This morning, the House Committee on Appropriations Subcommittee on Labor, Health and Human Services, Education, and Related Agencies passed the Fiscal Year 2010 appropriations bill and in doing so eliminated traditional sources of abstinence-only-until marriage programs. Powerful Appropriations Committee Chair Congressman David Obey (D-WI), and a long-time supporter of abstinence-only programs, shepherded these changes through the process.
The committee also eliminated a ban on syringe exchange programs for HIV prevention among users of intravenous drugs. These programs, proven by evidence from throughout the world to be one of the single most effective HIV prevention strategies, was nonetheless banned for many years due solely to ideological opposition and false charges that such programs encouraged further drug use. Ironically, the House committee did what the President promised to do but later backtracked on doing: The White House has reneged on promises made during the campaign to eliminate the ban on syringe exchange.
Abstinence-only-until-marriage programs, on which some $1.5 billion has been spent by the U.S. government over the past 10 years, have been widely and deeply discredited and have contributed to a rise in both teen pregnancies and a rise among youth of sexually transmitted infections including but not limited to HIV infections.
The complete elimination of abstinence-only-until-marriage programs, and the replacement of these programs by evidence-based comprehensive sexual health education programs (which also emphasize abstinence and delay of sexual initiation among youth but also equip youth with the knowledge and skills to live safe, healthy sexual and reproductive lives throughout their entire lives) has been a central goal of the public health and human rights advocacy communities for years.
What is still not clear as of this writing however is what will replace these programs, and whether abstinence-only-until marriage programs will continue to receive federal funding through other budget lines. Language in the bill is still being analyzed by experts in the public health advocacy community, according to the Sexuality Information and Education Council of the United States, and it is as yet not clear what kinds of funding will be provided under the new teen pregnancy initiative proposed by the White House and incorporated into the House bill.
The bill states:
Included within this bill is $114.5 million for a new teenage pregnancy prevention initiative that will support both evidence-based and other approaches, such as abstinence, to reducing teen pregnancies, which are on the rise. These approaches will be systematically evaluated, generating new knowledge about the effectiveness of a variety of approaches to addressing rising teen pregnancies.
Advocates have had several concerns about this initiative, including what appears to be a limited approach to teen pregnancy prevention as the key outcome, rather than a broader approach through comprehensive programs which would focus on preventing teen pregnancy but also preventing sexually transmitted infections, building negotiation skills, increasing safe behaviors, addressing sexual violence and coercion, respect and responsibilty, and address the needs of gay, lesbian and transgender youth whose needs are not addressed within the narrow confines of "teen pregnancy prevention."
According to one expert:
We don’t know what exactly this [language] means yet and [neither the congressional staff nor the advocacy community have] seen
the actual language yet. [So we are not] sure if this leaves the door open for
ab-only funding (like the president’s language did).
We will update you as soon as greater clarity is gained on the implications of the House committee’s language.
Congressman Obey championed the elimination of the ban on needle exchange. In a statement prepared by the Chairmen’s office, he was quoted as saying:
This bill deletes the prohibition on the use of funds for needle exchange programs. Scientific studies have documented that needle exchange programs, when implemented as part of a comprehensive prevention strategy, are an effective public health intervention for reducing AIDS/AIV infections and do not promote drug use. The judgment we make is that it is time to lift this ban and let State and local jurisdictions determine if they want to pursue this approach.
The bill will now move to votes by the full Committee and the full House of Representatives.