Congress Debates Abstinence-Only Education Funding as Preliminary Report Finds ‘No Reliable Evidence’ Such Teaching is Effective

Yesterday's congressional debate over a provision in the welfare reform bill that reauthorizes funding for abstinence-only sex education coincided with the release of a preliminary HHS-funded report that found no proof such programs are effective, the AP/Los Angeles Times reports (AP/Los Angeles Times, 4/24). Federal funding for abstinence-only education programs comes from several sources, including the 1996 Welfare Reform Act, the 1981 Adolescent Family Life Act and HHS grants. The Welfare Reform Act, which is up for reauthorization this year, originally granted $50 million per year over five years to states for the provision of abstinence education, and Bush's proposed welfare reform renewal plan would extend abstinence-only education funding at this current level. Bush's fiscal year 2003 budget proposal also includes a request for $73 million in HHS grants to fund abstinence programs -- an increase of $33 million from the 2002 budget -- and $12 million in abstinence funding through the 1981 Adolescent Family Life Act, the same level as this year (Kaiser Daily Reproductive Health Report, 4/3). "There is ample information out there for young people about how to protect themselves in terms of comprehensive sex education. We have not made a clear, concise message to them about the benefits of abstinence," Claude Allen, deputy secretary of health and human services, said at a hearing of the House Energy and Commerce Committee's Health Subcommittee (Connolly, Washington Post, 4/24). Bush's FY 2003 budget proposal requests an overall 33% increase in abstinence education funding, a boost that would fulfill his promise to fund abstinence education programs at the same level as comprehensive sex education programs (Kaiser Daily Reproductive Health Report, 1/31).

Contraception, Not Abstinence
Some lawmakers criticized the administration's plans to fund both types of programs at the same level. "The parity argument is nonsense. Title X funding [the source of the majority of comprehensive sex education funding] is not about school-based educational programs. This is not even a case of apples and oranges; it's apples and marmalade," Rep. James Greenwood (R-Pa.) said. However, Rep. Billy Tauzin (R-La.) said that providing both abstinence-based and comprehensive sex education may provide "a greater benefit" (Washington Post, 4/24). Medical experts testifying at the hearing were also divided. "There is abundant evidence that the 'safer sex' paradigm, despite more than 20 years and a variety of education programs designed to promote condom use, has not solved the problem," Joe McIlhaney of the Medical Institute for Sexual Health said. But David Kaplan, a pediatrics professor at the University of Colorado School of Medicine, said that declines in teen pregnancy rates are due "not to abstinence messages but to more effective forms of contraception." He added that the "medical community is united in its recommendations that teenagers be urged to abstain but also taught how to use contraception" (Rovner, CongressDaily/AM, 4/24). A kaisernetwork.org HealthCast of the hearing will be available online today after 12 p.m. ET.

Evidence Inconclusive on Abstinence Education
Meanwhile, an independent, interim report sponsored by HHS states that there "is still no evidence" that abstinence-only education programs are effective in preventing teen pregnancy or the spread of sexually transmitted diseases, the Associated Press reports (Meckler, Associated Press, 4/24). The interim report, released yesterday, presents the early implementation findings of a five-year study conducted by Mathematica Policy Research under contract to HHS. The study, which began in 1999, is evaluating the impact of abstinence programs on reducing early sexual activity (HHS release, 4/23). The report says that there is "no reliable evidence" indicating whether the programs work. "Most studies of abstinence education programs have methodological flaws that prevent them from generating reliable estimates of program impacts," the report states (Associated Press, 4/24). The interim report says that most abstinence program participants report "favorable feelings" about their experiences in the program and that abstinence programs "offer more than a single message of abstinence," often including lessons on self-esteem and decision-making. However, the report also states that abstinence programs have difficulty "engaging parents," addressing peer pressure and forming partnerships with local schools (HHS release, 4/23). Other reports have also presented conflicting findings on the benefits of abstinence programs. Robert Rector, a researcher with the Heritage Foundation, recently released a report highlighting 10 "promising" evaluations of abstinence-only programs, although the report relied on several studies that were conducted over short periods of time with small groups of teens. A study by the National Campaign to Prevent Teen Pregnancy stated that there is no conclusive evidence regarding the impact of abstinence programs. An Institute of Medicine report released in 2000 stated that abstinence programs are "poor fiscal and public health policy" because of the lack of data on their effectiveness (Washington Post, 4/24).