Preferences in Timing of Sex Education Instruction among Tennessee Sex Education Providers and ETSU College Students

Introduction

In 2015, compared to the national rates, Tennessee had the 9 ^th highest teen birth rate, 15 ^th highest rate of reported cases of chlamydia, and 14 ^th highest rate of reported cases of gonorrhea. Sex education that includes instruction on contraception along with abstinence has been found to delay sexual initiation, decrease number of sexual partners, and increase condom or contraceptive use. These behavioral choices by young people can help reduce teen pregnancies and Sexually Transmitted Infections (STIs). Introduction of contraception topics in earlier grades can equip young people with necessary tools to prevent unwanted pregnancies and STIs before they become sexually active. We explored the grades in which sex education providers taught topics such as birth control, condoms, and abstinence and the lowest grade at which they prefer to teach these topics. We then compared providers’ responses with responses from ETSU college students who had their sex education in TN.

Methods

To obtain information from sex education providers in TN public schools, we sent a recruitment email or letter with a weblink to a web-based survey from April to June 2017, to 3,249 potential providers. Of all potential providers, 509 completed the survey, yielding a response rate of 15.7%. Of those who completed the survey, final analysis included 137 providers who taught sex education in the 2015-2016 school year to any of grades 5 through 12 students. To get information from recipients of sex education in TN schools, a convenience sample of ETSU college students were asked to complete a survey using the ETSU SONA system in Fall 2017 semester. Of 385 students who completed the survey, final analysis included 216 (56.1%) students who were between ages 18-24 and attended the grade in which they had most of their sex education in TN. Provider and student surveys had similar items on grades in which sex education topics were taught and the lowest grade in which they would want these topics to be covered. Survey responses were analyzed using descriptive tests.

Results

Most providers (83.9%) taught abstinence by grade 12, and 37.2% had taught it by middle school (i.e. at or before 8 ^th grade). Similarly, many students mentioned that abstinence was taught by 12 ^th grade (92.1%) and by 8 ^th grade (62.5%). Whereas, fewer providers taught topics, such as, birth control (65.0%), how to use condoms (22.6%), how to use and where to get birth control (31.4%), and much fewer providers taught these topics by middle school (17.5%, 8.0%, 8.8%, respectively). Most students expressed that these topics be taught by 12 ^th grade (97.7%, 97.2%, 96.3%, respectively), and over two-thirds preferred that these topics be taught by middle school (71.8%, 67.6%, 63.9%, respectively). Also, about half of providers expressed that these topics be taught by middle school (68.6%, 46.7%, 51.8%, respectively).

Conclusion

This study finds that students want contraception topics to be taught in earlier grades, and that providers also prefer to teach these topics earlier. Future research should focus on factors that can enable providers to teach these topics in earlier grades.