National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention 

Division of Adolescent and School Health 

CS216499 

Bringing High-Quality HIV and STD Prevention 

to Youth in Schools: 

CDC’s Division of Adolescent and School Health 

Schools Play a Critical Role in HIV and 

STD Prevention 

By the time young people graduate from high school, almost two thirds 

have had sex. Nearly 40 percent of sexually active students did not use a 

condom the last time they had sex, and one in five drank alcohol or took 

drugs before their last sexual intercourse. Such risky sexual behaviors can 

have serious health consequences: 

 Approximately 18 percent of all new HIV diagnoses are among young 

people aged 13–24 years.* 

 Teens and young adults have the highest rates of sexually transmitted 

diseases (STDs) of any age group. 

 Three in 10 young women become pregnant before they reach the age 

of 20. 

Helping adolescents make healthy choices requires the involvement of 

families, communities, and many other sectors of society—and schools 

are an essential part of that effort: 

 Schools have direct contact with more than 56 million students for at 

least 6 hours a day and for 13 critical years of their social, physical, and 

intellectual development. 

 The school environment is a key setting in which students’ behaviors and 

ideas are shaped. 

 Just as schools are critical to preparing students academically and socially, 

they are also vital partners in helping young people take responsibility for 

their health and adopt health-enhancing attitudes and behaviors that can 

last a lifetime. 

HIV/STD Prevention Programs Can Reduce 

Risk Behaviors and Be Cost-Effective 

Research shows that well-designed, well-implemented school-based HIV/ 

STD prevention programs can significantly reduce sexual risk behaviors 

among students. A review of 48 studies found that sexual health education 

programs resulted in a delay in first sexual intercourse, a decrease in the 

number of sex partners, and an increase in condom or contraceptive use. 

None increased the likelihood of having sex. 

Effective school-based HIV/STD prevention programs tend to be those that 

are delivered by trained instructors; are age-appropriate; and include such 

components as skill-building lessons, support of healthy behaviors in school 

environments, and the involvement of parents, youth-serving organizations, 

and health organizations. 

* In 2008 in the 37 states with long-term, confidential name-based reporting. 
Youth asset-development programs, which teach youth how to solve 

problems, communicate with others, and engage in healthy 

behaviors, have also been linked to long-term reductions in 

sexual risk behaviors. 

School-based HIV prevention programs are also cost-effective. 

A study conducted by CDC found that for every dollar invested 

in an effective school-based HIV, STD, and pregnancy prevention 

program, $2.65 in medical costs and lost productivity were saved. 

DASH Promotes Effective HIV Prevention 

Through Schools 

CDC’s Division of Adolescent and School Health (DASH) is a unique 

source of support for HIV prevention efforts in the nation’s schools. 

DASH provides funding and technical assistance that enables state and 

local education agencies to deliver HIV prevention programs that are 

scientifically sound and grounded in the latest research on effectiveness. 

Many of the strategies implemented by schools to prevent HIV infection 

can also help young people avoid other STDs and unintended pregnancy. 

Bridge between public health and education. State and local public 

health departments, which lead most HIV prevention efforts, cannot take

advantage of schools as a setting for HIV prevention without the strong 

support of education agencies. School curricula, policies, and services 

are determined by state education agencies and school districts, not 

by health agencies. Therefore, for more than two decades, DASH has 

supported a nationwide network of HIV prevention leadership in state 

and local education agencies. 

Nationwide network of leaders in school-based HIV prevention. DASH 

provides funding and technical assistance to HIV prevention programs 

in 49 states, the District of Columbia, 16 large urban school districts, 6 

territories, and 1 tribal government. Program activities include— 

 Implementing HIV prevention curricula that are medically accurate, are 

consistent with evidence of effectiveness, and teach critical skills such as 

how to access valid information about HIV and how to develop effective 

refusal and negotiation skills. 

 Helping communities collect and analyze data on sexual risk behaviors 

of young people to ensure that programs are data driven and 

responsive to local needs. 

 Providing state-of-the-art professional development to ensure that 

teachers have the knowledge and skills to effectively teach young 

people how to protect themselves from HIV infection. 

 Ensuring safe and supportive school climates that increase student 

engagement with school, reduce discrimination, bullying, and isolation, 

and decrease the likelihood that students will engage in risky behaviors. 

 Supporting the adoption and implementation of critical policies related 

to infection control procedures and confidentiality for students and staff 

with HIV infection. 

 Establishing links to community-based health services that provide 

testing, counseling, and treatment for HIV and other STDs. 

Schools are vital partners in 

helping young people take 

responsibility for their health 

and adopt health-enhancing 

attitudes and behaviors that 

can last a lifetime. 

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National HIV/AIDS Strategy 

A central tenet of the National HIV/AIDS Strategy for the United States, released by 

the White House in July 2010, is that all Americans should be educated about the 

threat of HIV and how to prevent it. The strategy emphasizes that “HIV awareness 

and education should be universally integrated into all educational environments” 

and that “educating young people about HIV before they begin engaging in risk 

behaviors that place them at risk for HIV infection should be a priority.” 

Specifically, the strategy stresses the role of schools in providing current and 

accurate information that “is grounded in the benefits of abstinence and delaying 

or limiting sexual activity, while ensuring that youth who make the decision to be 

sexually active have the information they need to take steps to protect themselves.” 

Because HIV cases in the United States are highly concentrated in specific 

populations and locations, DASH requires its funded programs to focus 

activities on reaching youth in groups and communities at high risk for 

HIV infection. 

DASH-funded education agencies are required to collaborate closely 

with the public health departments in their jurisdictions. These 

partnerships lead to integrated efforts that maximize program 

effectiveness, increase efficiency, and reduce redundancy. DASH and 

its partners also facilitate the integration of HIV, STD, and pregnancy 

prevention efforts to transcend bureaucratic barriers and maximize 

impact. 

In addition, DASH’s funded projects are held accountable for meeting 

targeted increases in the percentages of schools implementing policies 

and practices known to be effective in reducing sexual risk behaviors. 

National support. DASH funds 13 national, nongovernmental 

organizations to support the HIV prevention efforts of education 

agencies and other agencies that serve youth in high-risk situations. 

For example— 

 The National Association of County and City Health Officials (NACCHO) 

helps local health departments collaborate with school districts and 

schools on HIV prevention education. NACCHO coordinates with 

DASH and the National Coalition of STD Directors to improve HIV/STD 

prevention programs, policies, and services for school-aged youth 

through education and health agency partnerships. 

 The American Psychological Association provides science-based 

workshops for school counselors, nurses, psychologists, and social 

workers on how to reach lesbian, gay, and bisexual youth with HIV 

prevention messages and other health information. 

 To reach youth in educational settings outside of schools, the National 

Network for Youth trains staff at shelters for runaway and homeless 

youth to implement evidence-based HIV prevention programs, while 

ETR Associates does the same for staff in juvenile justice centers. 

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DASH’s Programs Are Data Driven and Evidence Based 

Data collection and analysis. Through three unique surveillance systems, 

DASH and its funded states, cities, territories, and tribes provide the nation’s 

most comprehensive data about the health risk behaviors of 

adolescents and the steps schools are taking to improve student 

health. These data sources are used by states, cities, and schools 

to identify trends in adolescents’ sexual behaviors, set priorities 

for school and community interventions, and, ultimately, drive 

improvements in HIV prevention practices, programs, and policies. 

 The Youth Risk Behavior Surveillance System (www.cdc.gov/yrbs) is 

a system of national, state, and large urban school district surveys 

of representative samples of high school students. Conducted 

every two years, these surveys monitor health risk behaviors 

among young people—including their sexual risk behaviors— 

so that health and education agencies can effectively target and 

improve programs. 

 The School Health Policies and Practices Study (www.cdc.gov/SHPPS) and 

School Health Profiles (www.cdc.gov/schoolhealthprofiles) are two surveys 

that enable DASH to monitor the extent to which different states and cities, 

and the nation as a whole, are implementing practices shown to 

be effective at preventing sexual risk behaviors. 

Research analysis and translation. DASH scientists analyze research on 

program effectiveness, develop guidelines for effective HIV prevention 

practices, and create tools to help schools implement these guidelines. For 

example, DASH’s Health Education Curriculum Analysis Tool (www.cdc.gov/ 

healthyyouth/HECAT) integrates research findings and national health 

education standards to help school districts select or develop health 

education curricula that are most likely to reduce sexual risk behaviors 

among the youth they serve. 

DASH supports rigorous evaluation research to expand knowledge about 

the types of programs and practices that can have a positive impact on 

youth sexual risk behaviors, including— 

 All About Youth, a randomized, controlled trial testing two HIV/STD 

education programs for middle school students: one that emphasizes 

sexual abstinence until marriage, and one that emphasizes abstinence in 

conjunction with skill-building activities for condom and contraceptive use. 

 Linking Lives, a program designed to build parents’ skills to help them 

reduce sexual health risks among their middle school children. 

For more than two decades, 

DASH has supported a 

nationwide network of HIV 

prevention leadership in state 

and local education agencies. 

October 1, 2010 

For More Information 

For more information about DASH and its programs, 

surveillance, and research, please contact: 

www.cdc.gov/HealthyYouth 

1-800-CDC-INFO (1-800-232-4636) 

nccddashinfo@cdc.gov 

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