Pennsylvania

 

In Fiscal Year 2010[1], the state of Pennsylvania received:

 

In Fiscal Year 2010, local entities in Pennsylvania received:

 

 

Sexuality Education Law and Policy

Schools in Pennsylvania are not required to teach sexuality education. Primary, intermediate, middle, and high schools, however, are required to teach sexually transmitted disease (STD)/HIV education; though primary schools are allowed to omit instruction on the sexual methods of disease transmission.[2] Schools must use materials that have been determined by the local school district, are age-appropriate, discuss prevention, and stress abstinence as “the only completely reliable means of preventing sexual transmission.”[3]

 

The state has created the Academic Standards for Health, Safety, and Physical Education, which includes STD- and HIV-prevention education. All decisions regarding HIV-prevention curricula and materials must be made by local school districts. School districts do not have to follow a specific curriculum, but they must use these standards as a framework for the development of their curricula.[4]

 

School districts must publicize the fact that parents and guardians can review all curriculum materials.  Parents and guardians whose principles or religious beliefs conflict with instruction may excuse their children from the programs.[5] This is referred to as an “opt-out” policy.

 

See Title 22 Pennsylvania Constitutional Statutes § 4.29, and the Academic Standards for Health, Safety, and Physical Education (Title 22 Pennsylvania Constitutional Statutes App. D).

 

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Recent Legislation

 

Bill to Require Comprehensive Sexual Health Education

House Bill 416, introduced in February 2011, would have required school districts that provide  instruction on HIV/AIDS and other sexually transmitted diseases (STDs) also to teach medically accurate and age-appropriate “comprehensive sexual health education.” Such instruction would have addressed the benefits and reasons for practicing abstinence and provided information on the “side effects, health benefits, effectiveness, safety, and proper use of all FDA-approved methods” for preventing pregnancy and STDs. Parents would have been required to provide written consent to remove their child from such instruction. The bill was referred to the House Committee on Education where it died.

 

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Youth Sexual Health Data

SIECUS has compiled the following data to provide an overview of adolescent sexual health in Pennsylvania. The data collected represents the most current information available.

 

Youth Risk Behavior Survey (YRBS) Data[6]

   

 

 

 

 

 

 

 

Philadelphia, Pennsylvania

 

 

 

 

 

 

 

Teen Pregnancy, Birth, and Abortion

 

 

 

HIV and AIDS[12]

 

 

 

 

Sexually Transmitted Diseases

 

 

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Teen Pregnancy Prevention Initiative

The President’s Teen Pregnancy Prevention Initiative (TPPI) funds medically accurate and age-appropriate programs to reduce teen pregnancy. The U.S. Department of Health and Human Services, Office of Adolescent Health (OAH) implements the grant program, which totaled $110 million in discretionary funding for Fiscal Year 2010. TPPI consists of two funding tiers that provide grants to local public and private entities. Tier 1 totals $75 million and provides funding for the replication of evidence-based programs proven to prevent unintended teen pregnancy and address underlying behavioral risk factors. Tier 2 totals $25 million and provides funding to develop and test additional models and innovative strategies. A portion of the Tier 2 funds, $15.2 million, was allocated for research and demonstration grants to test innovative approaches, while the remaining funding, $9.8 million, was allocated for grants to support communitywide initiatives. TPPI also dedicates $4.5 million in funding to conduct evaluations of individual programs.

 

TPPI Tier 1: Evidence-Based Programs

The TPPI Tier 1 grant program supports the replication of evidence-based programs proven effective through rigorous evaluation to prevent unintended teen pregnancy, underlying behavioral risk factors, or other associated risk factors.

 

Carnegie Mellon University, $1,480,578 (2010–2014)

Carnegie Mellon University (CMU) is a private research university located in Pittsburgh, Pennsylvania. With its TPPI funding, CMU partners with a clinical team from West Virginia University to implement What Could You Do? at family planning and adolescent health clinics. What Could You Do? is an evidenced-based, STD risk-reduction program that uses an interactive video to encourage safer sexual behaviors among female high school students. The program is designed as a one-on-one intervention, with each participant viewing the video individually. It aims to increase participants’ knowledge of STDs along with reducing their sexual risk behavior and risk of STD infection. The video includes vignettes featuring ethnically diverse young women involved in realistic scenarios related to sexual risk behavior, where the viewer must choose what action the character should take from different options. The vignettes give viewers the opportunity to practice how they would respond in different situations. The video covers sexual situations, risk reduction, reproductive health, and STDs. In addition, the video associates condom use with positive outcomes, such as pleasure and reassurance. What Could You Do? can be used in a physician’s office or clinic setting and could potentially be used in other settings, such as schools, as long as there was enough privacy for the viewer. An evaluation of the program published in Social Science & Medicine found that at a six-month follow-up to the intervention, participants were almost twice as likely not to have been diagnosed with an STD as those in the control group.[20]

 

CMU’s program targets racially diverse, urban and rural females, ages 14–19, seeking care at the participating clinics.  Project sites are located within Allegheny County, Pennsylvania; Franklin County, Ohio; and Braxton, Boone, Harrison, Mercer, Mingo, and Randolph counties in West Virginia.The overall goal of CMU’s program is to reduce the number of teen pregnancies and STD diagnoses among participants.  CMU plans for the program to reach approximately 1,800 youth annually.[21]

 

Opportunities Industrialization Centers of America, Inc., $1,000,000 (2010–2014)

Opportunities Industrialization Centers of America, Inc. (OICA) is a non-profit organization consisting of a national network of local education, employment, housing, and training programs serving the poor, unemployed, underemployed, youth, and families. The organization has 44 affiliates in 22 states and the District of Columbia.[22] OICA aims to enable “economically disadvantaged people of all races and backgrounds to become productive fulfilled members of the American society.”[23] 
 

OICA previously received abstinence-only-until-marriage funding through the now-defunct Community-Based Abstinence Education (CBAE) grant.Between Fiscal Years 2004 and 2007, the organization received $2.4 million in CBAE funding. It also receives federal funding under the Healthy Marriage Initiative, which it uses to provide programming to high school students, ages 14–18, in public, private, charter, and alternative schools throughout Philadelphia County.[24]

 

With its TPPI funding, OICA implement its “Teen Pregnancy Prevention” (TPP) initiative. TPP targets predominantly lower-income, African-American urban youth, ages 12–19.  According to the OICA website, TPP is “inclusive of all teen populations such as those of the LGBTQ community and teen parents.”[25]  The program’s overall goal is “to reduce the percentage of youth engaging in premature or unsafe sexual activity and educate youth on the importance of leading a sexually healthy lifestyle.”[26]

 

The organization partners with eleven Philadelphia public, private, charter, and alternative schools, as well as community- and faith-based organizations, to implement programming in middle and high schools.  The program implements Becoming a Responsible Teen(BART) to middle school students and Reducing the Risk to high school students. OICA plans for the TPP program to reach approximately 1,400 youth annually.

 

Becoming a Responsible Teen (BART) is an evidence-based HIV/AIDS-prevention education curriculum designed for African-American youth ages 14–18.  BART teaches students to reduce sexual risk taking by promoting safer sex practices while also teaching that abstinence is the most effective way to prevent HIV and unintended pregnancy. The curriculum combines education with behavioral skills training on assertion, refusal, self-management, problem solving, risk recognition, and correct condom use.[27]  BART includes interactive activities, group discussions, and role-plays developed by teens. It is designed for implementation in community-based settings and with single-sex groups. An evaluation of the program published in the Journal of Consulting and Clinical Psychology found that it increased participant knowledge of HIV and AIDS and increased participants’ ability to manage the pressure to engage in unprotected sex as well as to provide information to their peers regarding safe sexual practices. The program was also found to delay the initiation of sexual intercourse; reduce the frequency of sex and the incidence of unprotected sex; and reduce the incidence of unprotected anal sex.  Among male participants, the program was found to increase condom use [28]

 

Reducing the Risk: Building Skills to Prevent Pregnancy, STD and HIV is an evidence-based, pregnancy-, STD-, and HIV-prevention curriculum designed for classroom use with students in the ninth and tenth grades. It is appropriate for use with multi-ethnic populations.[29]  Reducing the Risk aims to reduce high-risk behaviors among participants and emphasizes strategies for abstaining from sex or practicing safer sex. The 16-lesson curriculum addresses both abstinence and contraception use and includes experiential activities that teach students to develop refusal, negotiation, and communication skills. An evaluation of the program published in Family Planning Perspectives found that it increased parent-child communication, especially among Latino youth, delayed the initiation of sexual intercourse, and reduced incidence of unprotected sex among lower-risk youth who participated in the program.[30]

 

Along with implementing programs to youth, OICA facilitates and hosts parent meetings to provide support to parents and guardians with youth participating in the program. 

 

TPPI Tier 2: Innovative Approaches

The TPPI Tier 2 grant program supports research and demonstration programs in order to develop, replicate, refine, and test additional models and innovative strategies for preventing teenage pregnancy.

 

TPPI Tier 2: Communitywide Initiatives

The TPPI Tier 2 grant program also supports communitywide initiatives to reduce rates of teenage pregnancy and births in communities with the highest rates. The program awards grants to national organizations as well as state- and community-based organizations. Funded national partners provide training and technical assistance to local grantees. The Centers for Disease Control and Prevention (CDC) implement the grant program in partnership with OAH.

 

Family Planning Council, $884,840 (2010–2014)

The Family Planning Council (FPC) is a private, non-profit organization located in Philadelphia, Pennsylvania whose mission is “to ensure access to high quality, comprehensive, reproductive and related health and prevention services to primarily low-income individuals and families.”[31] The organization provides programs and services to women, men, and adolescents as well as financial and technical support to more than 50 organizations throughout southeastern Pennsylvania, including family planning providers, AIDS service organizations, and reproductive health agencies among others.

 

With its Tier 2 community-wide initiative grant, FPC aims to reduce the teen birth rate within the predominately African-American community of West Philadelphia by increasing the number of youth ages 10–19 in the community who receive “evidence-based and evidence-informed” teen pregnancy- prevention programming and reproductive health care services. FPC provides training and technical assistance to youth service organizations and clinics “to select, implement, evaluate, and sustain evidence-based programs.” In addition, the organization provides training and technical assistance to clinics to increase adolescent access to reproductive health services, including creating a youth-friendly environment. The initiative also works to develop and strengthen relationships between youth service providers and clinics as well as to increase the number of health resource centers operating in Philadelphia public schools that implement evidence-based, teen pregnancy-prevention programming. Lastly, through the initiative FPC operates the “Askable Adult Program,” in which health providers “serve as a reproductive health resource” for youth in schools and community-based settings. The initiative will seek to engage additional community members and stakeholders by hosting an annual “Community Summit” and disseminating information to increase public awareness.[32]

 

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Personal Responsibility Education Program

The Personal Responsibility Education Program (PREP) totals $75 million per year for Fiscal Years 2010−2014 and is the first-ever dedicated funding stream for more comprehensive approaches to sexuality education. The U.S. Department of Health and Human Services, Administration for Children and Families (ACF) implements the grant. PREP includes a $55 million state-grant program, $10 million to fund local entities through the Personal Responsibility Education Innovative Strategies (PREIS) Program, $3.5 million for Indian tribes and tribal organizations, and $6.5 million for evaluation, training, and technical assistance. Details on the state-grant program and PREIS are included below. At the time of publication, the funding for tribes and tribal organizations had not yet been awarded.

 

PREP State-Grant Program

The PREP state-grant program supports evidence-based programs that provide young people with medically accurate and age-appropriate information for the prevention of unintended pregnancy, HIV/AIDS, and other sexually transmitted infections (STIs). The grant program totals $55 million per year and allocates funding to individual states. The grant does not require states to provide matching funds. Funded programs must discuss abstinence and contraception, and place substantial emphasis on both. Programs must also address at least three of the following adulthood preparation subjects: healthy relationships, positive adolescent development, financial literacy, parent-child communication skills, education and employment skills, and healthy life skills.

 

The Pennsylvania PREP state-grant program is designed to provide funding to social service agencies and community-based organizations that serve high-risk youth. These entities include residential programs for “delinquent youth,” residential alcohol and drug treatment facilities and psychiatric treatment facilities serving youth, and state-run youth forestry camps. The grant program requires funded programs to implement one of two intervention models: Riker’s Health Advocacy Program or Street Smart.[33]

 

Rikers Health Advocacy Program is an evidence-based HIV/AIDS-prevention education program designed for high-risk youth, particularly those who are incarcerated and have issues with substance abuse. The program aims to reduce HIV-risk behaviors among participants. Rikers Health Advocacy Program uses a “Problem-Solving Therapy” approach, which leads participants through the steps of identifying and defining a problem, understanding the nature of the problem, developing possible solutions, engaging in decision making, and implementing a solution. The intervention was originally designed for adolescent males ages 16–19 at Rikers Island correctional facility in New York. The program consists of four, one-hour sessions that are facilitated by a male instructor twice a week over a two-week time period. The instruction emphasizes active learning and addresses such topics as factors related to experimenting with drugs and drug use; risks related to sexual activity; the connection between drug use, sexual activity, and HIV risk; and how to access health care services and drug treatment.[34] Rikers Health Advocacy Program engages participants in discussions about HIV facts and beliefs; has participants identify attitudes or behaviors that place individuals at risk for HIV infection; and then has participants develop possible strategies for avoiding such risks, which are then evaluated by other participants. The program includes role-plays to act out the solution strategies developed for avoiding risky situations. An evaluation of the program found that program participants were more likely to use condoms during intercourse than those in the control group.[35]

 

Street Smart is an HIV-prevention curriculum that is intended for use with homeless and runaway youth ages 11–18 and other high-risk youth populations. The intervention is structured as small group sessions and implemented in conjunction with other social services, such as group counseling and other treatment programs. Street Smart includes skill-building exercises that teach social skills, coping mechanisms, problem-solving, assertiveness, and “strategies to increase safer sexual behaviors.” Curriculum lessons provide information about HIV and how it is transmitted, the importance of getting tested, the impact of HIV/AIDS stigma, risky behavior related to HIV transmission, among other topics. The program has been identified by the CDC as a promising intervention model.[36]

 

Implementation of either curriculum must also incorporate material from Sex Ed 101, a sex education teaching manual that includes lessons on goal-setting, problem-solving, abstinence, STDs, including HIV, contraception, and relationships.

 

Personal Responsibility Education Innovative Strategies (PREIS)

The PREIS Program supports research and demonstration programs to develop, replicate, refine, and test innovative models for preventing unintended teen pregnancy. ACF implements the grant program in collaboration with OAH and provides a total of $10 million in funding directly to local public and private entities.

 

Public Health Management Corporation, $933,907 (2010–2014)

Located in Philadelphia, Public Health Management Corporation (PHMC) is a non-profit, public health institute “that builds healthier communities through partnerships with government, foundations, businesses and community based organizations.”[37] PHMC provides health promotion, education, outreach, technical assistance, and direct services to communities in greater Philadelphia and across the country.

 

The organization uses its PREIS grant to implement “Plain Talk Philadelphia,” an enhanced version of the Plain Talk community-based initiative.  The program serves young people ages 12–18 and their parents in the Norris and Fairhill Apartments, two public housing developments in North Philadelphia. Plain Talk is a four-part series that assists parents in developing communication skills to talk openly and honestly to their children about sexuality issues. It focuses on character education and helps parents talk nonjudgmentally with their children about assuming adult responsibility. Topics include: “Setting Personal Boundaries,” “TV and Sex,” “Decision-Making,” and “Healthy Neighborhoods.”

 

“Plain Talk Philadelphia” offers an expanded program for youth participants by incorporating the 12-week curriculum, Life Planning Education: A Youth Development Program, developed by Advocates for Youth. The family life education curriculum addresses such topics as values, self-esteem, sexuality, relationships, reducing sexual risk, violence prevention, community responsibility, parenting, and career development and includes skill-building exercises.[38] Youth participants who complete the 12-week course have the opportunity to participate in the Youth Activist Network, an after-school youth group that engages young people in community advocacy activities. In part, the group works with local pharmacists and health care providers to expand adolescent access to reproductive health care and improve the services provided to young people. “Plan Talk Philadelphia” also includes particular activities for male youth. The overall goal of the program is to reduce rates of teen pregnancy and STDs, including HIV, among the target population.[39]

 

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Title V State Abstinence Education Grant Program

The Title V State Abstinence Education Grant Program (Title V Abstinence-Only Program) allocates $50 million per year to states for Fiscal Years 2010–2014. ACF implements the grant program. The Title V Abstinence-Only Program requires states to provide three state-raised dollars or the equivalent in services for every four federal dollars received. The state match may be provided in part or in full by local groups. All programs funded by the Title V Abstinence-Only Program must promote abstinence from sexual activity as their exclusive purpose and may provide mentoring, counseling, and adult supervision toward this end. Programs must be medically accurate and age-appropriate and must ensure abstinence is an expected outcome.

 

The Pennsylvania Title V abstinence-only program will provide funding to community- and faith-based organizations to implement evidence-based programming to underserved, minority youth populations. These populations include youth ages nine to 14 who are African American and Latino; in or transitioning out of foster care; have a disability or other special health care need; and who are lesbian, gay, bisexual transgender, and/or questioning (LGBTQ). The program aims to serve youth in all areas of the state.

 

Sub-grantees will be funded to implement Promoting Health Among Teens! (Abstinence-Only Intervention) in community-based settings. Promoting Health Among Teens! is an evidence-based curriculum developed to increase knowledge and awareness about STDs, including HIV, increase an understanding of how abstinence can prevent pregnancy and HIV/STDs, and build refusal and negotiation skills for practicing abstinence. Promoting Health Among Teens! aims for participants to abstain from vaginal, oral and anal intercourse until a time later in life when they are ready to handle the potential consequences of having sex and neither discourages nor encourages condom use.[40] Although originally intended for use with urban, African-American youth in small groups, the intervention can be adapted for use with larger groups and those in rural settings.[41]  The curriculum is designed as eight, one-hour modules that include group discussions, videos, role-playing, skill-building activities, games, and other experiential exercises. It is appropriate for use in both school- and community-based settings. An evaluation of the program published in the Archives of Pediatrics & Adolescent Medicine found that at a 24-month follow-up,  participants who were sexually inexperienced at the time of the program were significantly less likely to have initiated sex than participants in the control group.[42]

 

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Pennsylvania TPPI, PREP, and Title V Abstinence-Only funding in FY 2010

 

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Comprehensive Approaches to Sexuality Education

SIECUS has identified some examples of model programs, policies, and best practices being implemented in Pennsylvania public schools that provide a more comprehensive approach to sex education for young people.[43]

 

Revised School District Policy

Pittsburgh Public Schools

On February 24, 2009, the Pittsburgh Public Schools School Board overturned its abstinence-only-until-marriage policy and adopted a new, comprehensive sexuality education policy for grades K–12. The new policy requires schools to teach “sexuality health education” that is comprehensive, age-appropriate, and medically accurate.[44] Instruction must emphasize “abstinence as the expected norm and the only protection that is 100% effective against unintended pregnancy, sexually transmitted infections, and HIV when transmitted sexually,” and provide a “wholesome and comprehensive understanding of the emotional, psychological, physiological, hygienic, and social responsibility necessary for successful relationships and family life.”[45]

 

Under the policy, sex education curriculum must cover six major topic areas: human development, healthy relationships, personal skills, sexual behavior, sexual health, and society and culture.  Specific instructional content shall discuss, among other information, anatomy, reproduction, body image, gender roles, “orientation and stereotypes,” risk reduction behaviors, decision-making skills, and pregnancy and STD prevention that addresses both abstinence and contraception.[46] Parents have the right to exempt their child from instruction.  The policy specifies that any outside presenters must be approved by the Office of Curriculum, Instruction and Professional Development. Furthermore, any outside presenter whose services do not align with the guidelines established by the policy will be prohibited from presenting within district schools.[47]   

 

We encourage you to submit any updated or additional information on comprehensive approaches to sex education being implemented in Pennsylvania public schools for inclusion in future publications of the SIECUS State Profiles. Please visit SIECUS’ “Contact Us” webpage at www.siecus.org to share information.  Select “state policy” as the subject heading.

 

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Points of Contact

 

Adolescent Health Contact[48]

Abigail Coleman

Adolescent Health Program Administrator

Bureau of Family Health

Pennsylvania Department of Health

Health and Welfare Building

625 Forster Street

7^th Floor, East Wing

Harrisburg, PA 17120

Phone: (717) 772-2762 

 

PREP State-Grant Coordinator

Carolyn Cass

Director

Division of Child and Adult Health Services

Pennsylvania Department of Health

625 Forster Street

Harrisburg, PA 17120

Phone: (717) 772-2762

 

Title V Abstinence-Only Grant Coordinator

Michelle Connors

Director

Division of Community Systems Development and Outreach

Bureau of Family Health

Pennsylvania Department of Health

7^th Floor, East Wing

Health and Welfare Building

625 Forster Street

Harrisburg, PA 17108

Phone: (717) 772-2763

 

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Organizations that Support Comprehensive Sexuality Education

 

 

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Organizations that Oppose Comprehensive Sexuality Education

 

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Media Outlets

 

Newspapers in Pennsylvania[49]

 

 

Political Blogs in Pennsylvania

 

 

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