ArticleArchives of sexual behavior2026
State Sexual Health Education Policies and Sexual Behaviors among Adolescents in the USA Using Nationally Representative Data.
Article in Archives of sexual behavior, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Sexual health education varies across the USA due to nuanced state-level policy mandates. This study examined associations between sex education mandates and sexual health behaviors among public high school students, with a focus on four types of state-level policies: sexual health and HIV/STI education where abstinence alone is not stressed, abstinence-based sexual health education, abstinence-based HIV/STI education, and combined abstinence-based sexual health and HIV/STI education. Sexual health behaviors analyzed included ever having sex, sexual intercourse before age 13, history of multiple sexual partners, use of condoms or birth control pills, and HIV/STI testing. We drew health behavior data from the 2019 Youth Risk Behavior Surveillance survey. Findings from multivariable logistic regression models suggested that sexual health and HIV/STI education mandates where abstinence alone was not stressed were negatively associated with ever having sex. Combined abstinence-based sexual health and HIV/STI education mandates were negatively associated with having used a condom or birth control pills during the last sexual intercourse and having sexual intercourse before the age of 13. Abstinence-based sexual health education mandates were negatively associated with sexual intercourse before the age of 13. Abstinence-based HIV/STI education mandates were positively associated with being tested for HIV/STIs among students who reported having had sex (all ps < 0.05). These findings indicate that associations between state-level sexual health education mandates and adolescent sexual behaviors vary by policy type and outcome, highlighting the complexity of how education mandates relate to youth sexual health behaviors.
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