RFGA2024-020 Lottery Abstinence Education Services

The Arizona Department of Health Services (ADHS) Bureau of Women’s and Children’s Health (BWCH) oversees Adolescent Health programming to improve the health and well-being of young people in the state. As of 2005, BWCH has been administering state lottery funds for the prevention of teen pregnancies and sexually transmitted infections (STIs). According to the Arizona Vital Statistics, from 2011 to 2021, the teen birth rate for Arizona teenagers ages fifteen through nineteen (15-19) has declined from thirty-six point nine (36.9) to fifteen point three (15.3) per 1,000 females. The repeat birth rates of youth of the same age, who had already had a child decreased from 142.7 in 2011 to 135.8 per 1,000 in 2021. Despite the declines, birth rates for Arizona teens ages fifteen through nineteen (15-19)   exceeds   the   national   rate   of   thirteen   point   nine   (13.9)   in   2021 (https://blogs.cdc.gov/nchs/2023/01/20/7245/). Arizona's racial and ethnic groups exhibit significant disparities in teen pregnancy rates, with Hispanic, American Indian, and African American females aged nineteen (19) or younger experiencing the highest rates. In 2021, American Indian youth had a notably elevated pregnancy rate of sixteen point three (16.3) per 1,000 females, surpassing the state average of ten point six (10.6) per 1,000. Similarly, rates for Hispanic or Latino youth were fourteen point four (14.4) per 1,000, and for Black or African American youth, they were twelve point six (12.6) per 1,000, both above the state average, while rates for White Non-Hispanics six (6) per 1,000 and Asian or Pacific Islanders three point four (3.4) per 1,000 were considerably lower. Teen pregnancy is intricately linked with complex factors such as school failure, behavioral issues, and family challenges, which often hinder youths’ ability to avoid pregnancy. Positive Youth Development (PYD) programs present a promising approach by emphasizing the enhancement of protective factors over merely addressing risk behaviors. These programs have shown efficacy in reducing sexual risk behaviors, Human immunodeficiency virus (HIV), other sexually transmitted diseases (STDs), and unintended pregnancies. By fostering ongoing development and maturation, PYD programs empower youth to recognize and manage risk-taking behaviors, making them a viable strategy for teen pregnancy prevention (Gavin et al., 2010). According to the 2021 Arizona Surveillance STD case data, forty-nine percent (49%) of STD cases (chlamydia, gonorrhea, and syphilis) in Arizona were among adolescents under the age of twenty-five (25). Since 2019, the rate of chlamydia among teenagers fifteen through nineteen (15-19) years old has been slowly decreasing but still remains high at 2,031 per 100,000 in 2019 to 1,729 per 100,000 in 2021. For gonorrhea, the rate among these teenagers increased from 384 per 100,000 in 2019 to 467 per 100,000 in 2021. As for syphilis, in 2019, twenty-two (22) per 100,000 fifteen through nineteen (15-19) year-old teenagers were reported to have syphilis, increasing to twenty-six (26) per 100,000 in 2021. Regarding STDs/STIs, major disparities between Arizona’s racial and ethnic groups also persist. The Arizona 2021 Annual STD Report indicates that Black (994 per 100,000) and American Indian/Alaska Native (787 per 100,000) populations have consistently higher rates of chlamydia, the Black population (763 per 100,000) continues to have the highest rate of gonorrhea, and the American Indian/Alaska Native (172 per 100,000) and Black (123 per 100,000) populations have the highest rates of syphilis, surpassing their Hispanic, White, and Asian/Pacific Islander counterparts. Financial Notes: Approximately $700,000.00 will be available each Grant year for a five (5) year grant period to provide services to youth for the prevention of teen pregnancies and STIs. Annual funding for services will be provided during the state fiscal year, from July through June; Therefore, the first and last years of funding will be partial funding: first year funded upon award through June 30, 2025; fifth year from July 1, 2029 through September 30, 2029. Budgets will be reviewed annually and may be decreased based on: 1. Changes in state lottery funding allocations. 2. Failure to meet the number of youths proposed to be served; or meet the required program completion by youth for Teen Pregnancy Prevention Programming. 3. Failure to comply with Grant requirements. 4. Negative audit findings. 5. Failure to spend budget funds efficiently.