Associations between State‐Level High School HIV Education Policies and Adolescent HIV Risk Behaviors

Abstract

BACKGROUND School‐based human immunodeficiency virus (HIV) education can reach most adolescents, but inconsistencies exist in state‐level content policies. The purpose of this study was to evaluate the associations between state‐level high school HIV education policies and adolescent HIV risk behaviors. METHODS This was a cross‐sectional analysis of the 2019 Youth Risk Behavior Survey linked to the Guttmacher Institute Sex and HIV Education report. Logistic regression models examined the associations of state‐level HIV education mandates and content policies with 3 HIV risk behaviors: (1) 4 or more lifetime sexual partners; (2) substance use before last sex; (3) condomless last sex. RESULTS Across 33 states, 128,986 high school students were included. Multivariable adjusted models demonstrated no associations between mandated HIV education and risk behaviors. Covering abstinence along with other safe sex options was associated with lower odds, whereas stressing abstinence was associated with higher odds of at least 4 lifetime sexual partners and condomless last sex. Discriminatory sexual orientation content was associated with increased condomless last sex; associations for all HIV risk behaviors were stronger among sexual minority youth. CONCLUSIONS Increased HIV risk behaviors associated with state policies stressing abstinence or requiring discriminatory sexual orientation content support the need for comprehensive and inclusive HIV education.

The Effect of Educational Intervention Based on the Health Belief Model on Promoting Perceived Self-efficacy to Prevent HIV/AIDS Among the High School Students

“…Similar to the other necessities of human social life, it depends on the committed participation of all members of society (13). Schools are key places to promote health (14). Health education programs are valuable when they are effective.…”