In January, Arizona joined a growing list of states that are no longer participating in a key federal abstinence-only-until-marriage education program. To date, 16 states have declined to apply for the annual abstinence education grants set aside for them under Title V of the Social Security Act (see chart). The number of adolescents living in the states that have passed up Title V funding is now substantial, more than 12 million, or 41% of young people aged 12–18 nationwide. The foregone funds are also substantial, comprising some $19 million of the $50 million available annually under the program. Notably, those funds are not reallocated among the states remaining in the program; instead, they revert to the U.S. Treasury.

The trend in states opting out of the abstinence-only program accelerated in the past year as evidence mounted that the approach is ineffective. Last spring, a long-awaited, congressionally mandated evaluation of four U.S. programs considered to be especially promising found that none had a statistically significant beneficial impact on young people’s sexual behavior. Teens who participated in the programs were no more likely to abstain than those who did not. More recently, the National Campaign to Prevent Teen and Unplanned Pregnancy—following a comprehensive review of programs deemed to have strong evaluation components—reached the same conclusion. According to the Campaign’s report, Emerging Answers 2007, abstinence-only programs "did not delay the initiation of sex, increase the return to abstinence or decrease the number of sexual partners." By contrast, two-thirds of the programs that included abstinence education along with instruction about contraceptives "had positive behavioral effects," including delays in initiating sex, less frequent sex and a significant reduction in unprotected sex (related article, Spring 2007, page 2).

As state officials consider whether or not to accept Title V funding, it is clear that the statutory definition of what constitutes an "abstinence education" program has frustrated those who want to put state money toward more effective programs. To receive Title V funds, states must adhere to certain requirements, including barring teachers from discussing contraceptive methods (except to talk about their failure rates) and requiring them to teach that "sexual activity outside of the context of marriage is likely to have harmful psychological and physical effects." They also must pony up a $3 state match for every four federal dollars they receive. "As you are aware, several recent studies, including one commissioned by the federal government, have confirmed that abstinence-only programs are not producing results," wrote Janet Napolitano, governor of Arizona, in her letter rejecting about $1 million in federal funding for abstinence-only education set aside for the state. "When I find myself in the position of having to fight to protect services that clearly have an impact on the lives of Arizonans, like dental services for low-income seniors, I cannot in good conscience set funding aside for programming that is proven to be ineffective."

—Heather D. Boonstra