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• Within each state, relatively few high schools offered instruction on HIV, STDs or pregnancy prevention specifically relevant to lesbian, gay, bisexual, transgender, queer or questioning (LGBTQ) youth in 2014; the proportion ranged from 11% in South Dakota to 56% in Vermont.
Adolescents may receive information about sexual health topics from a range of sources beyond formal instruction.
For example, the share of rural adolescents who had received instruction about birth control declined from 71% to 48% among females, and from 59% to 45% among males.
• Only about half of adolescents (57% of females and 43% of males) received formal instruction about contraception before they first had sex; about four in ten (46% of females and 31% of males) received instruction about where to get birth control.
• There has been a shift toward evidence-based interventions in the United States over the last few decades.
The first dedicated federal funding stream for evaluation of adolescent sexual health programs was established in 2010 and has contributed to improvement in the quality and quantity of evaluation research.
• Proponents of “sexual risk avoidance” programs have appropriated the terms “medically accurate” and “evidence-based,” though experts in the field agree that such programs are neither complete in their medical accuracy nor based on the widely accepted body of scientific evidence.• Abstinence-only-until-marriage programs threaten fundamental human rights by withholding information about human sexuality and potentially providing medically inaccurate and stigmatizing information.• Most evaluations of sexual health programs focus on reducing levels of adolescent pregnancy, STIs and the behaviors that lead to them.• As of 2015, fewer than six percent of lesbian, gay, bisexual and transgender (LGBT) students aged 13–21 reported that their health classes had included positive representations of LGBT-related topics.• Leading public health and medical professional organizations—including the American Medical Association; the American Academy of Pediatrics; the American College of Obstetricians and Gynecologists; the American Public Health Association; the Health and Medicine Division of the National Academies of Science, Engineering, and Medicine (formerly the Institute of Medicine); the American School Health Association and the Society for Adolescent Health and Medicine—support comprehensive sex education.• The share of adolescents aged 15–19 who had received formal instruction about how to say no to sex but had received no instruction about birth control methods increased between 2006–20–2013, from 22% to 26% among females and from 29% to 35% among males.• Declines in formal sex education were concentrated among young people residing in rural areas.• Many health care providers do not talk with their adolescent patients about sexual health issues during primary care visits.When these conversations do occur, they are usually brief; in one study, conversations with patients aged 12–17 lasted an average of 36 seconds.• “Formal” sexual health education is instruction that generally takes place in a structured setting, such as a school, youth center, church or other community-based location.This type of instruction is a central source of information for adolescents.