United States

Almost all U.S. students receive some form of sex education at least once between grades 7 and 12; many schools begin addressing some topics as early as grades 5 or 6.^[26] However, what students learn varies widely, because curriculum decisions are so decentralized. Many states have laws governing what is taught in sex education classes or allowing parents to opt out. Some state laws leave curriculum decisions to individual school districts.^[27]

For example, a 1999 study by the Guttmacher Institute found that most U.S. sex education courses in grades 7 through 12 cover puberty, HIV, STIs, abstinence, implications of teenage pregnancy, and how to resist peer pressure. Other studied topics, such as methods of birth control and infection prevention, sexual orientation, sexual abuse, and factual and ethical information about abortion, varied more widely.^[28]

Two main forms of sex education are taught in American schools: comprehensive and abstinence-only. Comprehensive sex education covers abstinence as a positive choice, but also teaches about contraception and avoidance of STIs when sexually active. A 2002 study conducted by the Kaiser Family Foundation found that 58% of secondary school principals describe their sex education curriculum as comprehensive.^[27]

Abstinence-only sex education tells teenagers that they should be sexually abstinent until marriage and does not provide information about contraception. In the Kaiser study, 34% of high-school principals said their school's main message was abstinence-only.

The difference between these two approaches, and their impact on teen behavior, remains a controversial subject. In the U.S., teenage birth rates had been dropping since 1991, but a 2007 report showed 3% increase from 2005 to 2006.^[29] From 1991 to 2005, the percentage of teens reporting that they had ever had sex or were currently sexually active showed small declines.^[30] However, the U.S. still has the highest teen birth rate and one of the highest rates of STIs among teens in the industrialized world.^[31] Public opinion polls conducted over the years have found that the vast majority of Americans favor broader sex education programs over those that teach only abstinence, although abstinence educators recently published poll data with the opposite conclusion.^[32][33][34]

Proponents of comprehensive sex education, which include the American Psychological Association,^[35] the American Medical Association,^[36] the National Association of School Psychologists,^[37] the American Academy of Pediatrics,^[38] the American Public Health Association,^[39] the Society for Adolescent Medicine^[40] and the American College Health Association,^[40] argue that sexual behavior after puberty is a given, and it is therefore crucial to provide information about the risks and how they can be minimized; they also claim that denying teens such factual information leads to unwanted pregnancies and STIs.

On the other hand, proponents of abstinence-only sex education object to curricula that fail to teach their standard of moral behavior; they maintain that a morality based on sex only within the bounds of marriage is "healthy and constructive" and that value-free knowledge of the body may lead to immoral, unhealthy, and harmful practices. Within the last decade, the federal government has encouraged abstinence-only education by steering over a billion dollars to such programs.^[41] Some 25 states now decline the funding so that they can continue to teach comprehensive sex education.^{[42][43][44][45]} Funding for one of the federal government's two main abstinency-only funding programs, Title V, was extended only until December 31, 2007; Congress is debating whether to continue it past that date.^[46]

The impact of the rise in abstinence-only education remains a question. To date, no published studies of abstinence-only programs have found consistent and significant program effects on delaying the onset of intercourse.^[31] In 2007, a study ordered by the U.S. Congress found that middle school students who took part in abstinence-only sex education programs were just as likely to have sex (and use contraception) in their teenage years as those who did not.^[47] Abstinence-only advocates claimed that the study was flawed because it was too narrow and began when abstinence-only curricula were in their infancy, and that other studies have demonstrated positive effects.^[48]

It is estimated that more than half of all new HIV infections occur before the age of 25 and most are acquired through unprotected sex. According to the experts on AIDS, many of these new cases come about because young people don’t have the knowledge or skills to protect themselves. To try and resolve this problem the American Psychological Association (APA) is recommending that comprehensive sex education and HIV prevention programs become more available to the youth. The young people need this to help protect them from HIV/AIDS and other STDs they might get if they decide to have sex. Willenz, Pam.