WaPo | Rob Stein | originally posted 10/28/2010
Over the past decade, politicians have battled about how to reduce the teen pregnancy rate: safe-sex vs. abstinence-only sex education programs, even as films such as “Juno” and births by famous teens such as Bristol Palin and Jamie Lynn Spears seemed to make adolescent pregnancies more socially acceptable.
At the same time, after declining for years, the teen pregnancy rate increased, but the pace at which teens were having babies appeared to stop falling or even inch up.
Now, the Obama administration has entered the politically sensitive debate, promising to put scientific evidence before political ideology. A $110 million campaign will support a range of programs, including those that teach about the risks of specific sexual activities and the benefits of contraception and others that focus primarily on encouraging teens to delay sex.
The initiative exemplifies the administration’s oft-repeated quest to find new strategies to defuse some of the nation’s most divisive issues. In this case, officials are hoping to appease advocates of teaching teens about condoms and other forms of birth control as well as those who oppose sex outside marriage.
Although the program is being hailed by many adolescent health experts, it is being denounced by some on both sides of the abstinence debate.
“This is one of those emotionally charged issues where it’s very difficult to find compromise,” said Amy E. Black, a political scientist at Wheaton College in Illinois. “It inevitably becomes entangled in a larger constellation of issues, such as abortion, that raise ideological, moral and religious questions.”
During the George W. Bush administration, the federal government spent $1.5 billion on programs that encouraged teens to delay sex until marriage. Critics said it was grounded in religious tenets and conservative doctrine, failed to educate teens about condoms in the age of HIV and other sexually transmitted diseases, and ineffective.
In response, the Obama administration launched a teen pregnancy prevention program that officials promised would fund only programs that had been proven to work. Last month, the Department of Health and Human Services awarded $75 million to 75 groups to try to reproduce some of the 28 programs deemed to have been “proven effective through rigorous evaluation.”
HHS also awarded $35 million to 40 organizations to test “innovative strategies” that appeared promising. Altogether, 115 programs in 38 states and the District received funding.
“We were hoping for and hopefully got a healthy mix that will be both spreading evidenced-based programs around the country and allow us to identify programs that are as effective or more effective,” said Sharon Parrott, human services counselor for HHS Secretary Kathleen Sebelius.
Many experts agree.
“What’s exciting and innovative about that is not only the full-fledged return of science to the field of teenage pregnancy prevention but also the opportunity to adapt these approaches to the needs of individual communities,” said Michael Resnick, who studies adolescent health issues at the University of Minnesota.
But after studying the programs that won funding, critics of abstinence programs expressed dismay at the inclusion of curricula they consider discredited. Twelve grants totalling more than $9.3 million went to abstinence programs, according to HHS.
“They are funding programs that censor information about condoms and birth control and have elements that are clearly ideological and not science-based,” said James Wagoner of Advocates for Youth, a Washington advocacy group. For example, Live the Life Ministries of Tallahassee received $891,533 to try the WAIT Training abstinence program on 5,500 students in middle and high schools in 14 Florida counties.
“The problem is that this program is ineffective and withholds important information from young people,” said Monica Rodriguez, head of the Sexuality Information and Education Council of the United States, a nonprofit research and advocacy group. “There is very little information about condoms or other forms of contraception, and what information is there is biased and skewed towards portraying them in a negative light.”
Wagoner and others also criticized a $933,907 grant to Lighthouse Outreach in Hampton, Va., which plans to use the Choosing the Best curriculum to target 2,600 youths ages 10 to 19. Critics say the program includes misleading information about condoms and asks teens to make “virginity pledges.”
“I think the Obama administration is stretching the limits so it can ‘give something to the other side,’ ” Wagoner said, noting that the health-care overhaul legislation included $50 million a year for five years for abstinence funding. “Young people will end up paying the price.”
Wagoner and others expressed concern about some of the more than $1 million awarded to the Women’s Clinic of Kansas City, Mo. The clinic is one of the “pregnancy crisis centers” that have been denounced by reproductive rights supporters who say they proselytize to pregnant women about the evils of abortion.
Abstinence proponents said they were disappointed by the small number of abstinence programs that received funding, saying they had identified just five “authentic” abstinence programs receiving less than $5 million. Under the Bush administration, 169 abstinence programs were funded to serve more than 1 million students, and those programs face extinction, said Valerie Huber of the National Abstinence Education Association.
“We’re very disappointed,” she said. “Obviously, this policy change has taken away all emphasis on avoidance. A paltry number of abstinence programs were funded, neither giving priority to a risk-avoidance message nor giving equality to this message.”
Officials at some of the groups singled out by critics defended their programs, saying that they were required to provide “medically accurate” information about contraception and that it would be carefully evaluated by independent researchers.
“The goal is to come up with a road map for your life. What are your hopes and dreams? And how might sexual activity derail that?” said Richard Albertson, who heads Live the Life Ministries. “We want you to do things in the right order: Finish your education, postpone sexual activity until marriage, and then don’t get married when you are a teenager.”
“Our program is not going to be pro-choice or pro-life,” said Deborah Neel, executive director of the Women’s Clinic. “If they come into our center, we don’t say abortion is not an option. That’s stupid, because abortion is legal. But the thing is, you have to provide abortion education and abortion alternatives. You have to show the full range of choices.”
Joyce Richardson, project director for Lighthouse Outreach, said that the program does not teach students how to use condoms or other forms of contraception but focuses on how often they fail. But she said the information is balanced and accurate.
“We do teach them about the effectiveness rate, or lack thereof,” she said.
Parrott said that the programs trying to replicate proven curricula are required to follow the approved courses and that those trying new approaches must undergo independent evaluation.
“I think we have the appropriate oversight in place,” she said. “I think this is an opportunity for a broad range of programs to attack a really important problem.”