What Works: Sexual Health Education

Beautiful African American female teenage college student in classroom

The Centers for Disease Control and Prevention’s Division of Adolescent and School Health (DASH) has established an evidence-based approach schools can implement to help prevent HIV, STDs, and unintended pregnancy among adolescents. It includes quality health education, systems that connect students to health services, and safer and more supportive school environments. This info brief focuses on delivering quality sexual health education—a systematic, effective way schools can provide adolescents the essential knowledge and critical skills needed to decrease sexual risk behaviors.

What is sexual health education?

Quality sexual health education (SHE) provides students with the knowledge and skills to help them be healthy and avoid human immunodeficiency virus (HIV), sexually transmitted diseases (STD), and unintended pregnancy. A SHE curriculum includes medically accurate, developmentally appropriate, and culturally relevant content and skills that target key behavioral outcomes and promote healthy sexual development. The curriculum is age-appropriate and planned across grade levels to provide information about health risk behaviors and experiences. Sexual health education should be consistent with scientific research and best practices; reflect the diversity of student experiences and identities; and align with school, family, and community priorities.

Across states, fewer than half of high schools (43%) and less than one-fifth of middle schools (18%) teach key CDC topics for sexual health education.

Source: 2018 School Health Profiles

Quality sexual health education programs share many characteristics. These programs:

  • Are taught by well-qualified and highly-trained teachers and school staff
  • Use strategies that are relevant and engaging for all students
  • Address the health needs of all students, including the needs of lesbian, gay, bisexual, transgender, and questioning youth
  • Connect students to sexual health and other health services at school or in the community
  • Engage parents, families, and community partners in school programs
  • Foster positive relationships between adolescents andimportant adults.
How can schools deliver sexual health education?

A school health education program that includes a quality SHE curriculum targets the development of critical knowledge and skills needed to promote healthy behaviors and avoid risks. It is important that SHE explicitly incorporate skill development. Giving students time to practice, assess, and reflect on skills taught in the curriculum helps move them toward independence, critical thinking, and problem solving to avoid HIV, STDs, and unintended pregnancy.

Broward County Public Schools in Florida has used CDC’s Health Education Curriculum Analysis Tool (HECAT) to improve their health education curricula.

We compared our current curriculum with HECAT and made changes and modifications and enhancements based on what we analyzed.

Sebrina James, Broward County’s Instructional Facilitator and Sexual Health Coordinator

Quality sexual health education programs teach students how to:

  • Analyze family, peer, and media influences that impact health
  • Access valid and reliable health information, products, and services (e.g., HIV/STD testing)
  • Communicate with family, peers, and teachers about issues that affect health
  • Make informed and thoughtful decisions about their health
  • Take responsibility for themselves and others to improve their health.
What are the benefits of delivering sexual health education to students?

Promoting and implementing well-designed SHE programs positively impacts student health in a variety of ways. Students who participate in these programs are more likely to:

  • Delay initiation of sexual intercourse
  • Have fewer sex partners
  • Have fewer experiences of unprotected sex
  • Increase their use of protection, specifically condoms
  • Improve their academic performance.

In addition to providing knowledge and skills to address sexual behavior, quality SHE programs can be tailored to include information on high-risk substance use*, suicide prevention, and how to keep students from committing or being victims of violence—behaviors and experiences that place youth at risk for poor health and academic outcomes.

*High-risk substance use is any use by adolescents of substances with a high risk of adverse outcomes (i.e., injury, criminal justice involvement, school dropout, loss of life). This includes misuse of prescription drugs, use of illicit drugs (i.e., cocaine, heroin, methamphetamines, inhalants, hallucinogens, or ecstasy), and use of injection drugs (i.e., drugs that have a high risk of infection of blood-borne diseases such as HIV and hepatitis).
What does delivering sexual health education look like in action?

To successfully put quality SHE into practice, schools need supportive policies, appropriate content, trained staff, and engaged parents and communities. Schools can put these four elements in place to support SHE.

Keys To Success
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Include enough time during professional development and training for teachers to practice and reflect on what they learned (essential knowledge and skills) to support their sexual health education instruction.

Keys To Success
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By law, if your school district or school is receiving federal HIV prevention funding, you will need an HIV Materials Review Panel (HIV MRP) to review all HIV-related educational and informational materials. This review panel can include members from your School Health Advisory Councils, as shared expertise can strengthen material review and decision making.

For More Information

Learn more about delivering quality sexual health education in the Program Guidance.

Check out CDC’s tools and resources below to develop, select, or revise SHE curricula.

  1. CDC. PS18-1807 Program Guidance: Guidance for School-Based HIV/STD Prevention (Component 2) Recipients of PS18-1807 pdf icon[PDF – 120 pages]. Atlanta, GA: U.S. Department of Health and Human Services; 2019.
  2. National Health Education Standards. CDC Division of Adolescent and School Health website. Accessed December 20, 2019.
  3. Chin HB, Sipe TA, Elder R. The effectiveness of group-based comprehensive risk-reduction and abstinence education interventions to prevent or reduce the risk of adolescent pregnancy, human immunodeficiency virus, and sexually transmitted infections: Two systematic reviews for the guide to community preventive services. Am J Prev Med 2012;42(3):272–94.
  4. Mavedzenge SN, Luecke E, Ross DA. Effective approaches for programming to reduce adolescent vulnerability to HIV infection, HIV risk, and HIV-related morbidity and mortality: A systematic review of systematic reviews. J Acquir Immune Defic Syndr 2014;66:S154–69.
  5. Basch CE. Healthier students are better learners: A missing link in school reforms to close the achievement gap. J Sch Health 2011;81(10):593–8.
  6. CDC. Health-related behaviors and academic achievement among high school students—United States, 2015. MMWR 2017;66(35):921–927.
  7. CDC. Developing a Scope and Sequence for Sexual Health Education [PDF – 17 pages]. Atlanta, GA: U.S. Department of Health and Human Services; 2016. .
  8. CDC. Program guidance on the review of HIV-related educational and informational materials for CDC assistance programs pdf icon[PDF – 4 pages]. Atlanta, GA: U.S. Department of Health and Human Services; 2016.
  9. CDC. Health Education Curriculum Analysis Tool (HECAT). Atlanta, GA: U.S. Department of Health and Human Services; 2012.