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HHS Releases Extreme Version of Abstinence-Only Programs

On January 26, 2006 the United States Department of Health and Human Services (HHS) released a new funding announcement for the Community-Based Abstinence Education (CBAE) program. This funding announcement is extremely problematic as it overwhelmingly emphasizes marriage as a goal for young people and ignores the existing evidence that points to the ineffectiveness of abstinence-only-until-marriage programs.

The CBAE program has been in existence since 2001. It was created and ushered through Congress by Representative Ernest Istook (R-OK) in order to create tighter restrictions around what abstinence-only-until-marriage programs could and could not do. CBAE remains the strictest of all federal abstinence-only-until-marriage funding streams in that grantees must adhere to all 8-points of the federal definition of “abstinence education” and may not teach other methods of pregnancy or STD prevention in the same setting. Due to its popularity among conservative members of Congress, CBAE has grown from $20 million in 2001 to $141 million in 2006.

The new funding announcement takes these restrictions even further. First, it ignores an earlier emphasis on a positive youth development approach and instead emphasizes that “teen sexual abstinence improves preparation for stable marriage.” It goes on to credit sexual abstinence before marriage with leading to a happier life, including having a healthier marriage, having more money, having healthier future children, being more “responsible” parents, being honorable and having integrity, attaining a better education, having fewer psychological disorders, avoiding drug, alcohol, and tobacco use, committing fewer crimes and staying out of prison, and having a longer life span. The announcement also seems to suggest that funded programs should use fear and shame; discourage contraceptive use; and ignore the needs of sexually active students, LGBTQ individuals, and young people who have been or are being sexually abused.

Unfortunately, the funding announcement does not solve the problem of the many medical inaccuracies found in abstinence-only-until-marriage programs. While it now requires grantees to provide references for all data related to contraceptive efficacy and STD information, there is no requirement that these sources be scientifically sound studies or valid medical journals.

In another half-hearted attempt to fix past criticisms of abstinence-only-until-marriage programs, the funding announcement now requires grantees to use 15 percent of their grant money to evaluate their programs. However, grantees are only required to document “the number of youth served; the hours of service provided to each youth; and the number of youth that complete the program.” While there is some discussion of grantees having the option to evaluate program participants’ behaviors and attitudes, the ideal outputs are described to “calculate program efficiency and answer such questions as, ‘What is the overall cost of providing services per program graduate?’ or ‘What is the overall cost per student per hour of abstinence education?’” These evaluations will provide no meaningful data regarding the effectiveness of these programs.

According to William Smith , vice president for public policy at the Sexuality Information and Education Council of the U.S. (SIECUS), “This ‘Get Married’ approach to health education being promoted by the federal government leaves young people without the information and skills they need and puts their lives at significant risk. We can only conclude that the Bush Administration’s intention is to pump federal tax dollars into programs that share its narrow world view at the expense of the health and well-being our nation’s young people.”


The full funding announcement reviewed in this report can be found at: