Sex and HIV Education

September 1, 2023

Beginning in the 1970s, concerns over adolescent pregnancy—and later, HIV/AIDS—galvanized widespread public support for sex education in schools. Most states currently have a policy requiring HIV education, usually in conjunction with broader sex education. Meanwhile, as debate over the relative merits of abstinence-only-until-marriage messages versus more comprehensive approaches has intensified, states have enacted a number of specific content requirements. Growing acknowledgment of young people’s sexuality has popularized instruction on life skills, with most states now requiring instruction on healthy relationships and the prevention of sexual violence.

Highlights

General Requirements for Sex Education and HIV Education (see table 1 of 3)

38 states and the District of Columbia mandate sex education and/or HIV education.
- 25 states and DC mandate both sex education and HIV education.
- 3 states only mandate sex education.
- 10 states only mandate HIV education.
30 states and DC mandate that, when provided, sex and HIV education programs meet certain general requirements.
- 18 states require program content to be medically accurate.
- 26 states and DC require instruction to be appropriate for the students’ age.
- 10 states require the program to provide instruction that is appropriate for a student’s cultural background and that is not biased against any race, sex or ethnicity.
- 4 states prohibit the program from promoting religion.
40 states and DC require school districts to involve parents in sex education, HIV education or both.
- 25 states and DC require parental notification that sex education or HIV education will be provided.
- 6 states require parental consent for students to participate in sex education or HIV education.
- 35 states and DC allow parents the option to remove their child from instruction.

Content Requirements When Sex Education is Taught (see table 2 of 3)

21 states and DC require that information be provided on contraception.
39 states and DC require that information be provided on abstinence.
- 29 states require that abstinence be stressed.
- 10 states and DC require that abstinence be covered.
19 states require instruction on the importance of engaging in sexual activity only within marriage to be provided.
14 states and DC require either an inclusive or discriminatory view of sexual orientation.
- 10 states and DC require inclusive content with regard to sexual orientation.
- 4 states require only negative information to be provided on homosexuality and/or positive emphasis on heterosexuality. One state prohibits instruction on gender identity, gender expression or sexual orientation. 17 states and DC require inclusion of information on the negative outcomes of teen sex and pregnancy.

Content Requirements When HIV Education is Taught(see table 2 of 3)

19 states require inclusion of information on condoms or contraception.
37 states and DC require provision of information on abstinence.
- 28 states require that abstinence be stressed.
- 9 states and DC require that abstinence be covered.

Life Skills Requirements for Sexual Consent, Relationships and Prevention of Dating and Sexual Violence(see table 3 of 3)

35 states and DC require provision of information about skills for healthy romantic and sexual relationships.
- 31 states and DC require information on healthy relationships to be provided.
- 27 states and DC require instruction on self-control and decision making about sexuality.
40 states and DC require prevention of teen dating violence and sexual violence to be covered.
- 24 states and DC require provision of information on asserting personal boundaries and refusing unwanted sexual advances.
- 10 states require the importance of consent to sexual activity to be covered.
- 38 states and DC require provision of information on preventing, recognizing and responding to teen dating violence and sexual violence.

Current Policy Status Table

*General Requirements for Sex^ and HIV Education**
STATE	*SEX EDUCATION^ MANDATED**	HIV EDUCATION MANDATED	WHEN PROVIDED, SEX OR HIV EDUCATION MUST				PARENTAL ROLE
	*SEX EDUCATION^ MANDATED**	HIV EDUCATION MANDATED	Be Medically Accurate	Be Age Appropriate	Be Culturally Appropriate and Unbiased	Cannot Promote Religion	Notice	Consent	Opt-out allowed
Alabama		X		X					X
Alaska							X		X
Arizona			HIV	X			X	Sex	HIV
California	X	X	X	X	X	X	X		X
Colorado			X	X	X	X	X		X
Connecticut		X							X
Delaware	X	X
Dist. of Columbia	X	X		X			X		X
Florida	X	X		X					X
Georgia	X	X					X		X
Hawaii	X	X	X	X					X
Idaho									X
Illinois^†		X	X	X	X	X			X
Indiana^†		X					X		X
Iowa	X		X	X	X		X		X
Kansas	X
Kentucky	X^∑	X
Louisiana			X			X			X
Maine	X	X	X	X					X
Maryland	X	X					X		X
Massachusetts					X		X		X
Michigan		X					X		X
Minnesota	X	X
Mississippi^Ω	X			X			X	X
Missouri		X	X	X			X		X
Montana	X	X		X					X
Nevada	X	X		X			X	X
New Hampshire	X	X					X		X
New Jersey	X	X	X	X	X		X		X
New Mexico	X	X		X					X
New York		X		HIV					HIV
North Carolina	X	X	X	X
North Dakota	X	X
Ohio	X	X							X
Oklahoma		X	HIV				X		X
Oregon	X	X	X	X	X		X		X
Pennsylvania		X		HIV			HIV		HIV
Rhode Island	X	X	X	X	X				HIV
South Carolina	X	X		X			X		X
Tennessee	X^Ψ	X	X	X	X		X	X
Texas				X			X	X
Utah^ξ	X	X	X				X	X
Vermont	X	X		X					HIV
Virginia			X	X			X		X
Washington	X	X	X	X	X		X		X
West Virginia	X	X							X
Wisconsin		X					X		X
TOTAL	28+DC	35+DC	18	26+DC	10	4	25+DC	6	35+DC
* Sex education typically includes discussion of STIs. † Sex education is not mandatory, but health education is required and it includes medically accurate information on abstinence. Ω Localities may include topics such as contraception or STIs only with permission from the State Department of Education. Ψ Sex education is required in a county if the pregnancy rate is at least 19.5 or higher per 1,000 young women aged 15—17. ξ State also prohibits teachers from responding to students' spontaneous questions in ways that conflict with the law's requirements. β State required to teach adoption or other alternatives to abortion. Arkansas is required to teach the reasons the state prefers adoption over abortion. ∑ Kentucky prohibits sex education provided before 6th grade and requires parental consent for students in grades 6 and above.

Content Requirements for Sex^* and HIV Education
State	When provided, sex education must include:					When provided, HIV education must include:
	Contraception	Abstinence	Importance of sex Only within marriage	Sexual orientation	Negative outcomes of teen sex	Condoms	Abstinence
Alabama	X	Stress	X			X	Stress
Arizona		Stress			X		Stress
Arkansas		Stress	X				Stress
California	X	Cover		Inclusive		X	Cover
Colorado	X	Stress		Inclusive	X	X	Cover
Connecticut	X	Cover		Inclusive	X
Delaware	X	Stress		Inclusive		X	Stress
Dist. of Columbia	X	Cover		Inclusive	X		Cover
Florida		Stress	X	Negativeβ	X		Stress
Georgia		Stress	X				Cover
Hawaii	X	Stress				X	Stress
Idaho		Stress
Illinois	X	Stress	X	Inclusive		X	Stress
Indiana		Stress	X		X		Stress
Iowa				Negativeβ
Kentucky		Stress		Prohibited
Louisiana		Stress	X	Negative			Stress
Maine	X	Stress				X	Stress
Maryland	X	Cover		Inclusive		X	Cover
Michigan		Stress	X				Stress
Minnesota							Cover
Mississippi^Ω		Stress	X	Negative	X		Stress
Missouri	X	Stress	X		X		Stress
New Hampshire		Cover					Cover
New Jersey	X	Stress		Inclusive		X	Stress
New Mexico	X	Cover			X	X	Stress
New York							Stress
North Carolina	X	Stress	X		X	X	Stress
North Dakota		Cover	X		X
Ohio		Stress	X		X		Stress
Oklahoma		Stress		ᶲ		X	Stress
Oregon	X	Stress		Inclusive		X	Stress
Pennsylvania							Stress
Rhode Island	X	Stress		Inclusive	X	X	Stress
South Carolina	X	Stress	X				Stress
South Dakota		Cover
Tennessee		Stress	X		X		Stress
Texas	X	Stress	X		X	X	Stress
Utah^ξ		Stress	X				Stress
Vermont	X	Cover			X	X	Cover
Virginia	X	Cover	X		X	X	Cover
Washington	X	Stress		Inclusive		X	Stress
West Virginia	X	Cover			X	X	Cover
Wisconsin		Stress	X				Stress
TOTAL	21+DC	39+DC	19	13+DC	17+DC	19	37+DC
* Sex education typically includes discussion of STIs. Ω Localities may include topics such as contraception or STIs only with permission from the state Department of Education. ᶲ Mandated HIV education teaches that, among other behaviors, “homosexual activity” is considered to be “responsible for contact with the AIDS virus.” ξ State also prohibits teachers from responding to students' spontaneous questions in ways that conflict with the law's requirements. β Iowa prohibits STIs, gender identity, and sexual orientation from being taught before 7th grade. Florida mandates that sex is taught as binary and unchangeable and prohibits teaching sexual orientation pre-kindergarten through 8th grade.

*Sex Education to Include Life Skills on Sexual Consent, Relationships and Prevention of Violence**
State	Healthy relationships	Sexual decision-making and self-discipline	Refusal skills and personal boundaries	Consent	Dating and sexual violence prevention
Alabama		X	X		X
Alaska					X
Arizona	X	X	X		X
Arkansas	X	X	X		X
California	X	X	X		X
Colorado	X	X	X	X	X
Connecticut	X	X			X
Delaware	X	X	X	X	X
Dist. of Columbia	X	X	X	X	X
Florida	X	X			X
Georgia			X		X
Hawaii	X	X			X
Idaho	X	X
Illinois	X		X	X	X
Indiana					X
Iowa	X				X
Kentucky	X	X
Louisiana	X	X			X
Maine	X	X			X
Maryland	X	X	X	X	X
Massachusetts	X				X
Michigan		X	X		X
Mississippi					X
Missouri		X	X	X	X
Nebraska	X				X
Nevada		X
New Hampshire					X
New Jersey	X	X	X	X	X
New Mexico	X	X	X		X
North Carolina	X	X	X		X
Ohio	X				X
Oklahoma			X	X
Oregon	X	X	X	X	X
Pennsylvania	X
Rhode Island	X	X	X		X
South Carolina	X		X	X	X
Tennessee	X	X	X		X
Texas	X	X	X		X
Utah			X		X
Vermont	X	X			X
Virginia	X	X	X		X
Washington	X	X	X	X	X
West Virginia	X		X		X
Wisconsin					X
TOTAL	31+DC	27+DC	24+DC	10+DC	38+DC
* Sex education typically includes discussion of STIs.