What is sex education?

Sex education, which is sometimes called sexuality education or sex and

relationships education, is the process of acquiring information and forming attitudes and
beliefs about sex, sexual identity, relationships and intimacy. It is also about developing
young people's skills so that they make informed choices about their behaviour, and feel
confident and competent about acting on these choices. It is widely accepted that young
people have a right to sex education, partly because it is a means by which they are
helped to protect themselves against abuse, exploitation, unintended pregnancies,
sexually transmitted diseases and HIV/AIDS.
Teenagers have many questions about sexuality. One of the most common is "Am
I normal?" Most teens are concerned about body changes, fantasies, being sexually
attracted to others and having sexual feelings. Teens are also curious about
heterosexuality, homosexuality, bisexuality, masturbation, sexual satisfaction and just
feeling OK about being curious. You may also have questions about birth control,
pregnancy, abortion, sexually transmitted diseases and how to make decisions. It is
normal to be interested in all of these.
It's also normal to be curious about heterosexuality -- sexual relationships with
someone of the opposite sex, homosexuality -- or sexual relationships with someone of
the same sex, and bisexuality -- sexual relationships with people of both sexes. You might
find it helpful to talk over your thoughts and feelings with someone you trust, such as
your parents, a counsellor, a teacher, a school nurse, your doctor, or a friend.
We get ideas about sex from television, movies, music, ads, jokes, friends
and family. You need to sort out your own ideas and values, what it is you want.
Sometimes, one partner tries to pressure the other into becoming sexually active.
Knowing your values and what you want will help you in this situation. No means No.
Respect your partner and respect yourself. Sexual assault, even in a marriage or dating
relationship, is a criminal offence. Only yes means yes. Neither guys nor girls know all
about sex. Take time to communicate your feelings and get to know your partner.
Education on reproduction typically describes the process of a new human being
coming into existence in stages including conception, the development of the embryo and
fetus, and the birth of the new baby. It often includes topics such as sexually transmitted
diseases and how to avoid them, as well as methods of contraception. Although some sort
of sex education is part of many schools' curricula, it remains a controversial topic in
several countries as to how much and at which age schoolchildren should be taught about
contraception or safer sex, and whether moral education should be included or excluded.
In the United States in particular, the topic is the subject of much contentious debate.
Chief among controversial points is whether sexual freedom for minors is valuable or
detrimental, as well as whether instruction about condoms and birth control pills reduce
or increase out-of-wedlock pregnancy and STDs. Most people are not swayed by results
of scientific studies and cling to their predisposed notions. The existence of AIDS has
given a new sense of urgency to the topic of sex education. In many African nations,
where AIDS is at pandemic levels, sex education is seen by most scientists as a vital
strategy for preserving the health of citizens. Some international organizations such as
Planned Parenthood see worldwide benefit to sex education programs, such as the control
of overpopulation and advancement of the rights of women.
The human sexuality sphere is one in which many men and women tend to judge
the opposite sex as not being OK. Most making such sex judgments would feel better and
be happier if they adopted some of the opposite sex's ideas about sex via their own
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personal sex education.

The failure of men to be serious about the consequences of their sexual behavior
has been very harmful to our human society. Men have abandoned millions of children
and have helped cause the spread of sexually transmitted diseases. But hope is that their
partners can start demanding both serious and wild behavior from such men. For partners
sometimes can be the catalysts for human change, sex education advocates.

What are the Aims and Scope of sex education?

Sex education seeks both to reduce the risks of potentially negative outcomes
from sexual behaviour like unwanted or unplanned pregnancies and infection with
sexually transmitted diseases, and to enhance the quality of relationships. It is also about
developing young people's ability to make decisions over their entire lifetime. Sex
education that works, by which we mean that it is effective, is sex education that
contributes to this overall aim.
Sex Education is a new international refereed journal concerned both with the
practice of sex education and with the thinking that underpins it.
Contributions are welcomed from within a variety of academic disciplines particularly health education, sociology, philosophy and psychology - and from a variety
of ideological standpoints. Submitted work should connect significantly with issues
concerned with sex education and have presumptions made by the author(s) described
and defended.
Sex Education does not assume that sex education takes place only in educational
institutions and the family. Contributions are therefore welcomed which, for example,
analyse the impacts of media and other vehicles of culture on sexual behaviour and
attitudes. Medical and epidemiological papers (e.g. of trends in the incidences of sexually
transmitted infections) will not be accepted unless their educational implications are
discussed adequately.

Comprehensive Sex Education

Substantial evidence of the effectiveness of comprehensive sex education has
recently emerged. Comprehensive sex education stresses abstinence and includes ageappropriate, medically accurate information about contraception. Comprehensive sex ed
are also developmentally appropriate, introducing information on relationships, decisionmaking, assertiveness, and skill building to resist social/peer pressure, depending on
grade-level.
As part of welfare reform, Congress passed legislation in 1996 allocating $50
million in federal funds for abstinence-only-until-marriage programs - which censor
information about contraception. Since then, despite no evidence of the effectiveness of
these programs and Americans' opposition to federal funding for them, the government
has dumped more and more taxpayer money into unrealistic and unproven abstinenceonly programs.
For more than thirty years proponents of comprehensive sex education
have argued that giving sexual information to young children and adolescents will reduce
the number of unplanned pregnancies and sexually transmitted diseases. In that effort
nearly $3 billion have been spent on federal Title X family planning services; yet teenage
pregnancies and abortions rise.
Perhaps one of the most devastating popular critiques of comprehensive sex
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education came from Barbara Dafoe Whitehead. The journalist who said that Dan Quayle
was right also was willing to say that sex education was wrong. Her article, "The Failure
of Sex Education" in the October 1994 issue of Atlantic Monthly, demonstrated that sex
education neither reduced pregnancy nor slowed the spread of STDs.
Comprehensive sex education is mandated in at least seventeen states, so
Whitehead chose one of those states and focused her analysis on the sex education
experiment in New Jersey. Like other curricula, the New Jersey sex education program
rests on certain questionable assumptions.
The first tenet is that children are sexual from birth. Sex educators reject the
classic notion of a latency period until approximately age twelve. They argue that you are
"being sexual when you throw your arms around your grandpa and give him a hug."
Second, children are sexually miseducated. Parents, to put it simply, have not
done their job, so we need "professionals" to do it right. Parents try to protect their
children, fail to affirm their sexuality, and even discuss sexuality in a context of
moralizing. The media, they say, is also guilty of providing sexual misinformation.
Third, if mis-education is the problem, then sex education in the schools is the
solution. Parents are failing miserably at the task, so "it is time to turn the job over to the
schools. Schools occupy a safe middle ground between Mom and MTV."
Learning about Family Life is the curriculum used in New Jersey. While it
discusses such things as sexual desire, AIDS, divorce, condoms, and masturbation, it
nearly ignores such issues as abstinence, marriage, self-control, and virginity. One
technique promoted to prevent pregnancy and STDs is noncoital sex, or what some sex
educators call "outercourse." Yet there is good evidence to suggest that teaching teenagers
to explore their sexuality through noncoital techniques will lead to coitus. Ultimately,
outercourse will lead to intercourse.
Whitehead concludes
that comprehensive sex education has been a failure. For example, the percent of teenage
births to unwed mothers was 67 percent in 1980 and rose to 84 percent in 1991. In the
place of this failed curriculum, Whitehead describes a better program. She found that
"sex education works best when it combines clear messages about behavior with strong
moral and logistical support for the behavior sought." One example she cites is the
"Postponing Sexual Involvement" program at Grady Memorial Hospital in Atlanta,
Georgia, which offers more than a "Just say no" message. It reinforces the message by
having adolescents practice the desired behavior and enlists the aid of older teenagers to
teach younger teenagers how to resist sexual advances. Whitehead also found that
"religiously observant teens" are less likely to experiment sexually, thus providing an
opportunity for church- related programs to help stem the tide of teenage pregnancy.
Contrast this, however, with
what has been derisively called "the condom gospel." Sex educators today promote the
dissemination of sex education information and the distribution of condoms to deal with
the problems of teen pregnancy and STDs.

Morality of sex education

One liberal viewpoint on sex education, historically inspired by sexologists like
Wilhelm Reich and psychologists like Sigmund Freud and James W. Prescott, holds that
what is at stake in sex education is control over the body and liberation from social
control. Proponents of this view tend to see the political question as whether society or
the individual should dictate sexual mores. Sexual education may thus be seen as
providing individuals with the knowledge necessary to liberate themselves from socially
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organized sexual oppression and to make up their own minds. In addition, sexual
oppression may be viewed as socially harmful. A more common approach to sex
education is to view it as necessary to reduce risk behaviors such as unprotected sex, but
these views sometimes go hand in hand. Additionally, proponents of comprehensive sex
ed contend that education about homosexuality encourages tolerance, but does not "turn
students gay" as some conservatives believe. To another large and vocal group in the sex
education debate, the political question is whether the state or the family should dictate
sexual mores. They believe that sexual mores should be left to the family, and sexeducation represents state interference. They also claim that some sex education curricula
are intended to break down preexisting notions of modesty and encourage acceptance of
practices they deem immoral, such as homosexuality and premarital sex.

When should sex education start?

Sex education that works starts early, before young people reach puberty, and
before they have developed established patterns of behaviour. The precise age at which
information should be provided depends on the physical, emotional and intellectual
development of the young people as well as their level of understanding. What is covered
and also how, depends on who is providing the sex education, when they are providing it,
and in what context, as well as what the individual young person wants to know about.
It is important not to delay providing information to young people but to begin
when they are young. Providing basic information provides the foundation on which
more complex knowledge is built up over time. This also means that sex education has to
be sustained. For example, when they are very young, children can be informed about
how people grow and change over time, and how babies become children and then adults,
and this provides the basis on which they understand more detailed information about
puberty provided in the pre-teenage years. They can also when they are young, be
provided with information about viruses and germs that attack the body. This provides the
basis for talking to them later about infections that can be caught through sexual contact.
Some
people are concerned that providing information about sex and sexuality arouses curiosity
and can lead to sexual experimentation. There is no evidence that this happens. It is
important to remember that young people can store up information provided at any time,
for a time when they need it later on.
Sometimes it can difficult for
adults to know when to raise issues, but the important thing is to maintain an open
relationship with children which provides them with opportunities to ask questions when
they have them. Parents and careers can also be proactive and engage young people in
discussions about sex, sexuality and relationships. Naturally, many parents and their
children feel embarrassed about talking about some aspects of sex and sexuality. Viewing
sex education as an on-going conversation about values, attitudes and issues as well as
providing facts can be helpful. The best basis to proceed on is a sound relationship in
which a young person feels able to ask a question or raise an issue if they feel they need
to. It has been shown that in countries like The Netherlands, where many families regard
it as an important responsibility to talk openly with children about sex and sexuality, this
contributes to greater cultural openness about sex and sexuality and improved sexual
health among young people.
The role of many parents and careers as sex
educators changes as young people get older and young people are provided with more
opportunities to receive formal sex education through schools and community-settings.
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However, it doesn't get any less important. Because sex education in school tends to take
place in blocks of time, it can't always address issues relevant to young people at a
particular time, and parents can fulfill a particularly important role in providing
information and opportunities to discuss things as they arise.

Does Sex Education Work?

Should sex education be taught in schools?
The question is no longer should sex education be taught, but rather how should it
be taught. Over 93% of all public high schools currently offer courses on sexuality
or HIV. More than 510 junior or senior high schools have school-linked health
clinics, and more than 300 schools make condoms available on campus. The
question now is are these programs effective, and if not, how can we make them
better?
Why do youth need sex education?
Kids need the right information to help protect themselves. The US has more than
double the teenage pregnancy rate of any western industrialized country, with more
than a million teenagers becoming pregnant each year. Teenagers have the highest
rates of sexually transmitted diseases (STDs) of any age group, with one in four
young people contracting an STD by the age of 21. STDs, including HIV, can
damage teenagers' health and reproductive ability. And there is still no cure for
AIDS.
HIV infection is increasing most rapidly
among young people. One in four new infections in the US occurs in people
younger than 22. In 1994, 417 new AIDS cases were diagnosed among 13-19 year
olds, and 2,684 new cases among 20-24 year olds. Since infection may occur up to
10 years before an AIDS diagnosis, most of those people were infected with HIV
either as adolescents or pre-adolescents.
Why has sex education failed to help our children?
Knowledge alone is not enough to change behaviors. Programs that rely mainly
on conveying information about sex or moral precepts-how the body's sexual
system functions, what teens should and shouldn't do-have failed. However,
programs that focus on helping teenagers to change their behavior-using role
playing, games, and exercises that strengthen social skills-have shown signs of
success.
In the US, controversy over what message
should be given to children has hampered sex education programs in schools. Too
often statements of values ("my children should not have sex outside of marriage")
come wrapped up in misstatements of fact ("sex education doesn't work anyway").
Should we do everything possible to suppress teenage sexual behavior, or should
we acknowledge that many teens are sexually active, and prepare them against the
negative consequences? Emotional arguments can get in the way of an unbiased
assessment of the effects of sex education.
Other countries have been
much more successful than the US in addressing the problem of teen pregnancies.
Age at first intercourse is similar in the US and five other countries: Canada,
England, France, the Netherlands, and Sweden, yet all those countries have teen
pregnancy rates that are at least less than half the US rate. Sex education in these
other countries is based on the following components: a policy explicitly favoring
sex education; openness about sex; consistent messages throughout society; and
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access to contraception.
Often sex education curricula begin in high school, after
many students have already begun experimenting sexually. Studies have shown that
sex education begun before youth are sexually active helps young people stay
abstinent and use protection when they do become sexually active. The sooner sex
education begins, the better, even as early as elementary school.
What kinds of programs work best?
Reducing the Risk, a program for high school students in urban and rural areas in
California, used behavior theory-based activities to reduce unprotected intercourse,
either by helping teens avoid sex or use protection. Ninth and 10th graders attended
15 sessions as part of their regular health education classes and participated in role
playing and experimental activities to build skills and self-efficacy. As a result, a
greater proportion of students who were abstinent before the program successfully
remained abstinent, and unprotected intercourse was significantly reduced for those
students who became sexually active.
Postponing Sexual Involvement, a program for African-American
8th graders in Atlanta, GA, used peers (11th and 12th graders) to help youth
understand social and peer pressures to have sex, and to develop and apply
resistance skills. A unit of the program also taught about human sexuality, decisionmaking, and contraceptives. This program successfully reduced the number of
abstinent students who initiated intercourse after the program, and increased
contraceptive use among sexually experienced females.
Healthy Oakland Teens (HOT) targets all 7th graders attending a junior high
school in Oakland, CA. Health educators teach basic sex and drug education, and
9th grade peer educators lead interactive exercises on values, decision-making,
communication, and condom-use skills. After one year, students in the program
were much less likely to initiate sexual activities such as deep kissing, genital
touching, and sexual intercourse.
AIDS Prevention for Adolescents in School, a program for
9th and 11th graders in schools in New York City, NY, focused on correcting facts
about AIDS, teaching cognitive skills to appraise risks of transmission, increasing
knowledge of AIDS-prevention resources, clarifying personal values,
understanding external influences, and teaching skills to delay intercourse and/or
consistently use condoms. All sexually experienced students reported increased
condom use after the program.
A review of 23 studies found that effective sex education programs share the
following characteristics:
1. Narrow focus on reducing sexual risk-taking behaviors that may lead to HIV/STD
infection or unintended pregnancy.
2. Social learning theories as a foundation for program development, focusing on
recognizing social influences, changing individual values, changing group norms,
and building social skills.
3. Experimental activities designed to personalize basic, accurate information about
the risks of unprotected intercourse and methods of avoiding unprotected
intercourse.
4. Activities that address social or media influences on sexual behaviors.
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5. Reinforcing clear and appropriate values to strengthen individual values and

group norms against unprotected sex.
6. Modeling and practice in communication, negotiation, and refusal skills.
What still needs to be done?
Although sex education programs in schools have been around for many years,
most programs have not been nearly as effective as hoped. Schools across the country
need to take a rigorous look at their programs, and begin to implement more innovative
programs that have been proven effective. Educators, parents, and policy-makers should
avoid emotional misconceptions about sex education; based on the rates of unwanted
pregnancies and STDs including HIV among teenagers, we can no longer ignore the need
for both education on how to postpone sexual involvement, and how to protect oneself
when sexually active. A comprehensive risk prevention strategy uses multiple elements to
protect as many of those at risk of pregnancy and STD/HIV infection as possible. Our
children deserve the best education they can get.

Sex Education Programs

Definitions & Point-by-Point Comparison
Abstinence-Only Education teaches abstinence as the only
morally correct option of sexual expression for teenagers. It usually censors information
about contraception and condoms for the prevention of sexually transmitted diseases
(STDs) and unintended pregnancy.
Abstinence-Only-Until-Marriage Education teaches abstinence
as the only morally correct option of sexual expression for unmarried young people.
Programs funded under the 1996 Welfare Reform Act must censor information about
contraception and condoms for the prevention of STDs and unintended pregnancy.
Abstinence-Centered Education Another term normally used to
mean abstinence-only education.
Comprehensive Sex Education teaches about abstinence as the best method for
avoiding STDs and unintended pregnancy, but also teaches about condoms and
contraception to reduce the risk of unintended pregnancy and of infection with STDs,
including HIV. It also teaches interpersonal and communication skills and helps young
people explore their own values, goals, and options.
Abstinence-Based Education Another term normally used to mean
comprehensive sexuality education
Abstinence-Plus Education Another term for normally used to mean
comprehensive sexuality education.

Comprehensive Sex Education

Abstinence-Only-Until-Marriage
Education

Teaches that sexuality is a natural, normal, Teaches that sexual expression outside of
healthy part of life
marriage will have harmful social,
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psychological, and physical consequences

Teaches that abstinence from sexual

intercourse is the most effective method of
preventing unintended pregnancy and
sexually transmitted diseases, including
HIV

Teaches that abstinence from sexual

intercourse before marriage is the only
acceptable behavior

Provides values-based education and offers Teaches only one set of values as morally
students the opportunity to explore and
correct for all students
define their individual values as well as the
values of their families and communities

Includes a wide variety of sexuality related

topics, such as human development,
relationships, interpersonal skills, sexual
expression, sexual health, and society and
culture

Limits topics to abstinence-only-untilmarriage and to the negative consequences

of pre-marital sexual activity

Includes accurate, factual information on

abortion, masturbation, and sexual
orientation

Usually omits controversial topics such as

abortion, masturbation,
and sexual orientation

Provides positive messages about sexuality Often uses fear tactics to promote
and sexual expression, including the
abstinence and to limit sexual expression
benefits of abstinence

Teaches that proper use of latex condoms, Discusses condoms only in terms of failure
along with water-based lubricants, can
rates; often exaggerates condom failure
greatly reduce, but not eliminate, the risk of rates
unintended pregnancy and of infection with
sexually transmitted diseases (STDs)
including HIV

Teaches that consistent use of modern

Provides no information on forms of
methods of contraception can greatly reduce contraception other than failure rates of
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a couples risk for unintended pregnancy

condoms

Includes accurate medical information

about STDs, including HIV; teaches that
individuals can avoid STDs

Often includes inaccurate medical

information and exaggerated statistics
regarding STDs, including HIV; suggests
that STDs are an inevitable result of
premarital sexual behavior

Teaches that religious values can play an

Often promotes specific religious values
important role in an individuals decisions
about sexual expression; offers students the
opportunity to explore their own and their
familys religious values

Teaches that a woman faced with an

unintended pregnancy has options: carrying
the pregnancy to term and raising the baby,
or carrying the pregnancy to term and
placing the baby for adoption, or ending the
pregnancy with an abortion

Teaches that carrying the pregnancy to term

and placing the baby for adoption is the
only morally correct option for pregnant
teens

Science and Success: Sex Education and Other Programs That Work to
Prevent Teen Pregnancy, HIV & Sexually Transmitted Infections
Despite recent declines in teen pregnancy, US teen birth and sexually transmitted
infection (STI) rates remain among the highest in the western world. Given the need to
focus limited prevention resources on effective programs, Advocates for Youth undertook
an exhaustive review of existing research to compile a list of the programs proven
effective by rigorous evaluation.
Criteria for Inclusion All programs had evaluations that:

Were published in peer-reviewed journals (a proxy for quality of evaluation

design and analysis).
Used an experimental or quasi-experimental design, with treatment and control /
comparison conditions.

Included at least 100 young people in treatment and control / comparison groups,
combined.

Collected baseline and post-intervention data from both treatment and control /
comparison groups.
Further, the evaluations either:

Continued to collect data from both groups at three months or later after
intervention, and

Demonstrated that the program led to at least two beneficial changes in sexual
behavior
among
program
youth,
relative
to
controls.
Or:

Showed program effectiveness in reducing pregnancy, STIs, or HIV among

intervention youth, relative to controls.

Risk Avoidance through AbstinenceTwelve programs effectively demonstrated a

statistically significant delay in the timing of first sex among program adolescents,
relative to control youth. One of the 12 programs is an intervention for elementary school
children and their parents. The other 11 programs include information about abstinence
and contraception within the context of a sex education component.
Risk Reduction for Sexually Active YouthIn addition to the delay of first sex, 17
programs also demonstrated reductions in other sexual risk-taking behaviors among
participants, relative to control youth, including increased use of condoms and other
contraception (11 and 8 programs, respectively) and reduced number of sexual partners,
frequency of sex, and incidence of unprotected sex.
Reduction in Teen Pregnancy or STIsEight programs showed statistically
significant declines in teen pregnancy, births, HIV, or other STIs. Seven demonstrated a
statistically significant impact on teenage pregnancy / births among program participants,
compared to controls, and one, a reduced trend in STIs.
Effective School-Based Sex Education Programs
1. Reducing the Risk
Reducing the Risk is a sex education curriculum, including information on
abstinence and contraception. Given in 16 sessions, each lasting 45 minutes, it
offers experiential activities to build skills in refusal, negotiation, and
communication, including that between parents and their children. Designed for
use with high school students, especially those in grades nine and 10, it is
recommended for use with sexually inexperienced, urban, suburban, and rural
youthwhite, Latino, Asian, and black. Evaluation showed that it was more
effective with lower risk, than with higher risk, youth. Evaluationsof the
10

original program and of a replication of the programeach found delayed

initiation of sexual intercourse, and reduced incidence of unprotected sex /
increased use of contraception among participants as well as increased parentchild communication about abstinence and contraception.
2. Postponing Sexual Involvement (Augmenting a Five-Session Human
Sexuality Curriculum)
This five-session, peer-led curriculum is designed to augment a fivesession human sexuality curriculum led by health professionals, who also refer
sexually active youth for nearby reproductive health care. It is recommended for
use with eighth grade students, black youth, sexually inexperienced youth, and
youth at higher risk due to socioeconomic disadvantage. Evaluation showed
delayed initiation of sexual intercourse and, among sexually experienced
participants, reduced frequency of sex and increased use of contraception. When
replicated without fidelity (including omission of the five-session human sexuality
curriculum), the program led to no changes in sexual behavior among
participants relative to comparison youth.
3. Postponing Sexual Involvement, Human Sexuality & Health Screening
This pregnancy prevention program combines the five-session, peer-led
Postponing Sexual Involvement curriculum with elements drawn from the Self
Center, which include three classroom sessions on reproductive health, delivered
to seventh graders by health professionals and again the next year to eighth
graders; group discussions; and a full-time health professional from outside the
school, working in the school. Other components of the program include
individual health risk screening and an eighth grade assembly and contest. The
program is recommended for seventh and eighth grade, urban, African American,
economically disadvantaged youth. Evaluation found that the program assisted
female participants to delay initiation of sexual intercourse and increased the use
of contraception by sexually active female participants. Evaluation found no
statistically significant impact on the sexual behaviors of male participants.
4. Safer Choices
This is an HIV/STI and teen pregnancy prevention curriculum, given in 20
sessions, evenly divided over two years and designed for use with grades nine
through 12. The program includes experiential activities to build skills in
communication, delay the initiation of sex, and promote condom use by sexually
active participants. Other elements include a school health protection council, a
peer team or club to host school-wide activities, educational activities for parents,
and HIV-positive speakers. The program is recommended for use with white,
Hispanic, African American, and Asian, urban and suburban high school students.
Evaluation showed that Safer Choices effectively assisted sexually experienced
youth to increase condom and contraceptive use. Hearing an HIV-positive
speaker was also associated with participants' greater likelihood of receiving HIV
testing, relative to control youth. The program neither hastened nor delayed the
onset of sexual intercourse.
5. Reach for Health Community Youth Service
This program combines a health promotion curriculum (40 lessons per
year in each of two years), including sexual health information, with three hours
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per week of community service. Reflection and activities help students learn from
their community experience. The program is recommended for use with seventh
and eighth grade, urban, black, and Hispanic youth, especially those who are
economically disadvantaged. Evaluation showed delayed initiation of sexual
intercourse, an effect that continued even through 10th grade. The program also
assisted sexually active participants in reducing the frequency of sex and
increasing use of condoms and contraception.
6. AIDS Prevention for Adolescents in School
This HIV/STI prevention curriculum comprises six sessions, delivered on
consecutive days, and includes experiential activities to build skills in refusal, risk
assessment, and risk reduction. It is recommended for use with African American,
Hispanic, white, and Asian, high school students in urban settings. Evaluation
found that this program assisted sexually experienced participants to increase
monogamy, reduce the number of their drug-using sexual partners, and increase
condom use. The program had no significant effect on delaying the initiation of
sex. Evaluation found the program to be associated with a favorable trend in the
incidence of STIs among participants, relative to controls.
7. Get Real about AIDS
This HIV risk reduction curriculum comprises 15 sessions delivered over
consecutive days. It includes experiential activities to build skills in refusal,
communication, and condom use. Other components include activities, such as
public service announcements, to reach more youth and reinforce educational
messages. It is recommended for use with sexually active, white and Hispanic,
urban, suburban, and rural, high school students. Evaluation found that the
program assisted sexually active participants to reduce the number of their sexual
partners, increase condom use, and increase condom purchase. The program did
not affect the timing of sexual initiation. It did not reduce the frequency of sex
among sexually active youth nor their use of drugs and alcohol prior to having
sex.
8. School / Community Program for Sexual Risk Reduction among TeensThis
intensive, school-based intervention integrates sex education into a broad
spectrum of courses throughout public education (kindergarten through 12th
grade). It includes teacher training, peer education, school-based health clinic
services (including contraceptive provision), referral and transportation to
community-based reproductive health care, workshops to develop the role
modeling skills of parents and community leaders, and media coverage of a
spectrum of health topics. The program is recommended for use with black and
white, rural students (kindergarten through 12th grade). Evaluation found that
this program reduced teen pregnancy rates in the participating community
relative to comparison counties. Replication in two counties in another state
found that it assisted youth in one county to delay the initiation of sexual
intercourse and assisted males in another county to increase their use of
condoms, relative to youth in comparison counties.
Effective Community-Based Sex Education Programs
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9.

Self Center (School-Linked Reproductive Health Services)

This model of the school-linked health center (SLHC) offers free
reproductive and contraceptive health care to participating youth from nearby
junior and senior high schools. SLHC staff works daily in participating schools,
providing sex education lessons once or twice a year in each homeroom and
offering daily individual and group counseling in the school health suite. Staff is
also available daily in the SLHC to provide students with education and
counseling and, for those youth registered with the clinic, reproductive and sexual
health care. The program is recommended for use with urban, black, and
economically disadvantaged, junior and senior high school students. Evaluation
found that the program assisted participants to delay the initiation of sexual
intercourse and to use reproductive health services prior to initiating sex. It also
assisted sexually active participants to reduce the incidence of unprotected sex
and increase their use of contraception. The program resulted in a reduction in
teen pregnancy rates among participants, relative to comparison youth.

10. California's Adolescent Sibling Pregnancy Prevention Program

This
teen pregnancy prevention program provides individualized case management and
care as well as sex education, including information on abstinence and
contraception, to the adolescent siblings of pregnant and parenting teens. The
program is recommended for economically disadvantaged, Hispanic youth, ages
11 to 17. Evaluation found that the program assisted female youth to delay the
initiation of sexual intercourse and assisted male youth to increase the consistent
use of contraception. The program resulted in reductions in teen pregnancy rates
among program youth, relative to comparison youth.
11. Adolescents Living Safely: AIDS Awareness, Attitudes & Actions
This HIV prevention program is designed to augment traditional services
available at shelters for runaway youth. The program involves 30 discussion
sessions for small groups, each lasting one-and-a-half to two hours and including
experiential activities to build cognitive and coping skills. Intensive training of
shelter staff and access to health care, including mental health services, are also
important components of the program. It is recommended for use with black and
Hispanic runaway youth, ages 11 through 18, living in city shelters. Evaluation
found that the program assisted youth to reduce the frequency of sex and numbers
of sexual partners, and increase condom use. The program did not affect the
timing of sexual initiation.
12. Becoming a Responsible Teen
This HIV prevention, sex education, and skills training curriculum
comprises eight one-and-a-half- to two-hour sessions. It includes experiential
activities to build skills in assertion, refusal, problem solving, risk recognition,
and condom use and is designed for use in single-sex groups, each facilitated by
both a male and a female leader. It is recommended for use with African
American youth, ages 14 through 18. Evaluation found the program assisted
participants to delay the initiation of sex and assisted sexually active participants
to reduce the frequency of sex, decrease the incidence of unprotected sex
(including anal sex), and increase condom use.

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13. Children's Aid SocietyCarrera Program

This multi-component youth development program provides daily afterschool activitiesincluding a job club and career exploration, academic tutoring
and assistance, sex education that includes information about abstinence and
contraception, arts workshops, and individual sports activities. A summer program
offers enrichment activities, employment assistance, and tutoring. The program
provides year-round comprehensive health care, including primary, mental,
dental, and reproductive health services. The program involves youth's families
and provides interpersonal skills development and access to a wide range of social
services. The program is recommended for use with urban, black and Hispanic,
socioeconomically disadvantaged youth, ages 13 through 15. Evaluation found
that the program assisted female participants to delay the initiation of sexual
intercourse and resist sexual pressure. It also assisted sexually experienced
female participants to increase their use of dual methods of contraception. The
program assisted both male and female participants to increase their receipt of
health care. Otherwise, evaluation showed no positive, significant behavioral
changes in participating males relative to comparison males. The program
resulted in reduced rates of teen pregnancy among participants, relative to
comparison youth.
14. Be Proud! Be Responsible! A Safer Sex Curriculum
This HIV prevention curriculum comprises six sessions, each lasting 50
minutes, and includes experiential activities to build skills in negotiation, refusal,
and condom use. It is recommended for use with urban, black, male youth, ages
13 through 18. Evaluation found that it assisted young men to reduce their
frequency of sex, reduce the number of their sexual partners (especially female
partners who were also involved with other men), increase condom use, and
reduce the incidence of heterosexual anal intercourse.
15. Making Proud Choices!
This HIV prevention curriculum emphasizes safer sex and includes
information about both abstinence and condoms. It comprises eight, culturally
appropriate sessions, each lasting 60 minutes and includes experiential activities
to build skills in delaying the initiation of sex, communicating with partners, and
among sexually active youth, using condoms. It is recommended for use with
urban, African American youth, ages 11 through 13. Evaluation found the
program assisted participants to delay initiation of sex and assisted sexually
active participants to reduce the frequency of sex, reduce the incidence of
unprotected sex, and increase condom use.
16. Poder Latino: A Community AIDS Prevention Program for Inner-City
Latino Youth
This community-wide, 18-month long program provides peer education
workshops on HIV awareness and prevention and peer-led group discussions in
various community settings. Peer educators also lead efforts to make condoms
available via door-to-door and street canvassing and make presentations at major
community events. Radio and television public service announcements, posters in
local businesses and public transit, and a newsletter augment the work of the peer
educators. The program is designed for use in urban, Latino communities, to reach
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adolescents ages 14 through 19. Evaluation showed that the program assisted the
community's male teens to delay the initiation of sexual intercourse and assisted
the community's sexually active female teens to reduce the number of their sexual
partners. The program did not affect sexually active participants' frequency of
sex.
Other Programs to Prevent Teen Pregnancy, HIV & Sexually Transmitted Infections
17. Seattle Social Development Project
This is a school-based program to provide developmentally
appropriate, social competence training to elementary school children.
Components include educator training each year and voluntary parenting classes
on encouraging children's developmentally appropriate social skills. The program
is recommended for use with urban, socioeconomically disadvantaged children
white, Asian, and Native American, but especially African Americanin grades
one through six. Evaluation when study participants were age 18, and again
when they reached 21, found that the program assisted youth who participated in
the program as children to significantly delay the initiation of sexual intercourse
and, among sexually experienced youth, to reduce the number of sexual partners
and increase condom use, relative to comparison youth. By age 21, the program
also showed reduced rates of teenage pregnancy and birth in participants,
relative to comparison youth. Other long-term positive outcomes for participating
youth, relative to comparisons, included increased academic achievement and
reduced incidence of delinquency, violence, school misbehavior, and heavy
drinking.
18. Abecedarian Project
This full-time educational program consists of high quality childcare from
infancy through age five, including individualized games that focus on social,
emotional, and cognitive development, with a particular emphasis on language.
During the early elementary school years, the program works to involve parents in
their children's education, using a Home School Resource Teacher to serve as a
liaison between school and families. The program is recommended for use with
healthy, African American infants from families that meet federal poverty
guidelines. Evaluation found long-term impacts, including a reduced number of
adolescent births and delayed first births as well as increased rates of skilled
employment and college education and reduced rates of marijuana use among
former participants, relative to controls.
19. Teen Outreach Program
This school-based, teen pregnancy and dropout prevention program
involves weekly classroom sessions, lasting one hour, that integrate the
developmental tasks of adolescence with lessons learned from community service
(lasting at least 30 minutes each week). The curriculum focuses on values, human
growth and development, relationships, dealing with family stress, and issues
related to the social and emotional transition from adolescence to adulthood. The
program is recommended for high school youth at risk of teen pregnancy,
academic problems, and school dropout, and is most effective with ethnic
minority youth, adolescent mothers, and students with academic difficulties,
including previous school suspension. Evaluation of the original program and
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evaluations of two replications all found that the program reduced rates of
pregnancy, school suspension, and class failure among participants, relative to
control/comparison youth.
The American Medical Association's Recommendations for Good Sex Education
The American Medical Association (AMA) urges schools to implement
comprehensive, developmentally appropriate sexuality education programs that:
Are based on rigorous, peer reviewed science;

Show promise for delaying the onset of sexual activity and a reduction in sexual
behavior that puts adolescents at risk for contracting human immunodeficiency virus
(HIV) and other sexually transmitted diseases;
Include an integrated strategy for making condoms available to students and for
providing both factual information and skill-building related to reproductive biology,
sexual abstinence, sexual responsibility, contraceptives including condoms,
alternatives in birth control, and other issues aimed at prevention of pregnancy and
sexual transmission of diseases;
Utilize classroom teachers and other professionals who have shown an aptitude for
working with young people and who have received special training that includes
addressing the needs of gay, lesbian, and bisexual youth;
Include ample involvement of parents, health professionals, and other concerned
members of the community in the development of the program; and

Are part of an overall health education program.

Characteristics of Effective Sexuality Education Programs

The curricula of the most effective programs share characteristics. These
programs:
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Focus on reducing one or more sexual behaviors that lead to unintended pregnancy or
sexually transmitted infections, including HIV.

Deliver and consistently reinforce a clear message about abstaining from sexual
activity and/or using condoms or other forms of contraception. This appears to be one
of the more important characteristics distinguishing effective from ineffective
programs.

Provide basic, accurate information about the risks of teen sexual activity and about
ways to avoid intercourse or to use methods of protection against pregnancy and
sexually transmitted infections.

Include activities that address social pressures that influence sexual behavior.

Provide examples of and practice with communication, negotiation, and refusal skills.

Incorporate behavioral goals, teaching methods, and materials that are appropriate to
the age, sexual experience, and culture of the students.

Employ teaching methods designed to involve participants and have participants

personalize the information.

Are based on theoretical approaches that have been demonstrated to influence other
health-related behaviors and identify specific important sexual antecedents to be
targeted.

Select teachers or peer leaders who believe in the program and then provide them with
adequate training.

Last a sufficient length of time (i.e., more than a few hours).

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Generally speaking, short-term curriculawhether abstinence-only or sexuality

education programsdo not have measurable impact on the behavior of teens.

Myths & Facts about Sex Education

Youth have rights to accurate, balanced sex educationincluding information
about contraception and condoms. Armed with accurate information, confidential health
services, and a secure stake in the future, youth can be trusted to behave responsibly.

The Claims

The Facts

Abstinence-only-until-marriage works.

"Current research findings do not support

the position that the abstinence-only
approach to sexuality education is effective
in delaying the onset of intercourse."

Sex education encourages students to

become sexually active at younger ages.

The World Health Organization reviewed

evaluations of 47 programs in the United
States and other countries. In 15 studies, sex
and HIV/AIDS education neither increased
nor decreased sexual activity and rates of
pregnancy and STI. However, in 17 studies,
HIV and/or sex education delayed the onset
of sexual activity, reduced the number of
sexual partners, and/or reduced unplanned
pregnancy and STI rates.

Teaching students about contraception

Expert panels that have studied this issue
encourages sexual activity and increases the have concluded that comprehensive sex and
chance of teenage pregnancy.
HIV/AIDS education programs and condom
availability programs do not increase sexual
activity and can be effective in reducing
high-risk sexual behaviors among
adolescents.

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Contraceptives fail so frequently that we

should only teach teens to abstain.

Modern contraceptives are highly effective.

The percent of women experiencing
pregnancy within one year ranges from 0.03
percent using Depo-Provera to nine percent
using the cervical cap (with perfect use).
Even imperfect use protects women far
better than does using no protection. Rates
of pregnancy with imperfect use range from
0.03 percent using Depo-Provera to 21
percent using the female condom compared
to 85 percent of women using no
protection.

Contraceptives do not protect against HIV

and other sexually transmitted infections.

Other than total sexual abstinence, only

condoms currently provide significant
protection against HIV and other STIs. That
is why good programs educate students
about the importance of condoms.

Condoms have a high failure rate.

The National Institutes of Health (NIH)

confirms that condoms are very effective in
affording protection against HIV and
unwanted pregnancy. The NIH also reports
that laboratory studies show that condoms
can afford good protection against
discharge diseases, such as gonorrhea,
chlamydia, and trichomoniasis.

Condoms do not protect against human

papillomavirus (HPV).

Condoms cannot protect against viral

infections on portions of the anatomy that
condoms do not cover. However, the NIH
report concludes that condom use can
reduce the risk of HPV-associated diseases,
such as cervical cancer. HPV-associated
diseases can be prevented by consistent and
effective condom use and by annual Pap
smears for early detection of HPV.

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Condoms are not effective in preventing the The NIH report confirms that condoms are
transmission of HIV.
an effective public health tool in the fight
against HIV infection. Another study of
HIV-serodiscordant couples in Europe (one
of the couple is HIV-infected and one is
not), has shown no transmission to the
uninfected partner among any of the 124
couples who used a condom at every act of
sexual intercourse. Among those couples
that were inconsistent users of condoms, 12
percent of the uninfected partners became
infected with HIV.

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