Comprehensive Sexual Health Education for Youth Needs
Data Supporting a Comprehensive Approach to Reproductive and Sexual Health Education to Meet the Needs of Youth
Elissa Barr, PhD1, Carmen Smotherman, PhD, MPH, MS2, Michele Moore, PhD3, Zhigang Xie4, Emily Balaguer5,
Main Article ContentElissa Barr, PhD
OPEN ACCESS
PUBLISHED: 31 Decemner 2024
CITATION: BARR, Elissa et al. Data Supporting a Comprehensive Approach to Reproductive and Sexual Health Education to Meet the Needs of Youth. Medical Research Archives, Available at: <https://esmed.org/MRA/mra/article/view/6140>.
COPYRIGHT: © 2025 European Society of Medicine. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
DOI: https://doi.org/10.18103/mra.v12i12.6140
ISSN 2375-1924
Abstract
In the United States (U.S.), reproductive and sexual health education in middle school and high school is inconsistent across states and remains under scrutiny. The Centers for Disease Control and Prevention (CDC) identifies 22 critical sexuality education topics. Yet only 24% of middle schools teach grades 6-8 and 45% of high schools (grades 9-12) are required to address all 22 topics in 2022. Additionally, other states have laws requiring comprehensive sexuality education in all schools, 16 states provide abstinence-only sex education, and only 13 states require sex education to include information on consent. In Florida, the focus is on the prevention of teen pregnancy and sexually transmitted infections (STIs), but the research documents a more comprehensive approach to reproductive and sexual health education is necessary for adolescents, particularly in the state of Florida. This paper aims to provide a comprehensive approach to reproductive and sexual health education that is relevant and responsive to the needs of youth.
Keywords: reproductive health, sexual health education, youth, Florida, comprehensive approach
Introduction
In the United States (U.S.), reproductive and sexual health education in middle school and high school is inconsistent across states and remains under scrutiny. The Centers for Disease Control and Prevention (CDC) identifies 22 critical sexuality education topics. Yet only 24% of middle schools teach grades 6-8 and 45% of high schools (grades 9-12) are required to address all 22 topics in 2022. Additionally, other states have laws requiring comprehensive sexuality education in all schools, 16 states provide abstinence-only sex education, and only 13 states require sex education to include information on consent. In Florida, the focus is on the prevention of teen pregnancy and sexually transmitted infections (STIs), but the research documents a more comprehensive approach to reproductive and sexual health education is necessary for adolescents, particularly in the state of Florida.
According to the Florida Department of Health, in this same year, the state of Florida was identified as one of eight states that accounted for 57% of all new HIV infections. According to the Florida Department of Health, one in every 154 adults in Florida were living with HIV in 2020.
Teens also experience high rates of unplanned pregnancy and teen births. Although on a downward trend since 2013, the teen pregnancy rate in Florida remains high, with 10% of teen moms (15-19 years) having had a child by age 19. In 2020, there were 16,000 births to teens aged 15-19, which represents a rate of 18.8 births per 1,000 females aged 15-19. The Florida Department of Health reported that 57% of all new HIV infections in 2020 occurred among young people aged 20 to 24, closely followed by those 15 to 19. Among the estimated 31,200 new HIV infections in 2022, persons aged 15-29 accounted for 6,400 cases, or 20% of these cases, and 42,200 young people in this age group were living with HIV.
DATA
Participants’ baseline characteristics were collected via a survey provided to educational administrators for individuals 25 years and older, to age, sex, and race/ethnicity. Demographic weights were calculated using the U.S. Census Bureau’s American Community Survey (ACS) 5-year estimates for the adult population of Duval County. Party registration information was obtained from the election authorities in each county. All weighted demographic variables were applied using the SPSS version 27 rate weighting function, which will not assign a weight if one of the weighting demographic variables is missing. Individuals with missing demographic data were manually assigned a weight of one.
DATA COLLECTION: Data collection took place over a 10-month period from November 2021 to August 2022. Participants were contacted by live callers via telephone. The survey was administered via telephone interviews with a 27-question survey regarding sexual health education.
Variable
| Variable | Category | Count |
|---|---|---|
| Education | Less than high school | 13 (0.1%) |
| High school graduate | 539 (91%) | |
| Some college | 60 (10%) | |
| Post graduate | 213 (0.3%) |
Overall, 86% of participants reported that learning about sex education to be important in high school, with a higher proportion reporting it as important among younger participants (from 95% among 18 to 24 years old, to 80% among 65 years old or older, p=0.04), minority participants (86% Hispanic, p=0.004), and those with less education (100% among those without a high school diploma, p=0.015) (Table 2).
Table 2: Support for Sexual Health Education and Education Types
| Variable | Category | How important is sex ed in high school? | How do you feel about sex ed in high school? |
|---|---|---|---|
| Gender | Male | 74% (84) | 87% (92) |
| Female | 81% (93) | 83% (91) |
In general, the majority of participants support teaching all eight topics in both high school and middle school. In high school, support for teaching gender and sexual orientation to 93% for teaching human anatomy and reproduction (Table 3).
Table 3: Overall Support for Sexual Health Topics
| Topic | Support |
|---|---|
| How to talk with parents about sex education | 74% |
| Anatomy & Reproduction | 81% |
| HIV and STDs | 87% |
| Abstinence from sexual activity | 78% |
| Birth control methods | 72% |
| Condom use | 70% |
| Gender and sexual orientation | 87% |
Discussion
Results from this study add to the research documenting support for a more comprehensive approach to reproductive and sexual health education. Among participants, 83% prefer school taught abstinence, but only 11% prefer schools do not teach abstinence. This research indicates that sexual education received the least support yet was supported by well over half of respondents. The support for the need for sexual health education was significant among those aged 18 to 24 and those with a high school education (66%, p=0.050). There were no significant differences in support for topics taught in middle school by education (Appendix B).
The findings support the need for a comprehensive approach to sexual health education in Florida, recent state practice in Florida is not reflective. This relatively new direction is coming from the state level government to include the Florida Department of Education. House Bill 1069, approved by the State Board of Education in Florida, became effective in July of 2023. This bill now requires all materials used to teach reproductive health or any disease including HIV/AIDS to be approved by the Florida Department of Education. Prior to this bill, local districts had the autonomy to determine and select materials to meet the needs of their community. With the movement towards a more abstinence focused approach, Florida schools are becoming less inclusive in their content. Specific topics being excluded include sexual orientation, consent, and the importance of healthy relationships. This is concerning as the research indicates that the majority of youth are supportive of comprehensive sexual health education.
LIMITATIONS
The study had several limitations. First, the sample is representative of the residents of the United States (SIECUS). The SIECUS data cannot be generalized to other counties, states, or other regions. Second, for questions regarding support for each of the eight topics being taught in middle school and high school, only specific questions were used to imply the content of the specific topics to be taught. The support for the nature and depth of each topic was not known. Finally, only quantitative questions would have added to the richness and depth of the results allowing participants to explain why they support the specific topics and sexual health education in general.
Conclusion
Results from this study provide substantial support for comprehensive sexual health education in middle and high schools. The research indicates that youth in Florida are supportive of both comprehensive and abstinence-based education. The findings suggest that the current state level direction regarding sexual education in public schools, rests on the need for a comprehensive approach to sexual health education.
Conflict of Interest
The authors have no conflicts of interest to declare.
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