Four current programs have an exclusive focus on teenage pregnancy prevention education: 
the Teen Pregnancy Prevention (TPP) program, which is authorized under appropriations law; the Personal Responsibility Education Program (PREP), which is authorized under Title V of the Social Security Act; the Sexual Risk Avoidance Education program, which is authorized under Title V of the Social Security Act (and formerly known as the Title V Abstinence Education Grant program); and the Sexual Risk Avoidance Education program, which is authorized under appropriations law. This report will refer to the latter two programs as the Title V Sexual Risk Avoidance Education program and the Sexual Risk Avoidance Education program, respectively, to avoid confusion. The four programs are administered by the U.S. Department of Health and Human Services (HHS). This report begins with a brief discussion of recent developments in funding for the four teen pregnancy prevention programs. Table A-2 in Appendix A describes the changes made by the Bipartisan Budget Act of 2018 (BBA of 2018, P.L. The PREP program requires most grantees to place "substantial emphasis on both abstinence and contraception for the prevention of pregnancy among youth and sexually transmitted infections." Multiple HHS offices worked together to establish the Teen Pregnancy Prevention (TPP) Evidence Review process following enactment of the FY2010 omnibus appropriations law ( P.L. P.L. 111-117 also authorized the TPP program and required it to use models that are proven effective through rigorous evaluation in reducing teen pregnancy and related outcomes. Despite the connection to the TPP program, the review is intended to more broadly inform the teen pregnancy prevention field. The TPP Evidence Review seeks to identify which teen pregnancy prevention models have been shown to be effective based on studies from the past 20 years. Additional Research

HHS has taken additional steps to develop research on teen pregnancy prevention interventions. 111-117 ) established and provided annual funding for the Teen Pregnancy Prevention (TPP) program. However, HHS is in the process of discontinuing funding for the current cohort of TPP program grantees. Of the remaining amount, the appropriations laws have further stated the following:
75% is for grants to replicate programs that have been proven through rigorous evaluation to be effective in reducing teenage pregnancy, behavioral factors underlying teen pregnancy, or other related risk factors. 25% is for research and demonstration grants to develop, replicate, and refine additional models and innovative strategies for reducing teenage pregnancy. Tier 1B grantees are entities that are replicating evidence-based programs to scale in communities with populations in the greatest need. The Patient Protection and Affordable Care Act (ACA, P.L. 115-123 ) with mandatory funding of $75 million for each of FY2015 through FY2019. Recipients of PREP funds must fulfill requirements outlined in the law, including that they must implement programs that
provide youth with information on at least three of six specified adulthood preparation subjects (healthy relationships, adolescent development, financial literacy, parent-child communication, educational and career success, and healthy life skills); are "medically-accurate and complete"; include activities to educate youth who are sexually active regarding responsible sexual behavior with respect to both abstinence and the use of contraception; and provide age-appropriate information and activities, while ensuring these are delivered in the most appropriate cultural context for the individuals served in the program. Title V Sexual Risk Avoidance Education Program

The 1996 welfare reform law ( P.L. P.L. HHS has directed grantees to the TPP Evidence Review, though has not require grantees to use the models identified in the review. The appropriations laws have specified that Sexual Risk Avoidance Education grants are to
be awarded by HHS on a competitive basis; use medically accurate information; "implement an evidence-based approach integrating research findings with practical implementation that aligns with the needs and desired outcomes for the intended audience;" and "teach the benefits associated with self-regulation, success sequencing for poverty prevention, healthy relationships, goal setting, and resisting sexual coercion, dating violence, and other youth risk behaviors such as underage drinking or illicit drug use without normalizing teen sexual activity."
Congress has an interest in preventing pregnancy among teenagers because of the long-term consequences for the families of teen parents and society more generally. Since the 1980s, Congress has authorized—and the U.S. Department of Health and Human Services (HHS) has administered—programs with a focus on teen pregnancy prevention. This report intends to assist Congress with tracking developments in four teen pregnancy prevention programs that are currently funded. The report provides detailed information about each program and includes a table that can illustrate the ways in which the programs are both similar and different.
The four current programs are the Teen Pregnancy Prevention (TPP) program, the Personal Responsibility Education Program (PREP), the Title V Sexual Risk Avoidance Education program, and the Sexual Risk Avoidance Education program. Despite their similar names and purposes, the latter two programs have different authorizing laws and funding mechanisms. Generally, the four programs serve vulnerable young people in schools, afterschool programs, community centers, and other settings. Grantees include states, nonprofits, and other entities.
The TPP program was established and funded by the FY2010 omnibus appropriations law (P.L. 111-117). Subsequent appropriations laws have also provided discretionary funding. As required in appropriations law, the majority of TPP program grants (Tier 1) must use evidence-based education models that have been shown to be effective in reducing teen pregnancy and related risk behaviors. A smaller share of funds is available for research and demonstration grants (Tier 2) that implement innovative strategies to prevent teenage pregnancy. FY2018 funding for the TPP program is $101 million. HHS has taken steps to discontinue the current cohort of grants.
PREP was established under Section 513 of the Social Security Act by the Patient Protection and Affordable Care Act (ACA, P.L. 111-148) in 2010. The program receives mandatory funding and is designed to educate adolescents on both abstinence and contraception for preventing pregnancy and sexually transmitted infections, and on selected adult preparation subjects. The PREP authorizing law requires most grantees to replicate evidence-based programs that are proven to change behavior related to teen pregnancy. FY2018 funding for the program is $75 million.
The Title V Sexual Risk Avoidance Education program is authorized at Section 510 (Title V) of the Social Security Act. It was formerly known as the Title V Abstinence Education Grant program, which was authorized by the 1996 welfare reform law (P.L. 104-193). The Bipartisan Budget Act of 2018 (P.L. 115-123) renamed the program and made other changes. The program focuses on implementing sexual risk avoidance, meaning voluntarily refraining from sex before marriage. Grantees may set aside some of their funding to conduct rigorous and evidence-based research on sexual risk avoidance. FY2018 funding for the program is $75 million.
The Sexual Risk Avoidance Education program (not to be confused with the Title V program of the same name) was established and funded by the FY2016 omnibus appropriations law (P.L. 114-113). Other appropriations laws have since provided discretionary funding. Grantees are to use funding for education on voluntarily refraining from non-marital sexual activity, and they are encouraged to implement evidence-based approaches that teach the benefits associated with resisting risk behaviors. FY2018 funding for the program is $25 million.
Multiple HHS offices worked together to establish the Teen Pregnancy Prevention (TPP) Evidence Review process following enactment of the FY2010 omnibus appropriations law (P.L. 111-117). The review is intended to inform the teen pregnancy prevention field about which prevention models have been shown to be effective based on studies from the past 20 years. TPP Tier 1 grantees must use models identified in the review. HHS encourages grantees for the other teen pregnancy prevention programs to use models identified in the review as well.