Just Half of US Adolescents Getting Sufficient Sex Education

By Linda Carroll

November 19, 2021

NEW YORK (Reuters Health) - Across the U.S., only half of teens have received sex education that meets the minimum standard set in current national goals, a new study finds.

An analysis of survey data from nearly 8,000 teens reveals that when it comes to sex education, little changed between 2011-2015 and 2015-2019, with much of that education focusing on sexually transmitted diseases (STDs) and HIV, researchers report in the Journal of Adolescent Health.

"Evidence shows that adolescents in the United States are clearly not getting the quality sex education they need, and in fact, our research shows that young people are less likely to receive information about birth control than they were 25 years ago," said Dr. Laura Lindberg, principal research scientist at the Guttmacher Institute in New York City.

"Only half of U.S. adolescents get sex education that meet minimum federal standards, and many don't get any information at all on crucial issues like contraception and HIV prevention," Dr. Lindberg told Reuters Health by email. "Adolescents aren't getting the information they need to have healthy and safe sexual lives as they enter adulthood."

"There are also concerning inequities between who has access to sex education by race, gender, and sexual orientation that leaves young people vulnerable," she said. "Withholding critical information about people's sexual health violates their right to accurate, timely information."

Also concerning, Dr. Lindberg said, is the emphasis in many of the sex-education classes.

"Our research shows clear changes over time in young people's receipt of sex education," she added. "Today, more adolescents have received instruction about 'how to say no to sex' (81% of females and 79% of males) than instruction about birth control (64% of females and 63% of males). By comparison, in 1995, 87% of female adolescents and 81% of male adolescents received education about birth-control methods."

To take a closer look at sex education in the U.S., Dr. Lindberg and her coauthor, Dr. Leslie Kantor of Rutgers School of Public Health in Newark, New Jersey, turned to cross-sectional data from the 2011-2015 and 2015-2019 Centers for Disease Control and Prevention's National Surveys of Family Growth (NSFG). The survey was designed to oversample Black and Hispanic individuals and teens aged 15-19.

For their analysis, the researchers focused on teens aged 15-19, which left them with 2,047 girls and 2,087 boys in 2011-2015 and 1,894 females and 1,918 boys in 2015-2019.

NSFG asked respondents: "Before you were 18, did you ever have any formal instruction at school, church, a community center, or some other place about . . ." The seven possible responses included: "how to say no to sex," "methods of birth control," "sexually transmitted diseases," "how to prevent HIV/AIDS," "waiting until marriage to have sex," "where to get birth control," and "how to use a condom."

In follow-up questions, teens were asked what grade they were in when they first received instruction and whether they got instruction before they first had sexual intercourse.

At both time periods studied by the researchers, more than 90% of female and male teens said they had received instruction on STDs or HIV, which was more than any of the other six topics examined in the study.

More teens received instruction on "how to say no to sex" (79%-84%) or waiting until marriage (58%-73%) compared with instruction about any of the birth-control topics, including the more actionable topics of where to obtain birth control (40%-53%) and how to use a condom (54%-60%).

Only about half of the adolescents met the Healthy People 2030 composite sex education goal (49%-55%). Among those not meeting the Healthy People goal, the most common issue was the lack of instruction on birth control methods (80% of respondents).

In 2015-2019, girls were more likely than boys to report receipt of specific instruction in waiting until marriage to have sex (67%), whereas boys were more likely to report instruction in condom skills (60% vs. 55%).

"Sex education is a critical part of education for adolescents, which means it needs to be funded at appropriate levels, be medically accurate, inclusive and comprehensive," Dr. Lindberg said. "In order to move ahead, there also needs to be a more significant effort to build an equity focus into sex education policies and programs and eliminate troubling disparities in sex education by race and gender."

There were no other significant gender differences in 2015-2019, in contrast to the 2011-2015 gender differences in instruction. The researchers found large declines in receipt of instruction about waiting to have sex (73%-67% for girls and 70%-58% for boys). There was also some evidence that an increasing number of boys were getting instruction on birth-control methods (58%-63%) and where to get birth control (40%-45%), but declines in the number of girls being taught where to get birth control for females (53%-48%).

SOURCE: https://bit.ly/30ySrtE Journal of Adolescent Health, online November 4, 2021