As federal funding for promoting teen abstinence dries up, a shift is taking place in sex education in some Texas schools — often driven in part by concern over teen pregnancies.

More government money has been spent on the cause of sexual abstinence in Texas than any other state, but it still has the third-highest teen birth rate in the country and the highest percentage of teen mothers giving birth more than once.

The rate of student pregnancies in Austin high schools has increased 57 percent since the 2005-06 school year, and rates of sexually transmitted diseases are rising among Travis County teens.

Now some school districts — including Austin — are moving from so-called abstinence-only instruction to a more comprehensive sex education curriculum, also called "abstinence-plus," which has been taught in few Texas schools.

"We mainly did it because of our pregnancy rate," said Whitney Self, lead teacher for health and physical education at the Hays Consolidated Independent School District. "We don't think abstinence-only is working."

Roy Knight, Lufkin Independent School District superintendent, echoed that view.

"Our data says that what we're doing isn't working, and our community is ready for us to do something different," said Knight, adding that his district's adoption of an abstinence-plus curriculum was "absolutely driven" by a teen pregnancy rate that is higher than the state average.

Both approaches to sex education teach that refraining from sexual activity is the safest choice for teens.

But abstinence-only gives limited information about contraceptives and condoms and tends to downplay their effectiveness, while abstinence-plus stresses the importance of using such protection if teens are sexually active.

The latter approach fits the Obama administration's effort to shift dollars from abstinence promotion to strategies aimed at lowering teen pregnancies. The federal abstinence program known as Title V expired June 30, and an even larger program, Community Based Abstinence Education, is expected to cease after 2010.

Together they have sent about $14 million a year to Texas — most of it in federal grants to nonprofit groups that contract with school districts to tell kids about the benefits of abstaining from sex until marriage.

Though most Central Texas schools' arrangements with these groups remain in place for now, that could change. The loss of Title V funds slashed abstinence spending in the new state budget that took effect Sept. 1, and many private contractors are chasing money to stay in business.

Among their options: charging schools for instruction and materials that federal funding had enabled them to provide for free.

Some already have begun to do so, such as Worth the Wait, an abstinence program developed under the auspices of Scott & White Memorial Hospital in Temple.

Round Rock has used the program since 2002 but will be considering other options this year, said Anita Gordon, secondary science coordinator.

"The fundraising initiatives we're throwing around right now are new for us," said Amanda Brown, program director for Austin LifeGuard, which contracts with about a dozen school districts in Central Texas.

An offshoot of Austin LifeCare, a faith-based nonprofit group, LifeGuard operates with a $582,900 federal grant that covers about 80 percent of its budget, Brown said.

Until this year, LifeGuard made weeklong presentations that were part of the Austin district's required health classes. The district dropped LifeGuard this summer after revising the human sexuality portion of its health curriculum for grades 7-12.

"We could not find a packaged program that met the needs of our district (so) we developed our own program," said Tracy Lunoff, the district's health coordinator.

What about condoms?

The revised Austin district program relies on a new curriculum created by Dr. Janet Realini, a San Antonio physician and public health expert who has long worked on teen pregnancy prevention.

The lessons are taught by regular classroom teachers and provide extensive information on sexually transmitted diseases as well as clinical data on the success rates of many kinds of contraception, including intrauterine devices and hormone implants.

"We wanted something that was inexpensive, honest and gave a lot of attention and support to abstinence," Realini said. "The key message is, if you're sexually active, you need to use a condom, because it will reduce the risk of (sexually transmitted diseases) and reduce the chance of pregnancy."

Realini said the abstinence-only message undermines "confidence in condoms themselves and birth control itself. I worry about young people being discouraged from using condoms. ... That's not a helpful public health approach."

Critics of comprehensive sex education say there's not enough evidence they actually lower pregnancy and sexually transmitted disease rates — and that focusing primarily on abstinence can delay a teen's first sexual experience by at least one or two years.

Such data "argues for continued support and expansion of abstinence-centered education, especially considering the regret that most sexually active teens express for becoming sexually active," said Utah-based researcher Stan Weed in testimony before Congress last year on abstinence programs.

In 2004, Realini testified before the State Board of Education against the health textbooks now used in Texas schools, citing what she says is faulty information on condoms, contraceptives and sexually transmitted diseases. Only one of the four texts acknowledges that condoms can substantially reduce the risk of pregnancy, HIV and some STDs. The others do not discuss risk reduction except for avoiding all sexual activity.

Though supplemental guides for the high school text used by the Austin school district contain more practical information, including how to use condoms, the guides are used at the teachers' discretion.

Available without charge online, Realini's "Big Decisions" curriculum has also been adopted by the Hays County school district and others in San Antonio, Lufkin and the Rio Grande Valley. The Houston Independent School District, the largest in the state, will consider adding "Big Decisions" for use next year, said Rose Haggerty, manager of secondary health and physical education for the district.

Houston has more babies being born to girls younger than 15 than any city in the country, according to a recent report based on data from the U.S. Centers for Disease Control and Prevention. Its rate of repeat teen births — 24 percent — is the same as Austin's.

Total pregnancies among Austin middle and high school students reached 400 this year, the most since 2003-04, when the total reached 421 before falling the next year.

"We didn't realize how big it's grown," said Shannon Carr, who leads the district's Student Health Advisory Council. But she said "a lot of different factors" tipped the council's recommendation for the new, "stronger curriculum with a lot more information."

"Any unmarried pregnant female is a concern for us," Lunoff said, but "the reason that we revised the curriculum wasn't the pregnancy rate. It was really because it was time. It had been 10 years."

Approach losing favor

The abstinence-only approach to sex education, which has cost U.S. taxpayers at least $1.3 billion since 1996, has fallen out of favor in many parts of the country. Half the states had withdrawn from Title V by the time it ended in June. In other recent developments:

The American Medical Association adopted a report that found that sex education programs based on promoting abstinence produced "no delay of initiating sexual activity, no reduction in the number of sexual partners and no increase in abstinence." The AMA recommended schools use comprehensive sex education instead.

A study released by Columbia University found that earlier progress in increasing contraceptive use among teens has stalled. Another troubling trend: The CDC reported that birth rates among adolescents ages 15-19 are continuing to increase after years of decline; so are rates of gonorrhea and syphilis infection.

Sex education is not required in Texas schools, but when offered, it must meet strict abstinence mandates, added to the Texas Education Code in 1995, that are widely interpreted as barring detailed instruction about birth control and condoms.

Among other things, classroom discussions of contraceptive methods must be couched in terms of how often they fail. Though school districts have enough discretion to adopt more comprehensive sex education curricula, few have done so.

A study released by Texas State University researchers in February found that less than 5 percent of Texas school districts have comprehensive sex education. The rest rely on abstinence-only curricula, which the researchers said often gives students wrong or misleading information. The study was funded by the Texas Freedom Network, which describes itself as "a mainstream voice to counter the religious right."

The reluctance to venture beyond the abstinence boundaries may lead to conflict with Washington over exactly what Texas kids should be learning about sex the classroom.

The U.S. Congress is considering replacing abstinence-only funding with initiatives that include $104.5 million for programs proven "to delay sexual activity, increase contraceptive use (without increasing sexual activity), reduce the transmission of sexually transmitted infections or reduce teenage pregnancy."

It's unclear whether Texas could receive federal funding under such initiatives without changing its strict policies on sex education.

"Those are the same questions we're wondering," said Barbara Kier, acting director for health promotion and chronic disease prevention for the Department of State Health Services. "Decisions will be made ... (but) until the feds put out the guidelines, we just don't know."

Another question is whether groups that have existed primarily to market abstinence would be willing to alter their message to meet new federal requirements.

"We will definitely be considering (applying) for sure," LifeGuard's Amanda Brown said. "But the ideal is that we wouldn't be funded by federal grants."

Meanwhile, abstinence contractors like Amarillo-based Worth the Wait (unrelated to the Scott & White program), which serves 32 schools in the Panhandle, are stepping up their private fundraising appeals. "I think everybody in our position is doing what we're doing," said Amy Christi, executive director.