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For more than a decade, the rate of teen pregnancies in America steadily went down, but a study released a few months ago shows that that decline ended in 2006, when the rate started to go back up.
It raised questions about the value of abstinence-only sex education programs. So under a new program, the Obama administration has devoted $100 million to fund sex education programs with proven records of reducing teen pregnancy, even if they don't only focus on abstinence.
NPR's Brenda Wilson has this report on one program considered to be among the most successful in the country.
BRENDA WILSON: Michael Carrera spent years developing a teen pregnancy prevention program, an interest that grew out of his experiences as a teacher in the Bronx 50 years ago.
Dr. MICHAEL CARRERA (The Children's Aid Society): I learned that if you spoke about sexuality to young people, they sat still.
WILSON: Carrera is now a well-known expert on adolescent development and sexuality education. He's worked for a long time in poor communities and learned young people have troubles that can't always be quantified: family, peers and self-esteem issues.
Dr. CARRERA: They brought them all with them, including their thirst for knowledge about sexuality and their interest in being with other boys and girls to talk about it. I concluded that the way to get the sexuality message to stick was to link it to all the other things that made them whole young people.
WILSON: First sponsored by New York City's Children's Aid Society in 1984, Carrera's program now has a number of in-school and after-school operations in the U.S. It's one of 28 programs approved by the Obama administration because they've shown they can get children to delay sex.
Carrera's model is being phased into the curriculum of the Arts and Technology Academy, a public charter school in one of Washington, D.C.'s poorest neighborhoods.
Ms. AARTI SHASTRY (Teacher, Arts and Technology Academy): All right, is everyone ready to play?
WILSON: In Aarti Shastry's fifth grade family life and sexuality education class, they're playing a game that challenges their ideas about gender.
Ms. SHASTRY: All right, ladies, which gender tends to talk more in conversation?
Unidentified Group: Females.
Ms. SHASTRY: Not correct, sorry. The answer is males. When people are having conversations, studies show that males are the ones that talk more.
WILSON: Later in the afternoon, Shastry's older seventh graders take on the more grownup subject of what happens to teens during puberty.
Ms. SHASTRY: The point of puberty is what?
Unidentified Man #1: Hair.
(Soundbite of laughter)
Ms. SHASTRY: Well - hair is something that happens during puberty, right? But what can a body do as adults that they can't do as kids?
Unidentified Man #2: Sex?
Ms. SHASTRY: Right. And so what is the consequence that can come from that? Kamate(ph)?
Unidentified Man #3: Having babies.
Ms. SHASTRY: Thank you.
WILSON: Carrera says giving young people information about sex is not the same thing as giving them permission to have sex.
Dr. CARRERA: That's what this is about. Sexual ignorance is not bliss. You do not make responsible decisions in the dark.
WILSON: He says young people need to know what options are available in life besides having children. That's why Carrera's program has a job club. Students learn about the world of work, get a stipend and keep a bank account. There is self-expression through music, art and athletics they can pursue a lifetime -all activities that are known to delay sex.
Susan Philliber, an independent evaluator, has seen the difference between teenagers in Carrera's New York City program and other teenagers in the city.
Dr. SUSAN PHILLIBER (Philliber Research Associates): So we followed them right up into some very high-risk years. In the program group, 10 percent got pregnant, but in the control group, it was 22 percent. That's more than double the percentage, and impressive.
WILSON: There's also comprehensive medical, dental and mental health care. Philliber says a girl in the program is not only more likely to use contraceptives, but protection against sexually transmitted infections.
Dr. PHILLIBER: Because she's saying, you know, I want this protection. I don't want any risk here. I'm in school. I need to think about other things.
WILSON: But Philliber says it doesn't work for everyone.
Dr. PHILLIBER: The boys that became the most difficult to engage in the program were the ones who by the age of 13 had already been sexually active. So these were high-risk little boys.
WILSON: So the program now starts early and goes from grade five to the end of high school.
It's hard to find people who don't like the Carrera model, including Ron Haskins of the Brookings Institution. He was a senior adviser to President George W. Bush at a time when abstinence-only programs were hotly debated. Haskin admires Carrera but wonders if others could faithfully adapt his program.
Mr. RON HASKINS (Brookings Institution): Imagine the organization and the funding that you have to have to do all the things that Carrera does, I mean, by the time you have help with schoolwork, and you have organized athletics, and you have visits to various places in the community, that you have a college prep and even more than that.
WILSON: Carrera's program costs about $2,500 per student. Most of that comes from national and local foundations. There are other programs on the administration's list for middle-class kids, white kids, Latino kids and black kids, though few are as comprehensive as Carrera's.
Brenda Wilson, NPR News.
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