behaviors, Family Planning Perspectives, 1998, 30(2):67-72 & 88. And Jane Mauldon, et. al., The effects of contraceptive education on method use at first intercourse, Family Planning Perspectives, 1996, 28:19-24 & 41.
[10]Jennifer Manlove, et al., Contraceptive use and consistency in U.S. teenagers’ most recent sexual relationships, Perspectives on Sexual and Reproductive Health, 2004, 36(6):265-275.
[11]Monica Ruiz, et al., No Time to Lose: Getting More from HIV Prevention (Washington, D.C: Institute of Medicine, 2000), 6.
[12]“Abstinence and U.S. Abstinence-Only Education Policies: Ethical and Human Rights Concerns,” Policy Statement, American Public Health Association, 8 November 2006, accessed 30 March 2010, <http://www.apha.org/advocacy/policy/policysearch/default.htm?id=1334>.
[13]Section 510(b) of Title V of the Social Security Act, P.L. 104-193:
For the purposes of this section, the term “abstinence education” means an educational or motivational program that
A. has as its exclusive purpose teaching the social, psychological, and health gains to be realized by abstaining from sexual activity;
B. teaches abstinence from sexual activity outside marriage as the expected standard for all school-age children;
C. teaches that abstinence from sexual activity is the only certain way to avoid out-of-wedlock pregnancy, sexually transmitted diseases, and other associated health problems;
D. teaches that a mutually faithful monogamous relationship in the context of marriage is the expected standard of sexual activity;
E. teaches that sexual activity outside of the context of marriage is likely to have harmful psychological and physical effects;
F. teaches that bearing children out-of-wedlock is likely to have harmful consequences for the child, the child’s parents, and society;
G. teaches young people how to reject sexual advances and how alcohol and drug use increase vulnerability to sexual advances, and;
H. teaches the importance of attaining self-sufficiency before engaging in sexual activity.
[14]Amy Bleakley, PhD, MPH, et. al., Public Opinion on Sex Education in US Schools, Archives of Pediatric & Adolescent Medicine,. 2006; 160:1151-1156.
[15]Sex Education in America: General Public/Parents Survey (Washington, DC: National Public Radio, Kaiser Family Foundation, Kennedy School of Government, 2004).
[16]Peter D. Hart Research Associates, Inc., “Memorandum: Application of Research Findings,” (Washington, DC: Planned Parenthood Federation of America and National Women’s Law Center, 12 July 2007), accessed 2 October 2007, <http://www.nwlc.org/pdf/7-12-07interestedpartiesmemo.pdf>.
 
 
 
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