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Given this reality, it is especially alarming that the federal government continues to spend money on programs that simply do not work.Although a small number of abstinence-only programs have shown limited effectiveness, the weight of scientific research indicates that strategies that solely promote abstinence outside of marriage while withholding information about contraceptives do not stop or even delay sex.Over the past two decades, the United States has spent approximately billion on ineffective and stigmatizing programming for adolescents focused on promoting abstinence from sex outside of marriage.

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At the same time, Congress will have the opportunity to reauthorize the Title V abstinence-only program and to set new funding levels for it as well as the smaller grant program for “sexual risk avoidance” education.

Despite the current emphasis on reducing spending levels, proponents of abstinence-only education may seek to ramp up funding in this area without affecting overall spending by diverting money from the more comprehensive programs. Elia JP and Eliason MJ, Dangerous omissions: abstinence-only-until-marriage school-based sexuality education and the betrayal of LGBTQ youth, , 2016, 11(1):33–52, https://gov/labs/articles/27677440/. Chin HB et al., The effectiveness of group-based comprehensive risk-reduction and abstinence education interventions to prevent or reduce the risk of adolescent pregnancy, human immunodeficiency virus, and sexually transmitted infections: two systematic reviews for the Guide to Community Preventive Services, , 2016, 78(2):546–561, Family and Youth Services Bureau (FYSB), National Clearinghouse on Families and Youth, U. Department of Health and Human Services (HHS), State abstinence education grant program fact sheet, North Bethesda, MD: HHS, 2016, https://hhs.gov/fysb/resource/aegp-fact-sheet. FYSB, National Clearinghouse on Families and Youth, HHS, Sexual risk avoidance education program fact sheet, North Bethesda, MD: HHS, 2017, https://hhs.gov/fysb/resource/srae-facts. UNFPA, , Paris: United Nations Educational, Scientific and Cultural Organization, 2015, Lindberg LD and Maddow-Zimet I, Consequences of sex education on teen and young adult sexual behaviors and outcomes, , 2012, 51(4):332–338, https:// Kohler PK, Manhart LE and Lafferty WE, Abstinence-only and comprehensive sex education and the initiation of sexual activity and teen pregnancy, , 2008, 42(4):344–351, https://gov/pubmed/18346659. Sexuality Information and Education Council of the United States (SIECUS), In good company: Who supports comprehensive sexuality education?

The bulk of this money—$75 million—is allocated for the Title V abstinence education program, a grant program for states that contains an eight-point statutory definition of an eligible “abstinence education” program.

Among its points are teaching that “sexual activity outside of the context of marriage is likely to have harmful psychological and physical effects” and that “a mutually faithful monogamous relationship in the context of marriage is the expected standard of human sexual activity.” The remaining $10 million is directed to a grant program for community-based organizations recently repackaged as “sexual risk avoidance” education, which seeks to teach adolescents how to “voluntarily refrain from non-marital sexual activity” and avoid “youth risk behaviors…without normalizing teen sexual activity.” Federal policy should focus on comprehensive, medically accurate and age-appropriate programs.

Although there is no federal funding stream dedicated to promoting truly comprehensive sex education, federal funding for teen pregnancy prevention has largely shifted away from a focus on abstinence-only programs to a more comprehensive approach that educates adolescents about contraception in addition to abstinence.

Of the 6 million provided for more comprehensive programs in FY 2016, million went to the Personal Responsibility Education Program (PREP), a grant program that mainly provides funds to states for programs that educate adolescents about both abstinence and the use of contraception for the prevention of pregnancy and STIs.

Ninety-five percent of Americans have sex before marriage and, on average, adolescents in the United States have sex for the first time at about age 17 but do not marry or begin having children until their mid- to late 20s.

During this long interim period, they may be at heightened risk for unintended pregnancy and STIs.

Abstinence-only programs violate adolescents’ rights, ignore their needs and do not work.

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