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Background: School health education, including sexual health education, plays a crucial role in shaping adolescents' protective health behaviors, experiences, and outcomes. Adolescents need functional knowledge and skills to practice, adopt, and maintain healthy behaviors for preventing sexually transmitted infections (STIs), including human immunodeficiency virus (HIV), and unintended pregnancy. Methods: The US Centers for Disease Control and Prevention's Division of Adolescent and School Health (CDC/DASH) has advanced school-based approaches to STI/HIV and pregnancy prevention through surveillance, research and evaluation, and program partnership and collaboration for over 3 decades. Results: CDC/DASH uses systematic and innovative strategies to identify the breadth of adolescent sexual health evidence; characterize key elements of effective educational curricula; and provide practical guidance to support school-based delivery. CDC/DASH's approach to effective health and sexual health education in schools has changed dramatically over the past 30 years and must continue to progress. Conclusion: This paper describes how and why that approach has evolved and outlines directions for the future.

Background: Transgender youth report high rates of negative experiences in schools. Using a lens of minority stress, this study sought to examine in-school experiences of transgender youth to understand youth coping and to identify key opportunities for improving school environments for transgender youth. Methods: Participants included 41 youth across 33 in-depth interviews (M[subscript age] = 21.7) and two focus groups (N = 8; M[subscript age] = 17.3). Thematic analysis was used to analyze data. Themes related to stress, coping, and facilitators/barriers to stress/coping were derived and coded. Results: Distal stressors, such as structural discrimination and prejudice events, were found to contribute to the exclusion of transgender youth from school life, while proximal stressors, such as concealment and expectations of rejection, reinforced transgender youth's feelings of personal isolation. Participants expressed coping with both challenges by advocating for inclusion through direct action with teachers and administrators and seeking/finding connection with trusted staff and peers. Conclusions: Findings suggest that creating safe and supportive environments at school for transgender youth is an attainable goal, as all identified barriers to inclusivity and connection were modifiable. By considering the needs of transgender youth in policies and programming, schools may improve climate for and wellbeing of transgender students.

Background: Transgender and gender diverse youth experience multiple disproportionate adverse sexual health outcomes. Sexual health education teaches knowledge, attitudes, and skills for promoting sexual health, including reducing risk for sexually transmitted infection, HIV acquisition, and unintended pregnancy. Provision of sexual health education may be protective, but research remains scarce. Methods: We conducted a multi‐stage thematic analysis of 33 in‐depth interviews among transgender and gender diverse youth (ages 15–24) living in the southeastern United States on their sexual health education experiences. Results: Our study participants described school‐based sexual health education as unhelpful due to a lack of relevant information, inadequately prepared teachers, and a perceived negative tone toward sexuality. They reported relying on online sources of sexual health information, finding relevant content and community despite some limitations. Participants desired content and pedagogy that expands beyond binary and white‐centric presentations of sexuality and gender and sought resources that provide relevant, accurate, and judgment‐free information while holding positive framing around sexuality and gender. Conclusion: There is much work needed to improve the breadth, quality, and relevance of school‐based sexual health education. Sexual health education can improve by strengthening critical media literacy skills of youth; raising staff cultural competency on gender, race, and sexual identity through training and supports; using culturally relevant and inclusive curricula; and partnering with community‐based organizations. Transgender and gender diverse youth would benefit from sexual health education from multiple sources which is queer‐friendly, affirms their existence, and provides information on gender, race, and sexuality in positive and expansive ways. [ABSTRACT FROM AUTHOR]

Background: School health education, including sexual health education, plays a crucial role in shaping adolescents' protective health behaviors, experiences, and outcomes. Adolescents need functional knowledge and skills to practice, adopt, and maintain healthy behaviors for preventing sexually transmitted infections (STIs), including human immunodeficiency virus (HIV), and unintended pregnancy. Methods: The US Centers for Disease Control and Prevention's Division of Adolescent and School Health (CDC/DASH) has advanced school‐based approaches to STI/HIV and pregnancy prevention through surveillance, research and evaluation, and program partnership and collaboration for over 3 decades. Results: CDC/DASH uses systematic and innovative strategies to identify the breadth of adolescent sexual health evidence; characterize key elements of effective educational curricula; and provide practical guidance to support school‐based delivery. CDC/DASH's approach to effective health and sexual health education in schools has changed dramatically over the past 30 years and must continue to progress. Conclusion: This paper describes how and why that approach has evolved and outlines directions for the future. [ABSTRACT FROM AUTHOR]

Adolescents need information about sex-related topics in order to reduce risk behavior and engage in healthy sexual decision-making. Parents have the potential to be an important source of this information. Using the 2006–2010 and 2011–2013 National Survey of Family Growth, we examined associations between parent–adolescent communication before age 18 about sex-related topics and HIV testing among respondents aged 18–24 that ever had sexual intercourse (women = 3893; men = 3359). Analyses showed that for both men and women, discussing how to prevent HIV/AIDS and how to use a condom with a parent before age 18 were positively associated with HIV testing. Among women only, discussions about methods of birth control, where to get birth control, and STDs were positively associated with HIV testing. Developing strategies and interventions to facilitate parent–adolescent communication about sex-related topics, particularly HIV prevention and condom use, may be important to increase HIV testing among young women and men. [ABSTRACT FROM PUBLISHER]