BOSTON — The state will use federal money to teach teenagers to abstain from sex before marriage, sparking concerns among some sex-ed advocates who say abstinence-only programs are ineffective.

Massachusetts is one of 35 states — including Alabama, Florida, Georgia, Louisiana and West Virginia — to accept a grant from the U.S. Department of Health and Human Services that must fund projects that teach participants to "refrain from non-marital sexual activity" and avoid risky behaviors such as underage drinking and drug use.

The state Department of Public Health, which applied for the money, declined to make officials available to discuss how the $808,000 will be spent.

In a statement, the agency said the money will complement existing programs including "education around healthy relationships, birth control (including emergency contraception), sexually transmitted infections, preventive cancer care such as cervical and breast cancer screenings, and overall reproductive health."

The money will fund programs at several nonprofits including the Boys & Girls Club of Chelsea, Girls Inc. in Lowell, Revere CARES and the YWCA of Central Massachusetts.

Those programs will focus on youth ages 10 to 15 with "evidence-based programming rooted in positive youth development principles proven to reduce risk factors and increase protective factors for teen pregnancy," such as abstaining from sex, the agency said.

Groups such as the Planned Parenthood League of Massachusetts say studies have shown telling teens to “just say no” doesn't prevent them from having sex, and may even contribute to the spread of sexually transmitted diseases and unwanted pregnancies.

"By distorting information about the effectiveness of contraceptives, blurring religion and science, treating gender stereotypes as facts and promoting medically inaccurate content, abstinence-only-until-marriage programs put young people, especially LGTBQ teens, at risk," said Jen Slonaker, the league's vice president of educational development.

Renewed effort

Abstinence-only education — encouraging young people to wait until marriage for sex — is making a comeback under a Republican administration in Washington, D.C.

Republicans in Congress approved a spending bill earlier this year that boosted funding for the federal grant program by 67 percent, bringing it up to $25 million.

In fiscal 2017, roughly one-third of the nearly $300 million in federal funding for teen sex education was devoted to abstinence-only education, according to federal budget data.

That's a shift from the Obama administration, which increased resources for programs focused on contraception, disease prevention and healthy relationships, while cutting funding for the abstinence-only programs.

The Trump administration also has encouraged organizations applying for Title X federal family planning funds to include in their programs a "meaningful emphasis" on the "benefits of avoiding sex.”

Advocates of sex ed programs that include contraception say they’re concerned about the effects of a shift toward abstinence-only messages on teen pregnancy.

In 2015, there were an estimated 23 births per 1,000 girls aged 15 to 19, according to the U.S. Department of Health. That's compared to 41 births per 1,000 girls in 2007.

In Massachusetts, the number of teenagers having babies has declined dramatically in recent years, which experts attribute largely to access to birth control and sex ed classes in schools.

Statewide 2,140 babies were born to mothers ages 15 to 19 in 2015, according to the Executive Office of Health and Human Services.

The state’s teen birth rate that year was 9.4 per 1,000 girls — lowest in the nation.

Despite that, teen birth rates remain high in some communities north of Boston, including Lawrence, Lynn and Haverhill.

Sex ed not required

Conservative groups such as the Massachusetts Family Institute argue that abstinence-only programs are effective and teaching about contraception encourages early sexual activity.

Under former Republican Gov. Mitt Romney, the state used a two-year $800,000 federal abstinence-only grant to teach middle school students to say no to sexual activity before marriage.

But the state doesn't appear to have sought federal abstinence-only grants since Romney occupied the governor's office.

Republican Gov. Charlie Baker has increased funding for sex-ed programs that focus on contraception and signed a bill last year requiring state insurers to cover birth control without a copay.

But the state doesn’t require sex-education classes, leaving school districts to decide whether to offer them and what kinds of standards to incorporate into local curriculums.

Some districts, including Lawrence, offer classes emphasizing abstinence in addition to the use of birth control and other forms of contraception.

On Beacon Hill, Planned Parenthood and other opponents of abstinence-only programs have lobbied to require districts to teach sex ed in a "medically accurate, age-appropriate" way.

Christian M. Wade covers the Massachusetts Statehouse for The Salem News and its sister newspapers and websites. Email him at cwade@cnhi.com.

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