The undersigned coalition of organizations dedicated to preserving the health care of young people is writing to ask you to oppose an amendment Representative Musgrave plans to introduce during tomorrow's mark-up of HR 1925, the Runaway, Homeless, and Missing Children Protection Act.  Homeless and runaway youth are some of America's neediest and most vulnerable young people.  It is contrary to sound public health policy to restrict access to health care services for these youth, including access to contraception.  The Musgrave amendment is a harmful attempt to deny essential and sometimes lifesaving contraceptive services to runaway and homeless teens, who are most at risk for unintended pregnancy and STD infection, including HIV/AIDS.  

The Musgrave amendment will further jeopardize the health of runaway and homeless youth.

This amendment is based on the dangerous and harmful notion that restricting access to contraception will reduce teen sexual activity.  To the extent that funds are used to support contraceptive services under this bill, they are used to provide life-saving prevention to runaway and homeless teens who are already sexually active, many of whom have been sexually abused or who are engaging in what is known as ""survival sex""-having sex in exchange for food, clothing and shelter.  Restricting access to contraception only serves to further jeopardize the health of these most vulnerable youth by putting them at increased risk of pregnancy and STD infection. 

A report published by the Department of Health and Human Services in November 2002 found that 21-40% of runaway youth had been sexually abused, compared to 1-3% of the general youth population.  Further, sexually abused teens were more likely to engage in survival sex, to have sex with a high-risk partner, and to have been pregnant or gotten someone pregnant.  

Street outreach programs funded under this bill are aimed at getting teens off the streets and into care.  However, before this can be accomplished, the initial intervention is to provide young people the services they need to protect themselves.  Contraceptive use, especially condoms, is essential to protecting the life and health of such teens.  

The Musgrave amendment will result in increased rates of unintended pregnancies, abortion, and STD infection, including HIV/AIDS.

Statistics for runaway and homeless teens bear out the need for more, not less, access to contraceptive services.  Seventy-eight percent of teen pregnancies in the United States are unintended, with half ending in abortion.  According to a study of Minnesota homeless youth, funded by the Centers for Disease Control and Prevention, a staggering 94% have had sex, and 32% have been pregnant.  In addition, a national study of homeless youth found the pregnancy rate of 13-15 year old homeless girls to be 14%, versus 1% for non-homeless girls.  

Half of the HIV cases in the United States are in the youth population.  The HIV prevalence rate among runaway and homeless youth is estimated to be two to ten times higher than for non-homeless teens, and one study of Houston homeless youth found an HIV rate of almost 13%.  

Restricting access to contraception would not have the effect of reducing teen's sexual activity, but, instead, would deter them from behaving responsibly and seeking much needed, sensitive health services.   When it comes to HIV/AIDS, this is a matter of life and death.  Again, we ask that you give homeless youth all the tools you can to help them protect their health and life while living the streets.  Oppose the Musgrave amendment.  

Sincerely,

AIDS Alliance for Children, Youth and Families
AIDS Project Los Angeles
American Academy of Pediatrics
American Association of University Women 
American Civil Liberties Union
American Public Health Association
American Social Health Association
American Society for Reproductive Medicine
Association of Reproductive Health Professionals
Association of Women's Health, Obstetric and Neonatal Nurses
Cascade AIDS Project (Oregon)
Catholics for a Free Choice
Center for Reproductive Rights
Child Welfare League of America
Gay Men's Health Crisis
Girls Incorporated
L.A. Gay & Lesbian Center
Lifelong AIDS Alliance
NARAL Pro-Choice America
National Association of Nurse Practitioners in Women's Health
National Council of Jewish Women
National Family Planning and Reproductive Health Association
National Minority AIDS Council
National Network for Youth
National Women's Health Network
National Women's Law Center
People For the American Way
Planned Parenthood Federation of America
Population Connection
Society for Adolescent Medicine
The Alan Guttmacher Institute