Sexual Health Education

About the Teen Pregnancy Prevention (TPP) Program

This tiered, evidence-based program administered by the Office of Population Affairs (OPA) provides competitive grants to a broad range of organizations and agencies. Polling data has shown widespread support for the TPP Program, and the program has been featured as one of 20 success stories in the Bipartisan Policy Center's Evidence Works: Cases Where Evidence Meaningfully Informed Policy.

In early 2023, 71 organizations received funding through the TPP Program that will continue for up to five years. 53 of those organizations are implementing effective TPP programs, 12 organizations are analyzing and evaluating new and innovative programs, and 6 organizations are developing collaborative pipelines to incubate and accelerate innovative strategies. These various programs will work in communities across the country to support adolescent health.

TPP and the Personal Responsibility Education Program (PREP) are complementary federal funding streams for teen pregnancy prevention education. Read more about these and other federal funding streams for sexual and reproductive health education.

Each year, funding must be secured for the program. Up to 10% of TPP Program funds can be used for training and technical assistance, evaluation, and other program support. Of the remaining funds:

• 75% go to Tier 1 grants to replicate teen pregnancy prevention programs that have shown to be effective through rigorous evaluation. 
• 25% go to Tier 2 grants to develop, replicate, refine, and rigorously evaluate additional models and innovative strategies to reduce teen pregnancy.

What Can You Do to Support TPP?

Contact your Representatives and tell them to increase funding, not eliminate the TPP Program.

Appropriations

FY 2025 (October 1, 2024 - September 30, 2025) - Status: In Process

Most Recent Action: On July 10, 2024, the House Appropriations Committee advanced its version of the FY 2025 Labor-HHS appropriations bill. The bill passed out of committee 31-25 and includes harmful anti-abortion riders and eliminates both the Title X Family Planning Program (Title X) and Teen Pregnancy Prevention Program (TPP). It also includes $40 million for the harmful sexual risk avoidance program (SRA), which are really abstinence-only programs. As we wait for this bill to move to the House floor, we urge Members of Congress to reject these attacks on reproductive well-being and vote against this proposed funding bill.

What happened previously:

• On June 27, 2024, the House Labor-HHS subcommittee marked up and approved its version of the FY 2025 Labor-HHS funding bill. The bill eliminated the TPP and Title X programs, proposed to defund Planned Parenthood, funds the abstinence only sexual risk avoidance programs at $40 million, and includes a host of harmful anti-abortion policy riders such as the Hyde and Weldon amendments and proposes to cut training for medical students on abortion.
• On June 26, 2024, the House Labor-HHS subcommittee released its proposed FY 2025 Labor-HHS funding bill. The proposed bill eliminates critical reproductive health programs and contains a host to harmful policy riders. See Power to Decide's statement on the proposed funding bill.
• On March 11, 2024, President Biden released his budget request for FY 2025. The President's budget is a proposal, and it does not become law. Congress ultimately determines government funding levels. The President's FY 2025 budget proposal requested $101 million, or level-funding for the TPP Program. For more information, see Power to Decide's statement on the President budget request.

FY 2024 (October 1, 2023 - September 30, 2024) - Status: complete

Most recent action: On March 23. The Senate voted to approve the final FY24 funding package including Labor, Health, and Human Services and Education (LHHS), which funds the Teen Pregnancy Prevention Program. The final bill which was signed by President Biden, funded the Teen Pregnancy Prevention program at $101 million.

What happened previously:

• On January 18, the House and Senate passed a continuing resolution (CR)—a stopgap measure to keep the government funded at current levels. The CR funds defense and security related appropriations through March 1, 2024, and domestic appropriations bills—including LHHS, which funds the TPP Program—through March 8 , 2024.
• On November 15, the House and Senate passed a CR that funded the government at current levels through January 19, 2024 (defense and security related appropriations) and February 2, 2024 (domestic appropriations bills—including LHHS).
• At the end of September, Congress passed, and President Biden signed a CR to keep the government funded at current levels through November 17, 2023.
• On June 27, the Senate Appropriations Committee passed its FY 2024 LHHS Appropriations bill, which maintains level funding ($101 million) for the TPP Program. In contrast, the U.S. House LHHS Subcommittee advanced a bill earlier in July, that eliminates funding for the TPP Program.
• On Thursday, March 9, President Biden released his budget request for the 2024 fiscal year. It proposes increasing funding for the TPP Program from its current level of $101 million to $111 million. The president's budget proposal is just that, a proposal. Congress ultimately has the power of the purse. Read Power to Decide's statement on the president's FY 2024 budget proposal and appropriations request to Congress.

Resources

• FY 2025 Appropriations Request Letter - explains why increased funding for the TPP Program is a priority. 
• FY 2023 - FY 2025 Budget Chart. 
• Report: Final one from the Bipartisan Commission on Evidence-Based Policymaking cites the TPP Program as an example of a federal program “developing increasingly rigorous portfolios of evidence” (see page 94).
• Polling Data: Demonstrates widespread support for the TPP Program (and PREP).

About the Personal Responsibility Education Program (PREP)

PREP funds evidence-based programs dedicated to educating adolescents on both abstinence and contraception to prevent pregnancy and STIs. PREP also educates youth on adulthood preparation topics, such as healthy relationships, parent-child communication, and financial literacy. The program targets youth ages 10–19 who are experiencing homelessness, in foster care, live in rural areas or in geographic areas with high teen birth rates, or come from racial or ethnic minority groups, as well as pregnant and parenting youth. PREP includes formula grants to states (or competitive grants to organizations in the states that decline the formula grants), grants to tribes and tribal organizations, and grants for research and demonstration projects to implement and evaluate innovative strategies. Polling data has shown that PREP has widespread support. You can see an overview of the program in our fact sheets, PREP at a Glance and Pregnancy Prevention Among Youth in Foster Care.

PREP and the Teen Pregnancy Prevention (TPP) Program are complementary federal funding streams for teen pregnancy prevention education. They are high-quality examples of tiered, evidence-based grant making that use evidence to inform awards and continuous program improvement.

Funding Status

Status: Funded through December 24

Through the Continuing resolution in early 2024, PREP funding has been extended until December 2024. PREP is funded at $75 million.

What Can You Do to Protect PREP?

If you are part of an organization that would like to protect evidence-based sex education, please consider signing on to our 2022 Letter in Support of the TPP Program and PREP and joining the nearly 100 groups who support increased funding for these critical programs.

Resources

• Developing Effective Sustainable Personal Responsibility Education Programs (from The Exchange).
• Adolescent Pregnancy Prevention in Underserved Populations: The Way Forward. American Journal of Public Health Special Supplement: Vol. 108, No. S1. February 2018. https://ajph.aphapublications.org/toc/ajph/108/S1
• Multi-Component PREP Evaluation 2011 – 2018.

About the HHS Teen Pregnancy Prevention Evidence Review

The HHS Teen Pregnancy Prevention Evidence Review is an independent, systematic, and rigorous review of evaluation studies conducted by Mathematica Policy Research and managed by the HHS Assistant Secretary for Planning and Evaluation (HHS' evidence and evaluation experts). The evidence review has identified a growing number of evidence-based teen pregnancy prevention program models that represent a variety of approaches.

Most State PREP grantees use models identified by the evidence review. Tier 1 TPP Program grantees (FY 2010 - FY 2014 & FY 2015 - FY 2019) also used these models—and it serves as a resource for communities around the country.

The latest 2023 findings on the TPPER identified 52 programs that meet the review criteria for evidence of effectiveness. The Teen Pregnancy Prevention Evidence Review is included in the Results First Clearinghouse Database, a project of the Pew-MacArthur Results First Initiative.

About the Real Education and Access for Healthy Youth Act (REAHYA)

The Real Education and Access for Healthy Youth Act (REAHYA), which was first introduced in Congress in 2021, would make essential investments in inclusive and honest sex education programs. The bill would also provide funding to help young people facing the greatest barriers to sexual health services get access to quality and culturally responsive care. You can read our full statement for more. 

REAHYA was reintroduced in the 118th Congress in May 2023 by Representatives Barbara Lee and Alma Adams, and Senators Mazie Hirono, and Corey Booker. The House version currently has 46 cosponsors, and the Senate version currently has 13 cosponsors.

Contact Your Members of Congress and tell them to Cosponsor REAHYA!

The Pregnancy Assistance Fund (PAF) was administered by the Office of Population Affairs. It provided $25 million annually from FY2010–2019 for competitive grants to states, tribes, and territories to support pregnant and parenting teens and women, and combat violence against pregnant women. Projects helped teens in high schools and community service centers and young women in institutions of higher education complete school and gain access to health care, childcare, family housing, and other critical supports. In the most recent period, there were 23 grantees in 22 states. Read more information about PAF here. 

Current Status: Funding for PAF ended on June 30, 2020. 

Latest Action

• President Biden’s first two budgets (FY 2022 and FY 2023) recommended funding PAF, but Congress ultimately controls what programs are funded.
• In December 2020, Reps. Spanberger (D-VA) and Cole (R-OK) introduced a bipartisan stand-alone bill HR 8862 to reauthorize PAF for 5 years. 
• In July 2019, Senators Murkowski (R-AK) and Casey (D-PA) introduced a bipartisan stand-alone bill to reauthorize PAF for five years, at $25 million annually (S 2296).