Three Decades of Research: The Case for Comprehensive Sex Education

PurposeSchool-based sex education plays a vital role in the sexual health and well-being of young people. Little is known, however, about the effectiveness of efforts beyond pregnancy and sexually transmitted disease prevention. The authors conducted a systematic literature review of three decades of research on school-based programs to find evidence for the effectiveness of comprehensive sex education.MethodsResearchers searched the ERIC, PsycINFO, and MEDLINE. The research team identified papers meeting the systematic literature review criteria. Of 8,058 relevant articles, 218 met specific review criteria. More than 80% focused solely on pregnancy and disease prevention and were excluded, leaving 39. In the next phase, researchers expanded criteria to studies outside the U.S. to identify evidence reflecting the full range of topic areas. Eighty articles constituted the final review.ResultsOutcomes include appreciation of sexual diversity, dating and intimate partner violence prevention, development of healthy relationships, prevention of child sex abuse, improved social/emotional learning, and increased media literacy. Substantial evidence supports sex education beginning in elementary school, that is scaffolded and of longer duration, as well as LGBTQ–inclusive education across the school curriculum and a social justice approach to healthy sexuality.ConclusionsReview of the literature of the past three decades provides strong support for comprehensive sex education across a range of topics and grade levels. Results provide evidence for the effectiveness of approaches that address a broad definition of sexual health and take positive, affirming, inclusive approaches to human sexuality. Findings strengthen justification for the widespread adoption of the National Sex Education Standards.     

High School Health‐Education Teachers' Perceptions and Practices Related to Teaching HIV Prevention

BACKGROUND: HIV/AIDS is one of the leading causes of illness and death in the United States with individuals between the ages of 13 and 19 years being especially vulnerable for infection. The purpose of this study was to examine the attitudes, perceptions, and instructional practices of high school health teachers toward teaching HIV prevention. METHODS: A total of 800 surveys were sent to a national random sample of high school health teachers and 50% responded. RESULTS: There was almost complete agreement (99%) among respondents that HIV prevention instruction is needed. The factors that emerged as significantly influencing the attitudes and perceptions of high school health teachers about teaching HIV prevention were related to teacher preparation, training, and years of experience teaching health education. A state mandate requiring HIV prevention instruction was significantly associated with higher teacher efficacy expectations and more perceived benefits, but did not have a significant influence in relation to practices in the classroom. Characteristics of high school health teachers that were significantly related to attitudes, perceptions, and instructional practices included the instructor's age, sex, and race/ethnicity. CONCLUSIONS: High school health teachers who reported the least experience teaching health education had the least supportive attitudes, perceived the most barriers, and had the lowest efficacy and outcome expectations related to teaching about HIV prevention. Whereas these findings support the importance of teacher preparation and training, they also suggest that more recent college graduates may not be fully prepared to provide effective instruction in HIV prevention.     

The Deaf Community and Sexuality Education

This paper addresses specific attributes of the Deaf community that make cultural specificity in sexuality education necessary for classrooms containing students who are deaf or hard of hearing. The attributes recognized are: an identification of stereotypes, a lack of accessibility, English as a second language, a list of Deaf Friendly resources, sign language usage, multiculturalism and diversity, family of origin versus family of choice, and role modeling. A strong case is made for why these factors can influence information needed in sexuality education.     

The Sexuality Education Program of the Massachusetts Statewide Head Injury Program

Traumatic brain injury (TBI) can create changes in a person's thinking and emotional self-control that can lead to unwanted and unsuccessful social behaviors. In some instances a person with a severe TBI may lose certain social abilities he or she may have once possessed, and might now show a lack of discretion or empathy or tact in their social behavior. Many individuals who were injured in childhood or adolescence might not have had sufficient opportunity to develop and refine adult socialization skills. These undeveloped, or diminished, social abilities are likely to affect an individual's sense of lovability and capability in terms of social and sexual relationships. Many persons with a TBI report a loss of pre-injury friendships, and increased loneliness and social isolation after an injury. Many individuals also report changes in their sexual drive, or sexual functioning, which additionally affect their ability to pursue intimate relationships, or successfully renegotiate changes in an existing intimate relationship. And yet, a person with a TBI will still experience normal human needs for closeness and affection, as well as normal sexual interests. Therefore, education and skill training and guidance are needed to assist the person with a TBI in making his or her best adjustment to these various changes and challenges. Also, some of the emotional and social challenges faced by the person with a TBI will be exhibited in his or her interactions with clinicians. So education and training is needed for staff as well in order for staff members to understand and respond to these behavioral concerns in an effective and skillful manner. To meet these needs, the Massachusetts Statewide Head Injury Program implemented the Sexuality Education Program. This article describes the components of a comprehensive sexuality related staff training and client education program for a statewide network of residential and day treatment programs serving adults with TBI.     

Understanding of Sexuality and Reproductive Health Among Women With and Without Physical Disabilities

This study compares differences in how women with disabilities and women without disabilities learned about their sexuality and reproductive functioning. A written questionnaire was sent to a national sample of women with disabilities and their non-disabled woman friends recruited through independent living centers and announcements in the media. Responses were received from 504 women with disabilities and 442 women without disabilities. Participants were asked how old they were when they first learned about the physical aspects of sexual intercourse. Women with disabilities learned about the physical aspects of sexual intercourse at about the same age (M = 13.16) as women without disabilities (M = 12.93). The most commonly reported sources for learning about sexuality and sexual functioning for both groups were books and other printed material, having sex, partners, friends, and teachers in primary school. More women with disabilities received information from a woman with a disability and a rehabilitation counselor. Women in both groups indicated that sex was never or seldom the subject of general family conversation. On average the women with physical disabilities had their first date at age 16.6, which is later than women without physical disabilities (M = 14.91). Women with physical disabilities who reported having acquired sexuality information at a later age reported having sexual intercourse at an older age (M = 20.37) than women without physical disabilities (M = 17.75). Age at acquiring sexuality information was neither associated with frequency of intimate touch nor frequency of sexual intercourse. The results of this study can be used to generate recommendations for health care professionals concerning ways to respond more effectively to the special needs for sexuality information of physically disabled women.     

Sexuality Training,Education and Therapy in the Healthcare Environment: Taboo,Avoidance, Discomfort or Ignorance?

Multiple sources of resistance are present in the healthcare environment to comprehensive assessment and intervention efforts in regard to sexuality. The authors survey both the diversity of needs and values presented by consumers, and encourage providers to equip themselves educationally, emotionally and ethically so that they can deliver relevant, holistic services to consumers.     

Innovation and Integration of Sexuality in Family Life Education

As a fundamental aspect of the human experience, sexuality is experienced at every stage in the life span. Sexual values, behaviors, and health are important components of individual and family well-being. Educating about such a fundamental aspect of life is both obvious and crucial. In this article, we consider the potential of sexuality education in the field and profession of family life education (FLE). We critique sexuality education in the United States and the marginal place of human sexuality in the FLE field. We then offer recommendations for incorporating life span, socioecological, family systems, and intersectionality perspectives into sexuality education, and recommendations for FLE and sexuality education research and practice. We argue that educating about sexuality in the context of FLE—and activating the profession of FLE for sexuality education—will strategically advance sexuality education, sexual health, and the field of FLE.