P3.021: Mind the Gaps: The Lack of Comprehensive Formal Sexual Education and its Impact on Young Adult Sexual Health Behaviors

Background: Comprehensive sex education critically influences the health behaviors of young adults. However, school-based sex education varies greatly by the state and district of each school. The National Sex Education Standards (NSES) guide schools on core content for comprehensive sex education, including topics such as consent and healthy relationships, anatomy and physiology, puberty and sexual development, gender identity and expression, sexual orientation, sexual health, and interpersonal violence. Despite this guidance, many states, including Florida, have not adopted these standards. This study aims to identify gaps in Florida public school sexual education and evaluate how education on certain topics influences sexual health behaviors in early adulthood.

Methods: The study data was collected via an anonymous survey using RedCap. The survey tools were approved under IRB-exempt status. Eligible participants were 18–24 years old and attended a Florida public school for most of their education. The survey was distributed to students at state colleges, youth-serving clinics in the community, and various popular public locations for young adults in the community. Basic statistical evaluation was performed using IBM SPSS.

Results: 133 responses were collected; the respondents represented 25 of 67 Florida counties. 75.9% (N=101) received formal sex education in school. Of the seven core NSES topics stated above, the most frequently covered among the respondents include Anatomy/Physiology (87%), Puberty/Sexual Development (78%), and Abstinence (67.3%). The least covered topics were Gender Identity/Expression (5%) and Sexual Orientation (8%). Only 1.5% of respondents (N=2) received comprehensive sex education covering all seven topics. Notably, school-based sex education that included the topic of abstinence was significantly correlated with using emergency contraception (p=0.03) and drinking alcohol before sex (p=0.05) in the last year.

Approximately 70% (N=93) of respondents reported being sexually active in the last year. These young adults were not all engaging in safe sex practices that would protect them from unintended pregnancy, sexually transmitted infections, and transmission of HIV. About 73% of the sexually active young adults reported using condoms, 60% reported themselves or partners using hormonal birth control, 45% reported getting tested for STIs, and only 4% reported using PrEP. 54% of sexually active respondents reported having sex after drinking or using drugs, and about 25% reported using emergency contraception in the last 12 months.

Conclusion: This study highlights that few young adults in Florida received comprehensive sex education that explored all core NSES content, particularly sexual and gender identity. Despite abstinence being a common focus, teaching it was linked to risky sexual behaviors. There are also significant gaps in sex education being delivered to adolescents in Florida, and a need for improvement in sexual health behaviors from young adults. These findings underscore the need for more comprehensive, inclusive sex education to improve sexual health outcomes and promote healthy behaviors.