November 7, 1991 marked my first encounter with public health. I was 8 years old, obsessed with sports, and Magic Johnson had just announced that he was HIV positive and retiring from the NBA.
I don't think I had ever heard of HIV before, and questions abounded as my friend and I walked to the Narberth sports card shop (we wanted to know how the news might affect the value of our Johnson basketball cards). Was HIV deadly? What was the difference between HIV and AIDS? Could we create and contract HIV by brushing against each other while playing basketball? I think we switched from full contact one-on-one to H.O.R.S.E. until these questions were resolved.
Luckily, thanks to HIV education provided at our school in the weeks following Johnson's announcement, these questions were promptly answered. Basketball activities quickly returned to normal. Kids in other states, however — say, Arizona — might not have been so lucky.
Earlier this month, the Centers for Disease Control and Prevention released a brief report on the state of education about HIV, sexually transmitted diseases, and pregnancy prevention in American public schools. The survey results highlight the diversity of what schools think kids should know about sex, and the trends are somewhat disappointing when it comes to protecting the public's health.
Between 2008 and 2010, the percentage of schools teaching all 11 recommended sex education topics – things like how STDs are transmitted, the benefits of being sexually abstinent, communication and negotiation skills to help prevent infection – in grades 6 to 8 decreased significantly in 11 of the 45 states surveyed. In Pennsylvania, for example, the proportion of schools teaching about all topics decreased from 55 percent to 40 percent. In Arizona it decreased by more than half, from 28 percent to 13 percent; only 20 percent of Arizona students in grades 6 to 8 graders were taught that they should be compassionate toward people living with HIV or AIDS, which was one of the recommended subject areas (80 percent of New York students were).
At the high school-level, Delaware is leading the way in the tri-state region, with 100 percent of the schools surveyed there reporting that they teach content across all eight of the topics recommended for grades 9 through 12, compared to 96 percent in New Jersey and 85 percent in Pennsylvania. More than 95 percent of schools surveyed in Delaware and New Jersey taught the importance of using condoms correctly and consistently – just the importance, mind you, not how to do it – while 78 percent did so in Pennsylvania.
The most taboo topic on the survey appeared to be that of teaching students where they can obtain condoms. This isn't particularly surprising, since all the other topics can be taught under premise that students will not actually have sex. The conversation really gets real when you direct students to a basket of Durex in the health office. While 62 percent of schools pointed the way in Pennsylvania, only 27 percent did so in Arizona and 12 percent in Utah. (The Philadelphia Department of Public Health, which is battling very high rates of HIV and other sexually transmitted diseases, provides a map of free condom locations, as well as an iCondom Philly app.)
Variations in sex education curricula among states to a large extent reflect the ideological diversity of the U.S. This does not, however, reflect the reality of sexual activity among teens.
In Arizona, one of the most conservative states for sex education, about 35 percent of high school students are sexually active. In New York, one of the most progressive sex education states, about 32 percent of high school students are. The national median is 35.4 percent. In other words, about one-third of high school students are having sex, and thus at risk for sexually transmitted diseases and infections, regardless of where they live.
All states have a responsibility to put ideological matters aside and encourage schools to embrace sex ed, which allows students to make informed decisions to protect their health and others'.