Adolescent Health: 

What Works in Schools

Evidence-Based Strategies for Your School 

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 delivering sexual health education, 

increasing access to sexual health services, and promoting 

safe and supportive environments. This info brief provides an 

overview of this approach and information to help educators, 

staff, and administrators as they implement HIV, STD, and 

unintended pregnancy prevention efforts in their schools.

What Are the Risks? A Current Snapshot of Student Health

Data from CDC’s Youth Risk Behavior Survey show that fewer high school students engage in health behaviors 

that put them at risk. But even though adolescents are making better decisions about their health, far too 

many are still at risk for human immunodeficiency virus (HIV), sexually transmitted diseases (STDs), and 

unintended pregnancy.

y Some youth engage in multiple and serious 

risk behaviors like high-risk substance use*

and sex without condoms, and go through 

harmful experiences such as being a victim 

of violence. 

y Youth who engage in these behaviors or 

who have these harmful experiences are 

more at risk for a variety of negative health 

outcomes including HIV and STDs.

y These risks are more common among some 

youth—including lesbian, gay, bisexual, and 

transgender youth, who are more likely to 

experience stigma, discrimination, family 

disapproval, social rejection, and violence. 

As a result, they are more likely to have 

poor health.

SEXUAL 

HEALTH 

SERVICES

SEXUAL 

HEALTH 

EDUCATION

SAFE AND 

SUPPORTIVE 

ENVIRONMENTS

46% of U.S. high school students did not 

use a condom the last time they had sex

More than 1 in 10

female students and 

1 in 28 male 

students have 

been physically 

forced to have sex

19% of high school 

students have been 

bullied at school

Nearly 1 in 7 high 

school students misuse 

prescription opioids

More than 47% of lesbian, gay, or 

bisexual students have considered suicide 

Source: 2017 National Youth Risk Behavior Survey

*

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).

@CDC_DASH

www.cdc.gov/healthyyouth

Published 2020
Adolescent Health: What Works in Schools

Evidence-Based Strategies for Your School 

2

What Works? CDC’s Approach to School-Based HIV 

and STD Prevention

CDC’s Division of Adolescent and School Health (DASH) has 

established an evidence-based approach to school-based HIV 

and STD prevention. It includes providing quality sexual health 

education, connecting students to sexual health services, and 

establishing safe and supportive school environments. These 

evidence-based strategies benefit all students. Further, activities 

related to health education and health services can be tailored to 

address health outcomes other than sexual behaviors, including 

high-risk substance use, violence victimization, and mental health. 

Promoting safe and supportive environments can address all of 

these health outcomes.

Sexual Health Education

Quality sexual health education (SHE) is a systematic 

approach to preparing students with the knowledge and 

skills needed to make informed health decisions to prevent 

HIV, STDs, and unintended pregnancy.

y Sexual health education includes planned, progressive 

learning objectives and outcomes across grade levels 

(K–12). 

y Sexual health education addresses knowledge and 

skills students need before risk behaviors and health 

issues emerge.

y Effective SHE programs:

9 Are taught by qualified, trained teachers

9 Connect students to health services

9 Engage parents and community partners

9 Foster positive relationships between students 

and trusted adults.

Students who receive evidence-based SHE can reduce 

health risk behaviors and experiences and may improve 

their academic performance in school.

Why Are Schools Important for 

Promoting Student Health? 

Schools offer valuable 

opportunities for improving 

adolescent health. 

9 They have direct contact with 

millions of students for at least 

six hours a day.

9 Students generally attend 

school throughout much of 

their social, physical, and 

intellectual development.

9 Many schools have staff with 

the knowledge to address 

critical health risk and 

protective behaviors.

9 Many schools have the 

infrastructure to support a 

varied set of evidence-based 

approaches and interventions. 

Benefits of Providing 

SHE to Students

Ï Knowledge to reduce 

sexual risk

Ï Condom negotiation skills

Ï Self-efficacy to delay 

sexual activity
Adolescent Health: What Works in Schools

Evidence-Based Strategies for Your School 

3

Sexual Health Services

Sexual health services (SHS) give students access to preventive health care, such as STD testing, HIV 

testing, contraception, and condoms, and referrals to appropriate treatment, if needed.

y Through SHS, students can gain access to broad 

preventive health services, such as sexual risk 

assessments and counseling on healthy decision making 

and protective behaviors.

y Schools can connect students to SHS by providing the 

services on site or by referring students to youth-friendly 

health care providers in the community.

These services can provide students with information, 

education, support, referrals, and counseling for a broad 

range of health behaviors and experiences that can affect healthy development. 

Safe and Supportive School Environments

Creating safe and supportive environments (SSE) emphasizes aspects of school settings and family 

relationships that can protect adolescents and reduce their risk for HIV, STDs, and unintended pregnancy.

y These protective factors include school connectedness, 

parental monitoring, and parent-adolescent 

communication (both generally and specifically 

about sex).

y Safe and supportive environments connect adolescents 

to a network of caring peers and adults, including 

parents, other primary caregivers, and teachers.

y Improving environments can have a broad and lasting 

positive impact on health. It also establishes a context 

for sexual health education and sexual health services 

to be effective.

Creating SSE involves schools, communities, families, and youth working together to protect students’ 

health and improve academic performance.

Benefits of Connecting 

Students to SHS

Ï Risk-reduction counseling

Ï HIV and STD testing

Ï Contraceptive use

Benefits of 

Promoting SSE

Ï School connectedness 

Ï Parental monitoring 

Ï Parent-adolescent 

communication

For More 

Information

Schools provide students with the opportunity to learn the importance of behaviors and skills needed to engage 

in a healthy lifestyle now and into adulthood. Learn more about CDC’s school-based approach to HIV and STD 

prevention at www.cdc.gov/healthyyouth/programguidance.

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

www.cdc.gov/healthyyouth/whatworks.