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.(1)
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.(2) 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.(3)
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.(4)
In 1994, 417 new AIDS cases were diagnosed among 13-19 year olds, and
2,684 new cases among 20-24 year olds.(5) Since
infection may occur up to 10 years before an AIDS diagnosis, most of
those people were infected with HIV either as adolescents or
Why has sex education failed to help our children?
Knowledge alone is not enough to change behaviors.(6)
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.(7)
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
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.(9)
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 access to
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.(10) 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.(11)
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, decision-making, 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.(12)
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
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.(14)
A review of 23 studies found that effective sex education programs
share the following characteristics:(10)
Narrow focus on reducing sexual
risk-taking behaviors that may lead to HIV/STD infection or
- Social learning theories as a foundation for program development,
focusing on recognizing social influences, changing individual
values, changing group norms, and building social skills.
- Experimental activities designed to personalize basic, accurate
information about the risks of unprotected intercourse and methods
of avoiding unprotected intercourse.
- Activities that address social or media influences on sexual
- Reinforcing clear and appropriate values to strengthen individual
values and group norms against unprotected sex.
- Modeling and practice in communication, negotiation, and refusal
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.
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Prepared by Pamela DeCarlo