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States Reject "Abstinence-Only" Funds:

The Washington Post reports that a growing number of states is rejecting federal funding for "abstinence-only" sex education programs in response to evidence that such programs are ineffective.

At least 14 states have either notified the federal government that they will no longer be requesting the funds or are not expected to apply, forgoing more than $15 million of the $50 million available, officials said. Virginia was the most recent state to opt out.

Two other states -- Ohio and Washington -- have applied but stipulated they would use the money for comprehensive sex education, effectively making themselves ineligible, federal officials said. While Maryland and the District are planning to continue applying for the money, other states are considering withdrawing as well.

Until this year, only four states had passed up the funding.

"We're concerned about this," said Stan Koutstaal of the Department of Health and Human Services, which runs the program. "My greatest concern about states dropping out is that these are valuable services and programs. It's the youths in these states who are missing out."

The number of states spurning the money has grown even as Congress considers boosting overall funding for abstinence-only education to $204 million, with most of it going directly to community organizations.

The trend has triggered intense lobbying of state legislators and governors around the country. Supporters of the programs are scrambling to reverse the decisions, while opponents are pressuring more states to join the trend.

Federal officials say they are "concerned" about this trend, and critics of "abstinence-only" hope this leads to less restrictive, or differently targeted, funding conditions. Should the state trend continue, I would hope it would prompt reconsideration of the federal role here. If states don't want this money, that's just one more reason to end the federal funding altogether. Congress, however, seems ready to increase funding by over 15 percent.

wm13:
My understanding is that the statistical evidence indicates that all sex education programs, whether abstinence-only or any other kind, are ineffective, if effectiveness is defined as reducing teenage pregnancy and sexually transmitted diseases. (If you define success as helping teenagers achieve sexual fulfillment, that might be different.) Can anyone point to any peer-reviewed, methodologically sound statistical analyses that suggest otherwise?
12.16.2007 2:54pm
Hei Lun Chan (mail) (www):
They turned down money? I didn't know state governments do that kind of stuff ...
12.16.2007 3:14pm
Teh Anonymous:
You'd think that given the current budgetary demands - you know, there's a war on, and all - Congress would sorta shrug and say "Okay! More for us!" But I guess I'm too cynical, or too naive. I can't decide which.

Also: interesting that a Congress not controlled by the Republican party wants to increase abstinence-only funding.
12.16.2007 3:16pm
gattsuru (mail) (www):
WM13, you can probably find some somewhere showing that sex ed is better than nothing.

I don't trust 'comprehensive' sexual education classes because they tend to overwhelmingly not actually cover everything truthfully. While I don't think we even want sex ed classes to cover literally everything, even in more liberal areas these classes tend to focus on male condoms to the detriment of other ways to reduce chances of pregnancy, and also overrate condom use -- you tend to see estimated effectiveness values in the ~90+ range, even as high as 99.99% when combined with spermicidal agents, which is laughably far off what studies have shown.

Given how craptastic the rest of the school system has shown itself to be, I really don't see why we should expect them to go from a physics class claiming Heisenberg's Uncertainty Principle as the observer effect to suddenly being competent on the matter of lust.
12.16.2007 3:18pm
Just Dropping By (mail):
Congress will soon come up with a solution: condition receipt of any federal funding for education on adopting an abstinence-only curriculum.
12.16.2007 3:20pm
John Burgess (mail) (www):
If cold showers aren't sufficient to deter heightened sexuality during puberty, then not much will!

Sex Ed programs are equally effective/ineffective. Sex is an individual endeavor, not something best handled at the lowest common denominator level. That's why parents should have the major role in handling sex education: they ostensibly know their kids better than others.

It's a sad fact that many parents do not accept this responsibility, shirking it as most other responsibilities they can't be bothered to accept. So that state, necessarily, has a role to inculcate at least a minimal set of data about reproduction and sexual hygiene. I think it should stay at that minimal, biology class level and leave the morality of it to churches, parents, or other interested, non-state parties.
12.16.2007 3:32pm
Alex F:
Condoms are >90% effective when used 1) correctly and 2) 100% of the time. The problem is that many people who use them do not meet both conditions. Anecdotally, I'd say that people who are in relationships tend to be lax about condition #2, and people having casual sex often fail to meet either or both conditions. The studies that show higher effective failure rates are done on people using condoms as their primary means of birth control, many of whom admit to not using them every time they have sex and/or are not putting them on correctly or at the correct time (some people only put them on towards the end of sex, under the mistaken impression that orgasm is the only time that sperm is produced).

One problem that I see among people I know, is that most people in relationships will abandon condoms as soon as the woman is on some kind of birth control. They do not seem to consider the possibility that their partner will cheat, or the possibility that he/she may already have an STD and don't know it. The most promiscuous people I know are the ones who get tested regularly and are very conscientious about condoms, while the people who stick to relationships seem to feel like they aren't in danger of STD's and "don't have to" get tested or use condoms.
12.16.2007 3:55pm
Vinnie (mail):
The same kind of thinking that gives us "Abstinence-Only" sex ed is the same kind of thinking that keeps us from wiping out most STDs. Lets face it smallpox is hard to fight and easy to get. We made it extinct(in the wild at least) STDs are hard to catch and (many of them) are easy to cure yet chlamydia is more common than the common cold.
12.16.2007 4:02pm
TribalPundit (W&M 1L) (mail) (www):
Uh, Vinnie, if everyone practiced abstinence then STDs would be pretty much eliminated.
12.16.2007 4:18pm
Justin (mail):
" If states don't want this money, that's just one more reason to end the federal funding altogether."

Did anyone else giggle when they saw that was Jon Adler's conclusion?
12.16.2007 4:22pm
Curt Fischer:

Lets face it smallpox is hard to fight and easy to get. We made it extinct(in the wild at least) STDs are hard to catch and (many of them) are easy to cure yet chlamydia is more common than the common cold.


I love this analysis. You somehow concluded that the only disease which *has* been largely eradicated is comparatively "hard to fight" relative to diseases which have *not* been eradicated.

Personally, I would look at the evidence and suggest the exact opposite. Maybe it's just a preference.
12.16.2007 4:24pm
Vinnie (mail):
"Personally, I would look at the evidence and suggest the exact opposite."

Get the 'clap then the pox and report back.
12.16.2007 4:38pm
theobromophile (www):

you tend to see estimated effectiveness values in the ~90+ range, even as high as 99.99% when combined with spermicidal agents, which is laughably far off what studies have shown.

I've seen data which suggest that the effectiveness is different for teenagers than for adults.

This should not be a state issue, let alone a federal one. Sexual activity does not spontaneously happen; it is related to the progression of the relationship, prior relationships, religion, home life, and values. I know many parents who discouraged their kids from dating while young, or who put grade and/or extracurricular requirements on their kids that prevented them from having too much time on their hands (and all attendant problems). There is no way to divorce sexual activity from the environment in which the child grows up.

Besides, high school is waaay too late to start talking to people about sex. There is a values discussion which needs to start sooner than that.
12.16.2007 4:48pm
LM (mail):
A federal official associated with the program and quoted in the linked WP article said, "I think it's awfully hard to blame abstinence education for the increase in birth rates." Damn, that's a ringing endorsement. Where do I sign up?

Look, I'm an unapologetically tax-and-spend, big government (in the FDR tradition) Democrat, but crap like this pushes me close to the pox on both your houses camp. I mean, the substance of the program violates at least Democratic sensibilities, if not platform priorities; plus it's so ineffective that states are lining up to refuse the money. Oh, but to be fair, at least there may be an argument that it's not doing too much harm. Well thanks for that. And Congress' response to all this is that they're considering upping the funding by 15%? Are they nuts, or am I missing something?
12.16.2007 4:54pm
Oren:

Uh, Vinnie, if everyone practiced abstinence then STDs would be pretty much eliminated.

Along with the human race. Hey, that gives me an idea to eliminate cancer!
12.16.2007 5:12pm
OhioGuy:
They turned down money? I didn't know state governments do that kind of stuff ...

I won't speak for any other states, but I think it is pretty clear that Ohio is doing it because the governor is a lefty who wants to poke his finger into Bush's eye. Ohio's politics are ugly ... partisanship is more important than federal funds or cutting teen pregnancy.
12.16.2007 5:14pm
SenatorX (mail):
Abstinence? snicker! Sex is bad mmmkay?
12.16.2007 5:34pm
George Weiss (mail):
i think people may not know that that is the kind of program that requires matching funds from the state if they want federal money.

so if it isnt worth their money...they cant get federal money...and if they get federal money thyee have to spend ther own
12.16.2007 5:40pm
Oren:

Ohio's politics are ugly ... partisanship is more important than federal funds or cutting teen pregnancy.


Given that the program requires matching funds, it's safe to say that Ohio made a rational decision that they could to do more good teaching condoms with $.50 than teaching abstinence with $1.


Besides, high school is waaay too late to start talking to people about sex. There is a values discussion which needs to start sooner than that.


Ideally, yes, the parents would handle that a bit earlier. The state still need to step in if someone has made it all the way to young-adulthood without being given the basic facts. I really don't see why both sides of the debate insist that we can't present simple factual information in a value-neutral sort of way (any pontification on our part is bound to be ignored anyway).
12.16.2007 6:05pm
theobromophile (www):
Oren,

What do you mean about "basic facts?" If you're talking biology, that makes sense (i.e. "this is how women get pregnant, these myths about pregnancy are not true, this is how STDs are spread, these are common STDs",) fine. That is a part of basic biology, and the fact that it also touches on social issues is totally irrelevant. (

At my middle school and high school, we learned that stuff in biology class. We also had a separate class to learn about "decisions" (smoking, drinking, drugs, sex) that taught us how to use contraceptives. I'm not sure that you can get through a basic biology course without touching on reproduction and disease transmission.

Beyond that, what do you consider to be "the facts" about sex? reproduction? Even if you leave morals out of it, do you discuss the emotional effects? the statistics about how many young women wish they had waited until they were older? What about contraceptives? What reliability studies do you use - consistent and correct use among middle-aged women, or real-world use among teenagers?

I'm not trying to be a relativist and to suggest that there is no such thing as an empirically-verifiable fact about contraception and sexuality, but I see that most of the fight is about which facts to present.
12.16.2007 6:35pm
Atheotatous (mail):
I thought that the recent GAO report on the matter should be consulted. From the GAO report on abstinence-only education programs (available here):
While the extent to which federally funded abstinence-until-marriage education materials are inaccurate is not known, in the course of their reviews OPA and some states reported that they have found inaccuracies in abstinence-until-marriage education materials. For example, one state official described an instance in which abstinence-until-marriage materials incorrectly suggested that HIV can pass through condoms because the latex used in condoms is porous.


While the conclusions about the actual impact of abstinence-only education are not acceptable by scientific standards, the fact that some of these programs are passing along incorrect information, whether intentionally or unintentionally, is disgrace enough. I'm reminded of the horror stories of Catholic priests informing third-world children that condoms do not work, so there's no point in using them. That's a good way to stop the AIDs pandemic.
12.16.2007 6:37pm
Oren:
TBP:

The basic facts include the relevant biology (including debunking the various myths about AIDS that persist) and the relevant real-world studies about behaviors and practices that are known to reduce risk: e.g., monogamy, condoms and birth control. There's just no excuse not to explain these things, including their real-world failure rates.
12.16.2007 6:57pm
Steve2:
That a Democrat Congress is considering an increase in funding for these programs strikes me as bizarre, considering that it was a Democrat Representative who asked for the investigation that led to this indictment of them. Then again, could just be that the wrong Democrats are in leadership positions.

As for abstinence as a form of birth control and STD prevention, I think it's disingenuous to call it that. Seems to me that it's analogous to saying "walking everywhere you go is the best method of defensive driving": birth control and STD prevention ought, by definition, to mean methods to separate the spread of sperm and other pathogens from the sex act, just as defensive driving means driving in a safe manner, not eschewing driving altogether.

I will admit, I'm heavily biased against abstinence, having been forced through all too many years of unwanted celibacy and believing that I would have grown into a better and nicer person had I not been warped by that experience. Still. Presenting "Abstinence is the best way to prevent pregnancy and STDs" as the core of a sex-ed program strikes me as entirely equivalent to presenting "Not driving anywhere is the best way to prevent death in a car crash" as the core of a driver's-ed program. I won't die in a car crash if I'm not in a car? No duh. Now tell me something useful, like how to drive safely. I won't knock someone up if I don't have sex? No duh. Now tell me something useful, like how to have sex with someone without knocking her up.
12.16.2007 7:07pm
theobromophile (www):

I won't knock someone up if I don't have sex? No duh. Now tell me something useful, like how to have sex with someone without knocking her up.

Or how to be a sexual person without premarital intercourse... or at the very least, intercourse in high school.

I'm not anti-abstinence, so I would modify your analogy to say that the abstinence-only group is not saying, "Don't drive at all;" rather, they are saying, "Don't drive until you are of ___ age and know that you are risking death in a car crash."

Oren,

I see what you are saying. Thank you for answering. :)

(P.S. - thanks for recognising that my pseudonym is not the ombrophile.)
12.16.2007 7:12pm
Vinnie (mail):
I'm not anti-abstinence either, but just say no doesn't work for drugs and sex is way more fun than drugs.
12.16.2007 8:40pm
wm13:
Huh, no one seems able to answer my request.

Let me say, to my understanding, sex education is like driver education. Studies show that driver education reduces accident rates, but, unfortunately, it also increases the number of teenagers who get driver's licenses, so the overall rate of death and injury remains the same. Similarly, the approved lib/lab type of of sex education increases the rate of contraceptive use, but, unfortunately, it also increases the rate of sexual activity, so the overall level of pregnancy and sexually transmitted disease remains the same.

Abstinence based education I presume to be useless. I thought (and still think) that almost everything my teachers taught me, from high school through law school, was nonsense; why should today's teenagers be different?
12.16.2007 8:51pm
gattsuru (mail) (www):
Atheotatous
... One state official described an instance in which abstinence-until-marriage materials incorrectly suggested that HIV can pass through condoms because the latex used in condoms is porous.


Er, those materials were correct, if not as accurate as they should have been. The FDA's documented that HIV particles can and do pass through condoms; since HIV is a whole 110nm wide (as opposed to the average human sperm tip's thirty times that), this isn't a particularly difficult pill to swallow.
Their statement is misleading -- the big risk for viral transmission comes from infected cells, which can not pass through normal pores in a condom, or from fluid contact and absorption, rather than single moving free HIV particles -- but it's still technically correct and usually an important thing to note when dealing with risky sexual interactions. Real-life testing has born this out; with proper use of condoms, HIV transmission rates drop to between 13% and 20% of "bareback" values. Those are much better than bareback, with you looking at 1:50,000 to 1:80,000 interactions for heterosexual sex, but it's a far cry away from not having risky sex (or injecting with used needles, or getting untested blood transfusions) in the first place (usually approximated at one in several million).

Alex F:
Condoms are >90% effective when used 1) correctly and 2) 100% of the time.

I see numbers like that tossed around pretty often, but most people never actually bothered with the original document. One document often cited for those same numbers, Contraceptive Technology: Nineteenth Revised Edition, put perfect use for male condoms at 98% effectiveness over a year, but the same methodology also puts perfect use for the withdrawal method at 96% effectiveness over a year.

I dare say that's a rather useless metric.

The reality is that, especially in individuals without significant practice with the real thing, there's a lot of risk of slippage, breakage, rips, improper removal, and a dozen other things that can't be fixed through a sex ed class short of having the students screwing on the floor. Claiming 90%+ effectiveness is a good way to reduce interest in other, more effective, methods.
12.16.2007 8:57pm
theobromophile (www):

The reality is that, especially in individuals without significant practice with the real thing, there's a lot of risk of slippage, breakage, rips, improper removal, and a dozen other things that can't be fixed through a sex ed class short of having the students screwing on the floor.

That's one way to reduce truancy.

(Sorry, couldn't resist.)
12.16.2007 9:08pm
Oren:

The reality is that [condoms are used imperfectly]. Claiming 90%+ effectiveness is a good way to reduce interest in other, more effective, methods. [paraphrased]


I don't see any method, presented in neutral terms, to be "reducing interest" in any other method. I'm for teaching abstinence - I'm not for teaching abstinence only.
12.17.2007 1:19am
Oren:

through a sex ed class short of having the students screwing on the floor


I dunno. Our Sex-Ed class required hands-on (simulated!) practice from both genders on proper condom use. Looking back on it, it was a rather useful (if awkward) experience.
12.17.2007 1:21am
rarango (mail):
Re "turning down federal money:" I am aware were some counties in home rule states (ie, WA state) have turned down some bioterrorism money because the costs of accepting those dollars was not commensurate with any benefits. In home rule states, the Feds power over counties is very tenuous unless the funds are tied to other funds that are really needed.
12.17.2007 10:07am
DocSteve (mail):
A friend of mine pointed me to your discussion, as she knows my background in researching adolescent sexual behavior and evaluating ab-only approaches since 1995, when the Heritage Foundation wrote the first bill and had it slipped into the Welfare Reform Act by their minions at midnight without debate in Congress. Your forum may be interested in knowing that since Clinton signed the bill over one-half billion of American tax dollars has been wasted on these programs, if you count the matching funds the states had to pony up to receive the monies. And evaluations have shown many of the approaches have actually done damage to our youth. [See the work of John Santelli of Columbia U Public Health among many others]. Abstinence-only is the least effective contraceptive approach, failing 88% of the time [see the research of C. Haignere of Temple U.]. And now, thanks to illogical transactional policics, the Democratic Congress is willing to increase funding for programs shown to be ineffective. No wonder so many states are finally following the lead of California and putting an end to such poor public health initiatives.

DocSteve
12.17.2007 11:03am
Aultimer:

Similarly, the approved lib/lab type of of sex education increases the rate of contraceptive use, but, unfortunately, it also increases the rate of sexual activity, so the overall level of pregnancy and sexually transmitted disease remains the same.

Any cite to support that "understanding"?

The comparison seems far fetched - what is the baseline against which "approved lib/lab" sex ed is measured? No sex ed whatsoever? Where do they find that control group? Bahrain? Time machine to 1956?
12.17.2007 11:51am
theobromophile (www):

Abstinence-only is the least effective contraceptive approach, failing 88% of the time

So only 12% of women who take abstinence-only education manage to not get themselves knocked up every year?

Um... considering your statement about the "minions" of the Heritage Foundation (can you order minions online? I could use a few!), I take it that you are biased on this issue....
12.17.2007 12:07pm
gattsuru (mail) (www):
Oren
I don't see any method, presented in neutral terms, to be "reducing interest" in any other method. I'm for teaching abstinence - I'm not for teaching abstinence only.


The nature of a teaching environment is a zero-sum game; there is only so much time available for a given class, and no matter how you divide the material, there is no way to make time out of nothing. Teaching a variety of methods is, as a result, going to provide less time and focus on any individual method than teaching a limited number.

Beyond that, regardless of what you personally recommend, in reality there are a number of biases on the individual level and obvious in the various educational texts that will get in the way. Condoms are focused on because, at least for now, they're the only thing men can do, and they apply to all relationships men can develop. The Pill likewise gets more attention than is really justified by its effectiveness, because it's well-known and about as culturally acceptable as it gets.

Our Sex-Ed class required hands-on (simulated!) practice from both genders on proper condom use. Looking back on it, it was a rather useful (if awkward) experience.

And I'd recommend such for any sex ed class with a focus on condoms, but application isn't even the portion with the most issues. There's a lot of different attributes that can result in failure, and simply giving them an in-class once-over isn't a realistic way to deal with them.
12.17.2007 8:44pm
b-rob (mail):
Abstinence before marriage did not work for Pat Robertson, Ronald Reagan, Newt Gingrich, David Vitter, and any number of other mature, conservative, adult males. Why conservatives think it would work for teenagers with less experience, less foresight, and less developed judgment about people, situations, and consequences, is beyond me . . . .
12.18.2007 6:11pm