Abstract
OBJECTIVES: The effects of the comprehensiveness of sex education on sexual health measures have not been well-studied. We compared trends in comprehensive sex education and its relation to contraceptive use at first intercourse and current contraceptive use for women ages 15-24 in the United States between 2011 and 2017. STUDY DESIGN: Analyses included females ages 15-24 from the 2011-2017 National Survey of Family Growth. We defined comprehensive sex education as including 6 topics queried in the NSFG (how to say no to sex, birth control methods, where to get birth control, how to use condoms, sexually transmitted infections, HIV/AIDS), and non-comprehensive sex education as including less than 6 topics. Multivariable regression models investigated associations with contraceptive indicators. RESULTS: Among 5445 respondents, percentages of women receiving comprehensive sex education in 2011-2013, 2013-2015, and 2015-2017 were 35%, 40%, and 34%. Across all periods, respondents reporting comprehensive sex education before first sex were less likely to report first sexual intercourse before age 15 (aOR 0.55; 95% CI: 0.40-0.74) and non-volitional first intercourse (aOR 0.42, 95% CI: 0.26-0.72) compared to those with non-comprehensive sex education. At first intercourse, those with comprehensive sex education were more likely to have used any (aOR = 1.63; 95% CI: 1.18-2.25) and very effective (aOR = 1.35; 95% CI: 1.04-1.75) contraception. Comprehensive sex education was unrelated to current contraceptive use (aOR = 0.87; 95% CI: 0.63-1.21). CONCLUSIONS: Comprehensive sex education was associated with increased odds of contraceptive use at first intercourse, but not current contraceptive use. IMPLICATIONS: Programs that promote comprehensive sex education may have a positive impact on preventive behaviors at sexual debut.