Adolescent Health: 

What Works in Schools

Sexual Health Education

The Centers for Disease Control and Prevention’s Division of Adolescent 

and School Health (DASH) has established an evidence-based approach 

schools can implement to help prevent HIV, STDs, and unintended 

pregnancy among adolescents. It includes quality health education, 

systems that connect students to health services, and safer and more 

supportive school environments. This info brief focuses on delivering quality 

sexual health education—a systematic, effective way schools can provide 

adolescents the essential knowledge and critical skills needed to decrease 

sexual risk behaviors.

What is sexual health education?

Quality sexual health education (SHE) provides students with the 

knowledge and skills to help them be healthy and avoid human 

immunodeficiency virus (HIV), sexually transmitted diseases (STD), 

and unintended pregnancy. A SHE curriculum includes medically 

accurate, developmentally appropriate, and culturally relevant 

content and skills that target key behavioral outcomes and promote 

healthy sexual development. The curriculum is age-appropriate and 

planned across grade levels to provide information about health 

risk behaviors and experiences. Sexual health education should be 

consistent with scientific research and best practices; reflect the 

diversity of student experiences and identities; and align with school, 

family, and community priorities. 

Quality sexual health education programs share many characteristics. 

These programs:

y Are taught by well-qualified and highly-trained teachers and 

school staff

y Use strategies that are relevant and engaging for all students

y Address the health needs of all students, including the needs of 

lesbian, gay, bisexual, transgender, and questioning youth

y Connect students to sexual health and other health services at 

school or in the community

y Engage parents, families, and community partners in school 

programs

y Foster positive relationships between adolescents and

important adults.

Across states, 

fewer than half of 

high schools (43%) 

and less than 

one-fifth of middle 

schools (18%) teach 

key CDC topics 

for sexual health 

education.

Source: 2018 School Health Profiles

@CDC_DASH

www.cdc.gov/healthyyouth

Published 2020
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Adolescent Health: What Works in Schools

Sexual Health Education

How can schools deliver sexual health education?

A school health education program that includes a quality SHE curriculum targets the development of critical 

knowledge and skills needed to promote healthy behaviors and avoid risks. It is important that SHE explicitly 

incorporate skill development. Giving students time to practice, assess, and reflect on skills taught in the 

curriculum helps move them toward independence, critical thinking, and problem solving to avoid HIV, STDs, 

and unintended pregnancy.

Quality sexual health education programs teach 

students how to:

y Analyze family, peer, and media influences that 

impact health

y Access valid and reliable health information, 

products, and services (e.g., HIV/STD testing)

y Communicate with family, peers, and teachers 

about issues that affect health

y Make informed and thoughtful decisions about 

their health

y Take responsibility for themselves and others to 

improve their health.

Broward County Public Schools in 

Florida has used CDC’s Health Education 

Curriculum Analysis Tool (HECAT) to 

improve their health education curricula. 

“We compared our current curriculum 

with HECAT and made changes and 

modifications and enhancements based on 

what we analyzed,” says Sebrina James, 

Broward County’s Instructional Facilitator 

and Sexual Health Coordinator.

What are the benefits of delivering sexual health education 

to students?

Promoting and implementing well-designed SHE programs positively impacts student health in a variety of 

ways. Students who participate in these programs are more likely to:

y Delay initiation of sexual intercourse

y Have fewer sex partners

y Have fewer experiences of unprotected sex

y Increase their use of protection, specifically 

condoms

y Improve their academic performance.

In addition to providing knowledge and skills to 

address sexual behavior, quality SHE programs 

can be tailored to include information on high-risk 

substance use,*

 suicide prevention, and how to 

keep students from committing or being victims 

of violence—behaviors and experiences that place 

youth at risk for poor health and academic outcomes. 

*

High-risk substance use is any use by adolescents of substances with a high risk of adverse outcomes (i.e., injury, criminal justice 

involvement, school dropout, loss of life). This includes misuse of prescription drugs, use of illicit drugs (i.e., cocaine, heroin, 

methamphetamines, inhalants, hallucinogens, or ecstasy), and use of injection drugs (i.e., drugs that have a high risk of infection of 

blood-borne diseases such as HIV and hepatitis).
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Adolescent Health: What Works in Schools

Sexual Health Education

What does delivering sexual health education look like 

in action?

To successfully put quality SHE into practice, schools need supportive policies, appropriate content, trained 

staff, and engaged parents and communities. Schools can put these four elements in place to support SHE. 

1. Implement policies that foster supportive environments 

for SHE:

9 Identify existing state, district, and school policies on 

health education and SHE for all students. 

9 Establish a skills-based health education course 

requirement—which includes SHE content—for all middle 

and high school students. 

2. Use health content that is medically accurate, 

developmentally appropriate, culturally inclusive, 

and grounded in science.

9 Develop a SHE scope and sequence document†

 that 

identifies behavioral and learning outcomes for all 

middle and high school students.

9 Develop or select a SHE curriculum—consistent with 

the approved scope and sequence—that includes 

instructional lessons, student activities, resources, 

and assessment strategies. CDC’s Health Education 

Curriculum Analysis Tool (HECAT) is a great resource to 

develop, select, and revise curricula. 

9 Promote the use of teaching tools and resources—for 

example, pacing guides or specific lesson plans—to 

continuously improve SHE content and delivery.

3. Equip staff with the knowledge and skills needed to deliver SHE.

9 Seek feedback from teachers, staff, students, and administrators within the school about what critical 

knowledge and skills are needed to effectively deliver SHE. 

9 Identify a set of instructional competencies—the essential knowledge and teaching skills—that those 

delivering SHE should know and be able to demonstrate during instruction.

9 Use the identified instructional competencies to design, implement, and evaluate teacher and staff 

professional development and training. These trainings can improve teachers’ knowledge and comfort 

with the subject matter and use of effective teaching skills needed for SHE. 

† A scope and sequence document outlines the key health topics and concepts to be learned across grade levels (scope), and the 

logical progression of health knowledge, skills, and behaviors to be addressed at each grade level (sequence)—from pre-kindergarten 

through 12th grade.

KEYS TO SUCCESS

Include enough time during 

professional development and 

training for teachers to practice 

and reflect on what they learned 

(essential knowledge and skills) 

to support their SHE instruction. 
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Adolescent Health: What Works in Schools

Sexual Health Education

4. Engage parents and community partners.

9 Create School Health Advisory Councils (SHACs), or 

similar committees, that regularly provide district-level 

guidance on the school health program for students 

and staff. Within SHE, a SHAC can make valuable 

recommendations to strengthen curriculum or 

professional development and training opportunities 

for staff. 

9 Use strategies to actively engage families and 

communities in school health programs, explicitly 

gaining their feedback on SHE curricula through 

participation on the SHACs.

KEYS TO SUCCESS

By law, if your school district or 

school is receiving federal HIV 

prevention funding, you will 

need an HIV Materials Review 

Panel (HIV MRP) to review 

all HIV-related educational 

and informational materials. 

This review panel can include 

members from your School 

Health Advisory Councils, 

as shared expertise can 

strengthen material review and 

decision making.

For More 

Information

Learn more about delivering quality sexual health education at www.cdc.gov/healthyyouth/programguidance.

Check out CDC’s tools and resources below to develop, select, or revise SHE curricula at 

www.cdc.gov/healthyyouth/tools. 

y Health Education Curriculum Analysis Tool (HECAT). This tool helps school and community leaders conduct 

clear, complete, and consistent analyses of health education curricula across a wide variety of topics (e.g., 

nutrition, tobacco, mental/emotional health).

y Health Education Curriculum Analysis Tool (HECAT), Module 6: Sexual Health. This module within CDC’s 

HECAT includes the knowledge, skills, and health behavior outcomes specifically aligned to sexual health 

education. School and community leaders can use this module to develop, select, or revise SHE curricula 

and instruction. 

y Developing a Scope and Sequence for Sexual Health Education. This resource provides an 11-step process 

to help schools outline the key sexual health topics and concepts (scope), and the logical progression of 

essential health knowledge, skills, and behaviors to be addressed at each grade level (sequence) from 

pre-kindergarten through the 12th grade. A developmental scope and sequence is essential to developing, 

selecting, or revising SHE curricula. 

Read additional info briefs in the Adolescent Health: What Works in Schools series at 

www.cdc.gov/healthyyouth/whatworks.