Skeptical states are shoving aside millions of federal dollars for abstinence education, walking away from the program the Bush administration touts for slowing teen sexual activity.
Barely half the states are still in, and two more say they are leaving.
Some $50 million has been budgeted for this year, and financially strapped states might be expected to want their share. But many have doubts that the program does much, if any good, and they're frustrated by chronic uncertainty that it will even be kept in existence. They also have to chip in state money in order to receive the federal grants.
Iowa Gov. Chet Culver, a Democrat, made his decision to leave based on the congressionally mandated curriculum, which teaches "the social, psychological and health gains of abstaining from sexual activity." Instructors must teach that sexual activity outside of marriage is likely to have harmful psychological and physical effects.
"It was just too strict," said Emily Hajek, policy adviser to Culver. "We believe local providers have the knowledge to teach what's going to be best in those situations, what kind of information will help those young people be safe. You cannot be that prescriptive about how it has to be taught."
A federal tally shows that participation in the program is down 40 percent over two years, with 28 states still in. Arizona and Iowa have announced their intention to forgo their share of the federal grant at the start of the fiscal year that begins Oct. 1.
The program was created by Congress in 1996 as part of welfare reform.
Since 2002, lawmakers have approved 19 short-term extensions - usually for three or six months at a time. But on three occasions, the program was extended for just a few days.
Whatever state officials think of the program's aims, that's not the kind of bureaucratic consistency they need to budget for employees and to put contracts out to bid.
"The funding stream became inconsistent. We didn't know from one quarter to the next whether we'd be getting the rest of the money," said Elke Shaw-Tulloch of the Idaho Department of Health and Welfare. "We got to the point where we didn't have any infrastructure to put the money to use. At the same time, there was mounting evidence the abstinence programs weren't proving to be effective."
Throw in a rising pregnancy rate among 15-19 year-olds in Idaho - 2,543 pregnancies in 2006 compared with 2,396 in 2004 - and state officials decided last summer it was time to get out.
Stanley Koutstaal, the federal official who oversees the abstinence-only program at the Administration for Children and Family Services, notes that more than half the states still choose to participate. "Obviously, many states still find it valuable and have adopted it as their approach to addressing the sexual activity of teens," he said.
He called for long-term reauthorization of the block grants so that states and their contractors can be more certain about the future and can plan accordingly.
Some states' officials do speak favorably of the program.
In Georgia, some 250,000 students have participated in abstinence education since 2000 through schools, church groups and nonprofit agencies.
Teachers in Georgia go beyond the abstinence message. They stress community service and doing better in school, said Jen Bennecke, executive director of the governor's office for children and families. Bennecke says the program has led to an almost a 50 percent drop in pregnancy rates for Georgia youth ages 15-17 since the mid-90s.
"We really see abstinence education as a clear, concise and positive message," Bennecke said. "We've presented it as a healthy lifestyle choice."
The abstinence-only grants have been controversial from the start.
Supporters say comprehensive sex education sends a mixed message and that abstinence is the only method that is 100 percent effective in preventing pregnancy and sexually transmitted disease. Critics say abstinence education simply doesn't stop teens from having sex, and those teens need more information about how to reduce pregnancy and disease.
In April 2007, a federally funded study of four abstinence-only programs by Mathematica Policy Research Inc., found that participants had just as many sexual partners as nonparticipants and had sex at the same median age as nonparticipants. The four programs had taught students about human anatomy and sexually transmitted diseases, helped them improve their communication skills, manage peer pressure, set personal goals and build self-esteem.
For Colorado, the study results sealed the decision to get out of the program. Dr. Ned Calonge, the state's chief medical officer, said Mathematica's methods were the gold standard for scientific studies.
"To show no benefit compared to nothing. That was striking," Calonge said. "These are tax dollars that are going for no useful purpose, and it would not be responsible for us to take those dollars."
Under the program, states have to put up $3 for every $4 they get from the federal government. The program, referred to as Title V, is one of three abstinence education programs funded by the federal government. Of the $50 million budgeted for the program this year, about $21 million has been distributed.
Koutstaal said the study was instructive on how to improve the program, but it wasn't a signal to scrap it. The study, he noted, focused on middle school children and tracked behavior at the high school level.
"One thing we learned from it was that it may not be enough to do something in middle school and expect that you're going to continue to see positive outcomes in high school," Koutstaal said.
As a result, applicants seeking abstinence education funding through another government program, called Community Based Abstinence Education, are required to show how they will serve high school students and how they will help young people deal with peer pressure.
Longtime critics of abstinence-only education say the dwindling participation is a signal that Congress should abolish the program or change it.
"If Congress isn't getting that message, it's difficult to figure out what will convince them," said William Smith, vice president for public policy at the Sexuality Information and Education Council of the United States.