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Obstetrics & Gynecology 2008;111:256-266
© 2008 by The American College of Obstetricians and Gynecologists
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ORIGINAL RESEARCH

What Schools Teach Our Patients About Sex

Content, Quality, and Influences on Sex Education

Stacy Tessler Lindau, MD, MAPP1,2, Adjoa S. Tetteh1, Kristen Kasza, MS3 and Melissa Gilliam, MD, MPH1

From the Departments of 1Obstetrics and Gynecology, 2Medicine, and 3Health Studies, University of Chicago, Chicago, Illinois.

OBJECTIVE: To identify predictors of comprehensive sex education in public schools.

METHODS: Using a three-stage design, 335 sex education teachers from a probability sample of 201 schools in 112 Illinois school districts were surveyed regarding the 2003–2004 school year. Coverage of at least all of the following topics constituted "comprehensiveness": abstinence, human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS), other sexually transmitted diseases (STDs), and contraception. A logistic regression model identified predictors of comprehensiveness.

RESULTS: Representing 91.3% of sampled schools, the teacher survey response rate was 62.4%. The most frequently taught topics included HIV/AIDS (97%), STDs (96%), and abstinence-until-marriage (89%). The least frequently taught topics were emergency contraception (31%), sexual orientation (33%), condom (34%) and other contraceptive (37%) use, and abortion (39%). Abstinence-only curricula were used by 74% of teachers, but 33% of these teachers supplemented with "other" curricula. Overall, two thirds met comprehensiveness criteria based on topics taught. Curricular material availability was most commonly cited as having a "great deal" of influence on topics taught. Thirty percent had no training in sex education; training was the only significant predictor of providing comprehensive sex education in multivariable analysis.

CONCLUSION: Illinois public school-based sex education emphasizes abstinence and STDs and is heavily influenced by the available curricular materials. Nearly one in three sex education teachers were not trained. Obstetrician-gynecologists caring for adolescents may need to fill gaps in adolescent knowledge and skills due to deficits in content, quality, and teacher training in sex education.

LEVEL OF EVIDENCE: III




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