January 22, 2015 

Comprehensive Sexuality Education: Efforts to Decrease Pregnancy and

Sexually Transmitted Diseases Among Youth

By: Heather Loran & Elissa Barr, PhD

         Adolescents have alarming rates of sexually transmitted diseases (STD) and unintended pregnancies due to risky sexual behaviors a lack of quality sexuality education. According to Stanger-Hall and Hall (2011), “The United States ranks first among developed nations in rates of both teenage pregnancy and sexually transmitted diseases” (p.1). Studies have shown that implementing comprehensive school health programs devoted to sexuality education is a critical component in decreasing these rates. Comprehensive sexuality education (CSE) covers a variety of age-appropriate topics to include human development, relationships, personal skills, sexual behavior, sexual health, and sociocultural factors. Although CSE teaches abstinence as the most reliable way to avoid STDs and unintended pregnancies, such programs also offer accurate and reliable education on the effectiveness of various contraceptives (Jeffries, Dodge, Bandiera, & Reece, 2010). According to Healthy People 2020 (2010), in 2006 only 39.3 percent of primary and secondary schools provided CSE to prevent unintended pregnancy and STDs.

            According to Kirby and Laris (2009), adolescents and young adults represent 25 percent of the sexually active population in the United States, but they account for almost 50 percent of all new cases of STDs. Research documents that 25 percent of teenagers who are sexually active will be diagnosed with an STD in the United States (Walcott, Chenneville, & Tarquini, 2011). Approximately four million new cases of STDs occur among teens every year (Kirby & Laris, 2009). In addition to the disturbing STD rates among our youth, teen pregnancy is also extremely concerning.  The New York Bureau of Maternal and Child Health (2011) identifies adolescent pregnancy as a significant public health problem, with 5.8 percent of adolescent females becoming pregnant annually. Approximately one-third of girls in the United States become pregnant before they reach the age of 20 (Kirby & Laris, 2009). Finally, there are many health, social and economic concerns that result from teen pregnancy and teen births.  According to Kuo et al. (2014) the socioeconomic burden of teen pregnancy alone justifies CSE to help reduce risky sexual behaviors and their negative outcomes among youth.  Comprehensive sexuality education is fundamental in helping to decrease pregnancy and STDs among students.

           CSE should be required in all primary and secondary educational institutions. Florida State Statute 1003.42 requires “family life” instruction and “prevention and control of disease” as required components of “Comprehensive Health Education.”  State Statute 1003.46 provides additional guidance regarding AIDs instruction. However, specific content and curriculum is determined by each local school district policy. Therefore, sexuality education varies greatly throughout Florida. According to Stanger-Hall and Hall (2011), “U.S. state laws and policies generally do not require that sex and STD education is taught in all schools, but only provide guidelines if local school boards decide to teach it” (p.1). Even if a school does decide to offer CSE, parents may still elect to hold their children out of such programs. However, according to Kuo et al. (2014) substantial progress has been noted in students' understanding of sexual health issues after completion of these programs. School systems and the local communities all need to be properly trained and active in educating youth in CSE. Stanger-Hall and Hall propose the incorporation of CSE into existing curriculum in schools. Advocates for Youth has reviewed current programs to compile a list of programs that have been verified effective, and Florida’s Sexual Health Education Community Outreach Tool Kit aims to deliver neighborhoods with materials to support communities in decreasing teen STDs and pregnancy in addition to improving wellbeing and academic success of students.

Heather Loran is a candidate for a Master's in Public Health at the University of North Florida. Her public health interest is in sexual health with a focus on adolescent sexual education. She graduated with honors from the University of Florida with a Bachelor of Health Science Degree with a concentration in public health.

Dr. Elissa Barr is an Associate Professor and undergraduate community health Program Director in the Department of Public Health at the University of North Florida. Her research addresses reducing risky sexual behaviors of youth through evidence based sexuality education, advocacy efforts, and policy change.


Bureau of Maternal and Child Health (September 2011). Priority Area: Healthy Mothers, Healthy Babies, Healthy Children - Adolescent Pregnancy Prevention. Retrieved from https://www.health.ny.gov/prevention/prevention_agenda/healthy_mothers/adolescent_health.htm

Comprehensive Sex Education: Research and Results. Advocates for Youth (n.d.). Retrieved October 23, 2014. Available at [http://www.advocatesforyouth.org/publications/1487]

Florida's Sexual Health Education Community Outreach Tool Kit. (n.d.). Retrieved October 22, 2014, from http://www.fldoe.org/bii/cshp/Education/HIV_STD/pdf/ToolKitF-4web.pdf

Jeffries, W. L., Dodge, B., Bandiera, F. C., & Reece, M. (2010). Beyond abstinence-only: relationships between abstinence education and comprehensive topic instruction. Sex Education, 10(2), 171-185. doi:10.1080/14681811003666317

Kirby, D., & Laris, B. A. (2009). Effective Curriculum-Based Sex and STD/HIV Education Programs for Adolescents. Child Development Perspectives, 3(1), 21-29. doi:10.1111/j.1750-8606.2008.00071.x

Kuo, K., Zhu, T. Y., Raidoo, S., Zhao, L. X., Sammarco, A., & Ashby, K. (2014). Original Study: Partnering with Public Schools: A Resident-Driven Reproductive Health Education Initiative. Journal Of Pediatric And Adolescent Gynecology, 2720-24. doi:10.1016/j.jpag.2013.08.006

Stanger-Hall, K. F., & Hall, D. W. (2011). Abstinence-Only Education and Teen Pregnancy Rates: Why We Need Comprehensive Sex Education in the U.S. Plos ONE, 6(10), 1-11. doi:10.1371/journal.pone.0024658

Statutes & Constitution :View Statutes : Online Sunshine. Florida Statute, Title XLVIII, Chapter 1003, Section 42, 46. (2014, October 23). Retrieved October 24, 2014.

U.S. Department of Health and Human Services. Office of Disease Prevention and Health Promotion. Healthy People 2020. Washington, DC. Available at [http://www.healthypeople.gov/2020/topicsobjectives2020/objectiveslist.aspx?topicId=11]. Accessed [September 11, 2014].

Walcott, C. M., Chenneville, T., & Tarquini, S. (2011). Relationship between recall of sex education and college students' sexual attitudes and behavior. Psychology In The Schools, 48(8), 828-842. doi:10.1002/pits.20592

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