Persons using assistive technology might not be able to fully access information in this file. For assistance, please send e-mail to: mmwrq@cdc.gov. Type 508 Accommodation and the title of the report in the subject line of e-mail.
HIV, Other STD, and Pregnancy Prevention Education in Public Secondary Schools — 45 States, 2008–2010
In the United States, 46% of high school students have had sexual intercourse and potentially are at risk for human immunodeficiency virus (HIV) infection, other sexually transmitted diseases (STDs), and pregnancy (1). The National HIV/AIDS Strategy for the United States recommends educating young persons about HIV before they begin engaging in behaviors that place them at risk for HIV infection (2). The Community Preventive Services Task Force (CPSTF) also recommends risk reduction interventions to prevent HIV, other STDs, and pregnancy among adolescents (3). To estimate changes in the percentage of secondary schools that teach specific HIV, other STD, and pregnancy risk reduction topics, a key intervention consistent with those supported by the National HIV/AIDS Strategy and CPSTF (2,3), CDC analyzed 2008 and 2010 School Health Profiles data for public secondary schools in 45 states. This report summarizes the results of those analyses, which indicated that in 2010, compared with 2008, the percentage of secondary schools teaching 11 topics on HIV, other STD, and pregnancy prevention in a required course in grades 6, 7, or 8 was significantly lower in 11 states and significantly higher in none; the percentage of secondary schools teaching eight topics in a required course in grades 9, 10, 11, or 12 was significantly lower in one state and significantly higher in two states; and the percentage of secondary schools teaching three condom-related topics in a required course in grades 9, 10, 11, or 12 was significantly lower in eight states and significantly higher in three states. Secondary schools can increase efforts to teach all age-appropriate HIV, other STD, and pregnancy prevention topics to help reduce risk behaviors among students.
School Health Profiles surveys have been conducted biennially since 1996 to assess school health practices in the United States.* States, territories, large urban school districts, and tribal governments participate in the surveys, either selecting systematic, equal-probability samples of their secondary schools (middle schools, junior high schools, and high schools with one or more of grades 6–12),† or selecting all public secondary schools within their jurisdiction.§ Self-administered questionnaires are sent to the principal and lead health education teacher at each selected school and returned to the agency conducting the survey. Lead health education teachers are asked questions regarding the content of required instruction related to HIV, other STD, and pregnancy prevention.¶ Data are included in this report only if the state provided appropriate documentation of methods and had a school response rate =70% for both the 2008 and 2010 surveys. Across states included in this report, school response rates ranged from 70% to 93% (median: 73%) in 2008 and from 70% to 86% (median: 73%) in 2010. The number of lead health education teachers who participated, by state, ranged from 71 to 472 (median: 245) in 2008 and from 65 to 677 (median: 249) in 2010. Participation in School Health Profiles is confidential and voluntary. Follow-up telephone calls, e-mails, and written reminders are used to encourage participation. For states that use a sample-based method, results are weighted to reflect the likelihood of schools being selected and to adjust for differing patterns of nonresponse. For states that conduct a census, results are weighted to adjust for differing patterns of nonresponse.
This report includes data from 45 states that provided weighted School Health Profiles data in 2008 and 2010.** For each of these states, three composite measures were created to determine the percentage of schools that taught 1) all 11 topics listed in the questionnaire in a required course in grades 6, 7, or 8; 2) all eight topics listed in the questionnaire in a required course in grades 9, 10, 11, or 12; and 3) all three condom-related topics listed in the questionnaire in a required course in grades 9, 10, 11, or 12. These topics reflect the knowledge and skills that are the focus of interventions shown to be effective in reducing risk that CPSTF and others use as a basis for their recommendations about interventions for adolescents (3–6). For each state, the percentages of schools that taught individual topics and the composite measurements are reported. Significant (p<0.05) differences between results from 2008 and 2010 were determined by t-test. Statistical software was used to account for the sample design and unequal weights.
Compared with 2008, the percentage of schools in 2010 in which all 11 topics were taught in a required course in grades 6–8 was significantly lower in 11 states and significantly higher in no state (Table 1). The percentage of schools in which all eight topics were taught in a required course in grades 9–12 was significantly lower in one state and significantly higher in two states (Table 2). Additionally, the percentage of schools in which all three condom-related topics were taught in a required course in grades 9–12 was significantly lower in eight states and significantly higher in three states (Table 3). Among the 45 states in 2010, the percentage of schools that taught all 11 topics in grades 6, 7, or 8 ranged from 12.6% (Arizona) to 66.3% (New York) (median: 43.3%), the percentage of schools that taught all eight topics in grades 9–12 ranged from 45.3% (Alaska) to 96.4% (New Jersey) (median: 80.3%), and the percentage of schools that taught all three condom-related topics in grades 9–12 ranged from 11.3% (Utah) to 93.1% (Delaware) (median: 58.1%).
For five of the 11 topics (Table 1), the percentage of schools teaching the topic in a required course in grades 6–8 increased significantly in no state, and for the remaining six topics, the percentage increased significantly in one state. Conversely, the percentage of schools teaching any one topic decreased significantly in one to 10 states. The percentage of schools teaching how HIV and other STDs are diagnosed and treated decreased significantly in 10 states, as did the percentage teaching health consequences of HIV, other STDs, and pregnancy. The percentage of schools teaching how to prevent HIV, other STDs, and pregnancy decreased significantly in nine states.
For five of the eight topics (Table 2), the percentage of schools teaching the topic in a required course in grades 9–12 increased significantly in no state; for two topics, the percentage increased significantly in one state; and for the remaining two topics, the percentage increased significantly in two states. Conversely, the percentage of schools teaching any one topic decreased significantly in one to four states. The relationship among HIV, other STDs, and pregnancy was the one topic that showed significant decreases in the percentage of schools teaching it in four states. No state showed a significant increase, and one to seven states showed a significant decrease in the percentage of schools teaching any of the three condom-related topics in any of grades 9–12 (Table 3). The percentage of schools teaching how to obtain condoms decreased significantly in seven states.
Reported by
Laura Kann, PhD, Nancy Brener, PhD, Timothy McManus, MS, Howell Wechsler, EdD, Div of Adolescent and School Health, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, CDC. Corresponding contributor: Laura Kann, lkk1@cdc.gov, 770-488-6181.
Editorial Note
CPSTF recommends group-based comprehensive risk reduction interventions delivered to adolescents, in schools or communities, to promote behaviors that prevent or reduce the risk for HIV, other STDs, and pregnancy. This recommendation is based on evidence of effectiveness in reducing engagement in any sexual activity, frequency of sexual activity, number of partners, and frequency of unprotected sexual activity, and in increasing the self-reported use of protection against STDs and pregnancy (3).
Although a median of 90% of all public secondary schools across the 45 states in this report taught HIV prevention in a required course during 2010 (7), the findings indicate that little progress was made in increasing the number of specific topics covered as part of HIV, other STD, and pregnancy prevention education during 2008–2010. The percentage of secondary schools that taught all HIV, other STD, and pregnancy prevention topics in a required course also varied widely across states. Further research is needed to understand determinants of the number of specific HIV, other STD, and pregnancy prevention topics taught in secondary schools.
HIV, other STD, and pregnancy prevention education in grades 6–8 is particularly important because most students in those grades are not yet sexually active (1,2). HIV, other STD, and pregnancy prevention education that is taught before most young persons engage in risk behaviors, and that includes information on the benefits of abstinence and delaying or limiting sexual activity, can prevent behaviors that might lead to HIV infection, other STDs, and pregnancy (2).
Because many students become sexually active during high school (1), HIV, other STD, and pregnancy prevention education in these grades also is critically important (2). HIV, other STD, and pregnancy prevention education that includes information on condom efficacy, the importance of using condoms consistently and correctly, and how to obtain condoms taught to those who might decide to be or are sexually active also can prevent behaviors that might lead to HIV infection, other STDs, and pregnancy (4–6).
HIV prevention education also can address misconceptions about how HIV is transmitted (2). A 2011 public opinion poll indicated that 20% of persons aged 18–29 years believe incorrectly that a person can become infected with HIV by sharing a drinking glass, or are unsure whether the statement is true or false (8).
The findings in this report are subject to at least three limitations. First, these data apply only to public secondary schools and, therefore, do not reflect practices at private schools or elementary schools. Second, these data were self-reported by lead health education teachers or their designees, and the accuracy of their description of the HIV, other STD, and pregnancy prevention topics taught in required courses was not verified by other sources. Finally, the effect of changes between 2008 and 2010 in the percentage of secondary schools in a state that taught HIV, other STD, and pregnancy prevention topics varies by the number of students attending public schools in the state during those years. States with fewer students would have less of a nationwide impact.
HIV prevention education supports strategies required to achieve the National HIV/AIDS Strategy goal of lowering the annual number of new HIV infections by 25% by 2015 (2). Families, the media, and community organizations, including faith-based organizations, can play a role in providing HIV, other STD, and pregnancy prevention education. However, schools are in a unique position to provide HIV, other STD, and pregnancy prevention education to young persons because almost all school-aged youths in the United States attend school (9). School policies can provide critical support for implementation of comprehensive HIV, other STD, and pregnancy prevention education in secondary schools (10).
CDC. Guide to community preventive services. Prevention of HIV/AIDS, other STIs and pregnancy: interventions for adolescents. Atlanta, GA: US Department of Health and Human Services, CDC; 2010. Available at http://www.thecommunityguide.org/hiv/riskreduction.html. Accessed March 28, 2012.
CDC. Health Education Curriculum Analysis Tool (HECAT). Atlanta, GA: US Department of Health and Human Services, CDC; 2009. Available at http://www.cdc.gov/healthyyouth/hecat. Accessed December 13, 2011.
Kirby D, Laris BA, Rolleri L. Sex and HIV education programs for youth: their impact and important characteristics. Scotts Valley, CA: ETR Associates; 2006. Available at http://www.etr.org/recapp/documents/programs/sexhivedprogs.pdf. Accessed December 13, 2011.
Kirby D, Coyle K, Alton F, Rolleri L, Robin L. Reducing adolescent sexual risk: a theoretical guide for developing and adapting curriculum-based programs. Scotts Valley, CA: ETR Associates; 2011. Available at http://pub.etr.org/upfiles/reducing_adolescent_sexual_risk.pdf. Accessed December 13, 2011.
Brener ND, Demissie Z, Foti K, et al. School Health Profiles 2010: characteristics of health programs among secondary schools in selected U.S. sites. Atlanta, GA: US Department of Health and Human Services, CDC; 2011. Available at http://www.cdc.gov/healthyyouth/profiles/2010/profiles_report.pdf. Accessed December 9, 2011.
Kaiser Family Foundation. HIV/AIDS at 30: a public opinion perspective. Menlo Park, CA: Kaiser Family Foundation; 2011. Available at http://www.kff.org/kaiserpolls/upload/8186.pdf. Accessed December 9, 2011.
Snyder TD, Dillow SA. Table 7. Percentage of the population 3 to 34 years old enrolled in school, by age group: selected years, 1940 through 2009. In: Digest of education statistics 2010. Washington, DC: US Department of Education, National Center for Education Statistics, Institute of Education Sciences; 2011. Available at http://nces.ed.gov/programs/digest/d10/tables/dt10_007.asp?referrer=report. Accessed December 9, 2011.
National Association of State Boards of Education. Someone at school has AIDS: a complete guide to education policies concerning HIV infection. Alexandria, VA: National Association of State Boards of Education; 2001.
† Alabama, Alaska, Arizona, Arkansas, California, Connecticut, Florida, Indiana, Iowa, Kansas, Kentucky, Maryland, Michigan, Minnesota, Mississippi, Missouri, Nebraska, New Jersey, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, South Dakota, Tennessee, Texas, Virginia, Washington, West Virginia, and Wisconsin.
§ Delaware, Hawaii, Idaho, Maine, Massachusetts, Montana, Nevada, New Hampshire, Rhode Island, South Carolina, Utah, Vermont, and Wyoming.
¶ In 2008, lead health education teachers were asked, "During this school year, did teachers in this school teach each of the following HIV, STD, or pregnancy prevention topics in a required course for students in any of grades 6, 7, or 8?" for a list of 11 topics (Table 1) (e.g., how HIV and other STDs are diagnosed and treated; how to prevent HIV, other STDs, and pregnancy; and the benefits of being sexually abstinent). Respondents were instructed to mark "yes" or "no" for each topic or "not applicable" if their school did not include grades 6, 7, or 8. Teachers also were asked the same question for grades 9–12 for a list of eight topics (Table 2) that repeated some of the 11 topics and added others (e.g., the relationship between alcohol and other drug use and risk for HIV, other STDs, and pregnancy), and three condom-related topics (Table 3). In 2010, lead health education teachers were asked, "During this school year, did teachers in your school teach each of the following HIV, STD, or pregnancy prevention topics in a required course for students in each of the grade spans below?" The topics, grade spans, and possible responses were the same as those specified in 2008.
** Alabama, Alaska, Arizona, Arkansas, California, Connecticut, Delaware, Florida, Hawaii, Idaho, Indiana, Iowa, Kansas, Kentucky, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Jersey, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Vermont, Virginia, Washington, West Virginia, Wisconsin, and Wyoming.
What is already known on this topic?
Schools provide a unique setting for reaching most youths nationwide with information they can use to prevent human immunodeficiency virus (HIV) infection, other sexually transmitted diseases, and pregnancy.
What is added by this report?
In 2010, compared with 2008, the percentage of public secondary schools in 45 states teaching specific HIV, other sexually transmitted disease (STD), and pregnancy prevention topics in required courses generally did not increase, and percentages teaching all topics varied widely across these states.
What are the implications for public health practice?
To help reduce HIV-, other STD-, and pregnancy-related risk behaviors among students, secondary schools can increase efforts to teach all age-appropriate HIV, other STD, and pregnancy prevention topics.
TABLE 1. Percentage of public secondary schools in which specific human immunodefiency virus (HIV), sexually transmitted disease (STD), or pregnancy prevention topics were taught in a required course in grades 6, 7, or 8 — 45 states, 2008 and 2010
State
Differences between HIV and AIDS
How HIV and other STDs are transmitted
How HIV and other STDs are diagnosed and treated
Health consequences of HIV, other STDs, and pregnancy
Benefits of being sexually abstinent
How to prevent HIV, other STDs, and pregnancy
2008
2010
2008
2010
2008
2010
2008
2010
2008
2010
2008
2010
Alabama
86.4
84.2
86.4
81.5
82.9
72.2§
85.1
73.1§
81.7
74.1
84.6
75.8
Alaska
58.4
42.7§
64.9
43.1§
53.0
40.1§
61.3
41.6§
59.6
44.6§
63.6
44.6§
Arizona
46.9
32.1§
47.6
33.7§
37.2
24.6§
45.2
31.1§
44.5
31.7§
44.8
32.3§
Arkansas
86.3
81.7
88.4
81.8
81.7
76.4
84.4
79.3
86.1
81.2
86.7
81.9
California
85.2
81.1
86.1
81.6
80.6
72.4§
84.6
79.3
81.6
78.9
85.0
76.0§
Connecticut
83.2
73.0
85.2
78.8
75.0
66.3
81.6
76.8
79.8
75.8
83.3
74.0
Delaware
74.1
67.7
83.4
70.6
78.1
64.7
78.6
69.7
78.6
73.5
82.9
72.7
Florida
76.8
73.2
77.5
74.6
70.4
68.1
74.8
70.4
78.2
73.5
75.6
70.5
Hawaii
79.9
90.1
84.7
94.8
69.8
83.0
77.5
87.6
83.9
92.4
81.8
90.1
Idaho
79.6
73.4
80.3
74.4
71.8
63.1
78.2
71.9
84.0
77.8
78.1
71.7
Indiana
92.0
90.5
95.1
91.5
89.8
84.5
93.8
90.2
94.3
93.8
91.8
92.0
Iowa
86.2
76.6
88.9
78.4§
79.8
68.3§
82.8
79.2
86.1
77.7
84.3
78.3
Kansas
74.9
75.4
76.8
77.2
68.4
68.7
74.4
74.1
76.0
78.4
74.3
77.8
Kentucky
86.7
78.6
88.9
81.9
79.6
67.9§
86.4
77.8
90.2
79.8§
90.2
77.3§
Maine
79.2
82.1
80.4
83.9
71.9
69.4
77.7
82.7
77.5
82.3
79.0
80.8
Maryland
89.2
81.4
88.6
81.5
85.4
77.1
87.1
77.5§
87.7
79.4
86.3
78.2
Massachusetts
75.6
72.4
76.1
75.1
68.9
69.6
75.3
71.3
75.3
74.4
74.3
72.9
Michigan
77.0
76.2
76.9
75.8
71.1
73.4
73.2
73.0
77.0
77.5
72.1
71.8
Minnesota
82.5
80.2
85.0
82.5
77.6
76.8
86.5
75.5§
83.4
87.7
83.2
79.2
Mississippi
59.4
57.0
64.5
56.4
55.1
52.7
62.6
57.2
65.7
56.5
60.3
55.0
Missouri
82.8
76.6
85.0
79.1
79.9
69.4§
83.2
79.0
81.1
79.3
79.5
77.8
Montana
83.8
72.8
83.0
77.0
74.6
66.4
82.7
74.0
80.1
77.2
79.1
74.7
Nebraska
77.1
63.6§
75.6
68.9
67.5
58.7
78.5
66.7§
77.6
70.3
77.9
64.6§
Nevada
82.2
93.6
83.2
95.5§
77.8
87.7
78.4
95.5§
80.2
90.4
81.5
95.5§
New Hampshire
83.1
73.6
83.9
77.7
72.8
71.9
78.6
76.6
81.4
78.7
77.7
77.8
New Jersey
90.2
88.5
90.7
89.9
85.9
85.4
90.2
87.3
85.7
88.0
86.7
86.9
New York
94.5
92.8
95.3
93.4
91.8
88.4
93.2
90.9
93.6
90.9
94.2
90.4
North Carolina
87.4
73.8§
89.7
75.9§
82.9
66.2§
88.1
72.9§
88.6
77.0§
88.2
74.9§
North Dakota
76.8
75.4
75.9
77.8
69.3
64.4
73.7
72.1
71.8
75.0
71.7
72.5
Ohio
82.4
71.2§
84.8
73.8§
79.1
65.5§
83.6
70.9§
83.7
74.3§
82.9
69.9§
Oklahoma
62.3
65.5
63.1
65.8
57.9
60.2
59.9
62.6
59.1
61.0
59.1
63.1
Oregon
86.7
81.0
87.5
85.1
79.9
67.4§
86.8
79.1
88.1
84.9
87.7
82.5
Pennsylvania
86.5
78.9§
86.5
78.3§
79.8
72.1
85.5
76.2§
84.9
79.2
84.4
75.3§
Rhode Island
89.8
92.1
87.4
92.1
77.2
83.9
85.0
87.5
79.7
88.2
87.4
88.2
South Carolina
91.2
90.4
89.2
89.4
82.9
85.8
89.2
86.9
89.2
89.9
87.5
87.5
South Dakota
73.9
63.7
74.9
67.0
62.8
59.2
81.1
60.6§
77.8
66.2
80.9
61.8§
Tennessee
67.7
63.6
68.4
65.8
59.8
58.5
66.8
63.0
68.4
64.5
65.3
63.2
Texas
75.6
77.9
76.6
78.7
69.6
71.7
74.1
77.8
75.4
80.7
73.1
76.9
Utah
90.7
92.8
91.8
89.7
76.6
81.4
89.0
86.1
91.7
85.6
85.6
83.0
Vermont
68.0
77.1
70.3
80.7
60.3
66.9
60.9
73.8
69.9
80.1
66.4
78.3
Virginia
85.7
83.7
86.8
84.5
80.3
80.2
84.5
82.2
87.3
85.2
84.9
85.0
Washington
90.1
91.9
91.2
91.2
80.0
85.9
88.7
88.6
89.4
86.2
89.5
85.6
West Virginia
88.5
84.2
89.5
86.2
83.9
79.9
85.9
82.9
88.6
90.1
88.6
85.0
Wisconsin
87.1
85.3
88.8
86.9
78.3
79.6
88.8
82.6
88.6
89.9
86.8
84.1
Wyoming
80.8
75.4
84.4
77.6
75.6
71.5
83.0
75.2
82.7
78.7
79.3
75.5
State median
82.8
77.1
84.8
78.8
77.2
69.6
82.8
76.6
81.6
78.9
82.9
77.3
State range
(46.9–94.5)
(32.1–93.6)
(47.6–95.3)
(33.7–95.5)
(37.2–91.8)
(24.6–88.4)
(45.2–93.8)
(31.1–95.5)
(44.5–94.3)
(31.7–93.8)
(44.8–94.2)
(32.3–95.5)
TABLE 1. (Continued) Percentage of public secondary schools in which specific human immunodefiency virus (HIV), sexually transmitted disease (STD), or pregnancy prevention topics were taught in a required course in grades 6, 7, or 8 — 45 states, 2008 and 2010
State
How to access valid and reliable health information, products, and services*
Influences of media, family, and social and cultural norms on sexual behavior
Communication and negotiation skills†
Goal-setting and decision-making skills†
Compassion for persons living with HIV or AIDS
All 11 topics
2008
2010
2008
2010
2008
2010
2008
2010
2008
2010
2008
2010
Alabama
75.3
64.1
78.8
65.0§
79.2
64.8§
79.6
67.4§
71.2
60.5
63.4
44.8§
Alaska
53.3
41.9
53.3
38.5§
50.9
39.3
56.7
38.9§
43.6
32.6
32.0
23.6
Arizona
35.0
25.8
43.4
28.6§
43.1
29.2§
40.9
26.5§
34.2
19.8§
27.7
12.6§
Arkansas
79.8
74.2
84.7
74.7
79.2
71.1
82.3
72.4
69.5
64.9
64.5
59.7
California
72.5
67.2
73.9
67.0
70.1
64.0
71.0
66.1
69.7
62.5
54.4
47.5
Connecticut
68.7
59.5
69.1
67.2
68.5
65.4
71.4
59.4§
70.0
62.9
47.9
39.0
Delaware
78.6
57.6
76.5
66.7
76.9
63.6
76.4
69.7
52.1
59.4
51.8
45.2
Florida
62.8
60.6
61.5
65.8
70.9
66.2
72.4
68.3
61.2
60.4
52.5
49.0
Hawaii
75.1
80.6
75.1
82.9
72.7
80.6
75.1
87.4
65.1
72.8
57.1
66.3
Idaho
66.5
59.0
73.5
69.1
67.8
67.0
72.9
66.0
67.4
50.9§
50.6
40.1
Indiana
76.0
73.0
89.2
86.5
85.6
83.1
87.1
80.1
75.6
66.6
65.9
54.7§
Iowa
76.6
66.0
77.4
71.4
71.0
64.8
74.8
67.2
66.8
55.4
51.4
41.4
Kansas
59.5
58.2
69.5
66.8
68.1
66.6
69.3
65.0
57.7
53.0
48.4
39.0
Kentucky
72.9
63.0
83.7
74.9
79.8
69.7
83.3
70.9§
69.0
56.3§
61.9
44.8§
Maine
64.8
68.0
69.8
75.9
67.6
74.9
66.1
72.0
65.2
58.5
44.8
42.2
Maryland
75.0
70.6
82.9
73.9
83.3
73.6§
86.9
76.6§
76.6
65.0§
66.1
57.7
Massachusetts
63.9
59.5
70.0
69.5
64.8
64.2
69.4
65.4
63.0
56.3
44.2
40.8
Michigan
63.1
57.7
67.8
65.3
63.9
63.6
65.4
66.1
63.0
56.1
48.9
39.5
Minnesota
69.8
64.8
75.4
76.3
75.0
68.1
74.3
73.3
63.6
49.7§
49.6
36.3§
Mississippi
55.2
51.5
57.4
50.7
56.6
49.2
59.4
53.8
51.4
45.6
49.4
36.4
Missouri
71.5
64.9
76.4
70.0
73.2
66.8
75.0
71.3
64.4
58.0
56.6
47.3§
Montana
71.9
60.5
72.4
68.8
72.6
62.7
67.8
63.3
67.7
57.1
50.9
41.6
Nebraska
56.7
58.4
74.2
65.9
67.2
63.1
67.7
59.1
55.7
53.7
41.3
35.9
Nevada
63.7
82.3§
75.5
82.7
72.7
88.9§
75.3
92.6§
62.2
70.4
55.6
65.5
New Hampshire
62.6
61.2
68.4
69.9
67.2
71.2
66.6
70.2
58.2
60.0
43.0
43.4
New Jersey
78.2
77.1
84.8
82.6
83.8
80.6
82.6
80.7
77.6
73.8
69.7
64.3
New York
81.6
81.3
87.2
84.7
87.8
84.5
86.8
83.3
83.4
80.2
71.9
66.3
North Carolina
80.4
61.7§
84.0
71.5§
85.6
69.7§
84.5
68.5§
73.3
54.6§
65.8
44.7§
North Dakota
63.5
57.2
71.4
71.5
68.9
64.3
70.5
64.5
60.0
60.8
50.2
39.7
Ohio
68.2
59.3
78.9
69.6
73.2
62.9§
77.8
70.8
61.9
57.5
54.9
48.6
Oklahoma
50.3
54.0
47.9
52.1
51.0
53.5
51.4
53.9
51.5
52.5
46.4
43.2
Oregon
70.1
67.6
83.6
77.9
77.8
74.3
80.2
70.7
57.6
57.2
52.7
40.1§
Pennsylvania
69.4
64.0
76.8
67.4§
74.4
67.2
76.7
72.2
66.9
53.2§
55.0
39.9§
Rhode Island
77.2
75.1
79.7
79.5
79.7
75.3
84.6
71.8
70.5
70.3
57.0
54.3
South Carolina
73.4
73.7
79.9
85.9
83.4
81.1
84.1
84.6
70.4
67.5
62.0
58.5
South Dakota
64.2
51.5
70.3
60.2
66.4
55.7
68.5
55.0
62.4
41.4§
46.0
27.6§
Tennessee
58.9
53.6
61.8
58.0
61.9
55.9
62.1
57.8
55.4
45.7
50.7
40.8
Texas
64.9
65.4
73.1
73.7
68.0
69.9
69.0
73.2
58.1
56.1
53.7
49.1
Utah
59.8
59.1
82.3
82.2
80.5
79.2
85.4
84.0
71.2
63.8
47.8
41.6
Vermont
63.4
65.6
64.6
69.6
66.0
67.6
65.1
61.3
53.5
55.6
42.9
39.4
Virginia
73.7
71.6
78.6
81.6
80.7
77.5
81.6
78.6
70.7
62.4
59.3
53.5
Washington
76.2
75.6
75.1
73.1
77.6
74.8
74.2
70.3
73.6
66.0
58.2
43.3§
West Virginia
82.3
76.5
85.2
86.1
82.3
77.3
85.0
80.3
77.8
72.4
71.3
62.3
Wisconsin
71.9
71.2
78.7
80.7
78.7
79.7
77.0
78.9
60.4
72.3§
50.0
51.3
Wyoming
69.0
60.9
78.2
72.9
77.7
73.1
77.7
71.0
51.9
56.7
49.7
37.8
State median
69.4
64.0
75.4
71.4
72.7
67.6
74.8
70.3
64.4
58.0
51.8
43.3
State range
(35.0–82.3)
(25.8–82.3)
(43.4–89.2)
(28.6–86.5)
(43.1–87.8)
(29.2–88.9)
(40.9–74.8)
(26.5–92.6)
(34.2–83.4)
(19.8–80.2)
(27.7–71.9)
(12.6–66.3)
Abbreviation: AIDS = acquired immunodeficiency syndrome.
* Related to HIV, other STDs, and pregnancy.
† Related to eliminating or reducing risk for HIV, other STDs, and pregnancy.
§ Significant difference between 2008 and 2010 (p<0.05).
TABLE 2. Percentage of public secondary schools in which specific human immunodefiency virus (HIV), sexually transmitted disease (STD), or pregnancy prevention topics were taught in a required course in grades 9, 10, 11, or 12 — 45 states, 2008 and 2010
State
Relationship among HIV, other STDs, and pregnancy
Relationship between alcohol and other drug use and risk for HIV, other STDs, and pregnancy
Benefits of being sexually abstinent
How to prevent HIV, other STDs, and pregnancy
How to access valid and reliable health information, products, and services*
Influences of media, family, and social and cultural norms on sexual behavior
Communica-tion and negotiation skills†
Goal-setting and decision-making skills†
All eight topics
2008
2010
2008
2010
2008
2010
2008
2010
2008
2010
2008
2010
2008
2010
2008
2010
2008
2010
Alabama
97.5
87.9§
98.1
86.9§
97.6
88.9§
98.7
82.7§
95.4
85.2§
94.7
83.6§
93.7
84.1§
95.6
86.4§
84.7
75.7§
Alaska
69.2
56.6§
72.5
62.0
66.6
65.1
74.9
65.9
63.9
61.7
65.7
56.7
63.1
58.2
64.1
56.9
48.4
45.3
Arizona
73.4
66.1
67.4
70.3
71.6
69.3
72.9
71.6
66.6
62.6
69.2
62.2
69.0
63.2
68.2
59.5
45.7
50.9
Arkansas
96.2
95.0
98.5
98.7
96.8
96.8
98.4
96.9
92.9
91.0
99.3
93.3§
95.3
91.2
96.1
90.0
87.2
84.9
California
95.2
89.7
93.8
91.9
93.7
91.3
94.5
93.3
93.0
89.7
93.8
87.7
91.6
88.5
89.6
89.1
80.1
84.4
Connecticut
95.4
94.2
97.5
95.0
95.0
95.0
97.5
95.2
95.4
93.1
89.7
90.4
87.2
91.6
91.7
89.0
79.6
80.2
Delaware
96.8
96.7
96.8
100.0
96.8
100.0
96.8
100.0
93.7
96.7
96.8
96.7
90.6
100.0
90.6
96.7
84.0
93.3
Florida
86.6
87.0
89.0
85.8
90.3
88.5
88.0
87.1
82.1
83.9
86.2
81.1
82.7
85.8
84.9
84.8
74.1
71.5
Hawaii
100.0
86.0
97.3
91.0
100.0
95.3
100.0
95.3
97.2
93.0
97.2
95.3
97.2
90.7
94.4
93.0
86.7
81.7
Idaho
95.2
94.5
96.0
96.5
98.6
97.8
97.1
97.1
85.9
92.8§
94.8
94.5
92.0
93.5
90.3
93.3
73.8
83.2§
Indiana
96.2
95.6
96.1
97.5
97.7
99.3
97.6
99.4
94.1
90.0
94.1
96.2
93.9
93.4
92.2
92.6
83.4
84.7
Iowa
84.1
81.9
82.9
82.3
82.6
82.2
82.8
83.8
78.3
74.6
77.8
76.8
74.7
73.6
74.8
72.1
67.6
66.9
Kansas
93.1
92.8
90.7
94.9
94.8
95.6
94.0
94.2
85.3
84.0
85.3
89.9
88.2
91.3
85.9
87.0
68.3
71.2
Kentucky
98.2
96.5
98.2
96.5
98.2
98.3
98.2
97.5
96.0
95.7
98.2
97.5
96.4
96.6
95.6
94.9
89.2
90.6
Maine
96.0
92.0
96.2
95.8
96.1
96.7
97.1
96.9
93.3
94.7
92.3
89.8
90.3
92.1
92.2
86.4
80.8
78.1
Maryland
99.1
98.9
99.1
100.0
99.1
100.0
99.1
100.0
95.3
97.6
97.2
94.8
96.0
100.0
96.2
98.9
88.3
92.1
Massachusetts
87.0
88.1
86.5
90.5
88.1
90.7
87.0
92.0
83.8
87.5
83.1
84.0
84.6
86.2
81.2
82.8
73.7
72.2
Michigan
93.7
90.9
93.7
90.9
93.7
93.1
93.7
92.3
88.3
82.3
88.5
87.8
87.8
86.4
87.7
86.3
73.7
76.3
Minnesota
88.8
89.7
90.4
94.0
88.6
97.1§
90.0
96.0§
83.0
89.8§
86.0
92.1
82.9
88.3
83.1
85.1
72.7
73.5
Mississippi
95.5
95.3
95.5
98.1
95.5
98.1
95.5
98.1
91.9
92.5
91.9
97.1
91.3
90.5
92.0
93.3
79.7
86.3
Missouri
93.9
95.6
92.6
96.9
93.8
97.5
95.3
97.5
87.0
92.5
91.3
92.4
91.5
89.2
88.6
90.4
77.8
84.5
Montana
88.9
86.4
91.4
91.2
89.7
91.4
90.6
91.3
85.3
82.1
84.5
85.4
82.3
82.8
77.5
79.7
63.8
67.9
Nebraska
82.0
82.7
84.3
84.7
83.5
86.1
84.2
85.4
72.4
77.3
78.2
79.5
72.0
70.6
73.7
74.8
64.9
63.6
Nevada
95.8
100.0
97.1
100.0
95.7
98.4
97.1
100.0
90.3
96.1
91.3
97.3
92.9
98.4
93.0
98.4
76.9
94.9§
New Hampshire
100.0
95.9
98.4
97.3
98.4
97.3
100.0
97.3
97.0
93.1
95.5
94.5
95.4
90.5
94.0
87.4
88.8
82.9
New Jersey
98.5
100.0
100.0
100.0
98.2
100.0
100.0
100.0
98.4
99.0
99.1
98.1
100.0
97.1
100.0
98.1
91.3
96.4
New York
100.0
99.2
98.7
99.0
99.0
98.9
100.0
99.5
95.3
98.3
97.0
97.9
96.6
96.8
97.3
96.9
90.6
92.0
North Carolina
94.5
86.0§
93.6
88.3
94.5
91.9
94.4
90.6
86.0
80.5
92.4
85.1
92.9
81.4§
92.0
80.9§
79.9
70.9
North Dakota
83.3
83.2
88.4
86.8
88.4
86.6
89.4
86.1
77.6
80.6
82.3
85.9
82.6
79.9
81.5
80.7
63.7
70.5
Ohio
94.8
95.3
97.8
95.2
96.1
95.2
96.1
94.7
92.7
91.2
92.0
90.9
92.0
92.8
93.0
90.6
84.6
80.6
Oklahoma
78.0
65.8§
77.8
67.4
74.8
68.2
77.7
68.3
73.3
64.9
70.4
62.4
70.8
64.6
71.5
64.9
58.5
51.1
Oregon
93.2
95.4
96.2
96.1
96.9
95.5
96.9
97.0
90.9
94.1
96.2
91.6
94.5
94.7
93.0
93.8
85.5
84.3
Pennsylvania
97.5
97.0
97.4
95.8
97.5
97.0
97.5
97.0
91.9
91.0
92.1
93.7
90.7
91.6
91.4
92.4
81.2
83.6
Rhode Island
92.1
88.9
92.7
93.2
92.7
93.2
92.5
93.2
91.9
92.9
85.3
87.4
89.6
92.7
94.9
88.4
80.6
81.8
South Carolina
92.3
91.1
92.3
92.3
93.4
93.9
93.3
93.2
88.9
88.9
85.7
90.3
87.5
88.3
87.5
89.0
77.1
83.8
South Dakota
73.5
65.1
77.0
71.8
73.7
66.2
76.7
69.5
69.9
61.3
70.9
63.8
68.8
60.3
66.5
60.6
53.6
48.1
Tennessee
97.8
94.2
98.5
93.4
97.0
96.2
97.7
94.3
95.5
92.4
90.9
90.5
93.9
89.4
94.6
89.3
84.9
82.1
Texas
92.9
91.7
94.9
92.6
95.3
94.0
95.1
92.3
88.0
80.0§
91.9
86.5
91.4
83.0§
90.7
87.7
76.7
73.5
Utah
93.1
89.6
93.1
92.0
97.2
94.6
94.3
88.1
83.4
81.0
90.4
88.9
90.6
92.3
95.8
84.5§
69.4
73.3
Vermont
100.0
91.3
100.0
93.9
100.0
94.0
100.0
94.0
100.0
94.0
97.7
91.5
97.7
85.7
97.7
87.2
91.3
80.3
Virginia
92.6
86.1
95.5
89.6
96.9
92.3
94.8
90.9
89.0
89.0
89.1
85.7
85.3
86.7
90.4
87.2
78.2
78.0
Washington
91.9
96.4
94.5
93.2
94.2
95.6
94.5
97.1
92.1
90.9
88.9
93.1
91.9
91.1
90.1
89.6
76.1
83.4
West Virginia
100.0
96.3
100.0
100.0
100.0
98.1
100.0
98.1
98.6
94.4
98.8
98.1
97.4
94.4
98.6
93.0
95.8
91.1
Wisconsin
94.1
89.7
96.4
90.8
97.1
95.1
96.4
93.9
93.4
87.3
97.1
90.5§
92.7
87.7
92.6
87.3
82.7
79.9
Wyoming
89.6
82.2
88.3
85.7
93.2
92.1
89.9
85.5
88.3
74.5
88.0
79.4
86.5
79.0
88.2
80.6
78.3
65.1
State median
94.1
91.3
95.5
93.2
95.5
95.1
95.3
94.2
90.9
90.0
91.3
90.4
91.3
89.4
91.4
87.7
79.6
80.3
State range
(69.2–100.0)
(56.6–100.0)
(67.4–100.0)
(62.0–100.0)
(66.6–100.0)
(65.1–100.0)
(72.9–100.0)
(65.9–100.0)
(63.9–100.0)
(61.3–99.0)
(65.7–99.3)
(56.7–98.1)
(63.1–100.0)
(58.2–100.0)
(64.1–100.0)
(56.4–98.9)
(45.7–95.8)
(45.3–96.4)
* Related to HIV, other STDs, and pregnancy.
† Related to eliminating or reducing risk for HIV, other STDs, and pregnancy.
§ Significant difference between 2008 and 2010 (p<0.05).
TABLE 3. Percentage of public secondary schools in which specific condom-related topics were taught in a required course in grades 9, 10, 11, or 12 — 45 states, 2008 and 2010
State
Efficacy of condoms
Importance of using condoms consistently and correctly
How to obtain condoms
All three topics
2008
2010
2008
2010
2008
2010
2008
2010
Alabama
79.2
71.8
62.0
59.5
51.1
38.2*
47.3
33.2*
Alaska
61.0
49.0
59.2
47.9
55.8
39.5*
52.2
38.9*
Arizona
56.5
51.0
47.7
45.2
36.4
26.6
31.2
26.1
Arkansas
79.7
85.2
66.9
74.0
62.8
61.9
60.5
61.8
California
89.3
89.2
82.9
85.8
73.7
74.2
66.3
73.0
Connecticut
90.5
91.3
87.6
90.3
83.1
84.4
79.7
83.4
Delaware
90.5
96.7
85.1
96.6
76.3
93.1
69.9
93.1*
Florida
76.7
64.7*
70.8
60.1
66.3
50.1*
59.0
46.0*
Hawaii
91.7
90.7
86.1
86.0
80.6
71.3
78.5
71.3
Idaho
75.2
77.4
64.3
64.0
58.1
47.4
49.7
46.2
Indiana
76.8
77.3
60.6
62.3
40.0
39.8
39.8
37.5
Iowa
75.5
75.0
69.5
67.4
56.3
58.1
56.5
58.1
Kansas
72.3
71.4
63.5
62.3
51.6
53.2
45.4
49.4
Kentucky
85.2
85.8
72.6
81.4
64.8
69.8
56.6
68.8*
Maine
93.1
92.5
95.2
91.6
82.7
87.5
79.8
86.9
Maryland
91.2
94.6
93.2
91.0
83.5
77.9
77.6
76.9
Massachusetts
84.8
85.2
81.5
84.8
74.2
77.5
72.9
75.9
Michigan
78.3
73.3
70.6
69.5
52.6
53.5
49.9
47.9
Minnesota
80.9
87.9
77.6
78.5
64.6
61.8
61.3
60.8
Mississippi
83.0
80.5
74.0
65.1
64.7
55.9
59.4
54.8
Missouri
71.5
73.5
61.4
64.1
47.1
47.3
47.5
48.1
Montana
71.2
73.3
62.3
64.1
52.2
56.3
50.6
48.1
Nebraska
67.8
64.6
54.3
55.7
40.0
41.0
38.0
39.5
Nevada
83.3
86.9
75.8
85.6
65.9
70.7
58.8
71.9
New Hampshire
96.9
94.5
96.9
94.5
87.7
88.9
85.5
90.5
New Jersey
97.6
98.1
96.9
96.2
92.7
94.4
87.0
93.0
New York
95.7
96.2
92.7
94.1
90.2
90.6
86.2
89.2
North Carolina
71.5
61.2
44.8
44.7
37.1
32.0
35.4
31.8
North Dakota
58.2
58.2
47.7
45.3
35.8
30.0
33.2
29.4
Ohio
85.1
84.7
73.7
71.8
57.6
46.4*
57.4
44.9*
Oklahoma
59.3
55.7
58.6
52.0
50.9
39.7
47.1
34.1*
Oregon
91.1
88.2
90.2
85.9
79.3
75.5
76.5
74.7
Pennsylvania
85.5
87.5
77.2
78.3
65.3
62.2
61.1
61.6
Rhode Island
85.0
88.2
85.0
86.5
79.9
73.0
78.5
71.9
South Carolina
78.7
82.9
74.4
80.0
57.9
65.5
49.8
64.2*
South Dakota
49.4
37.4
44.7
33.1
34.9
25.5
32.7
19.4*
Tennessee
83.3
73.3
72.6
62.1
62.5
57.1
59.3
50.9
Texas
74.9
64.3*
61.2
50.9
49.6
33.3*
47.5
34.0*
Utah
50.3
38.5
32.4
26.8
13.5
12.4
10.4
11.3
Vermont
100.0
94.0
100.0
94.0
95.6
90.0
93.6
90.4
Virginia
81.4
72.5
72.9
64.9
60.6
52.0
56.2
50.9
Washington
88.4
89.9
84.3
86.3
77.3
73.9
71.1
73.7
West Virginia
91.1
83.8
87.0
79.2
78.2
60.3*
73.0
58.4
Wisconsin
85.4
86.8
78.0
81.6
66.4
63.9
65.7
62.1
Wyoming
77.9
53.6*
68.8
50.6*
62.5
39.9*
55.4
35.0*
State median
81.4
82.9
72.9
71.8
62.8
58.1
58.8
58.1
State range
(49.4–100.0)
(37.4–98.1)
(32.4–100.0)
(26.8–96.6)
(13.5–62.8)
(12.4–94.4)
(10.4–93.6)
(11.3–93.1)
* Significant difference between 2008 and 2010 (p<0.05).
