HIV is no longer a death sentence, but young people being deprived of sex education is still an unaddressed public health crisis in many states. HIV prevention tools such as treatment as prevention (TasP), pre-exposure prophylaxis (PrEP), and post-exposure prophylaxis (PEP) have sparked optimism among the doubters, but issues such as cost, access, and stigma continue to impact certain communities disproportionately. And, while these prevention options have changed the face of the HIV epidemic, it is critical that we consider comprehensive sex education another tool in the box that equips young people with the knowledge to make healthy, informed decisions that prevent them from contracting the virus.
In Mississippi, comprehensive sex education is overwhelmingly supported -- by 92% of parents -- yet the state remains one of 37 that teach abstinence-based curriculums, if any curriculum at all. A majority of politicians in the state believe that teaching comprehensive sex education will provoke young people to engage in "unhealthy" sexual behavior before they are ready. However, reports show that more than 50% of Mississippi high school students are already having sex, and HIV diagnoses among Mississippi youth are almost double the national rate. This is why it is important to adopt comprehensive sex education as a practical strategy within the HIV prevention toolkit.
Some would argue that abstinence-only and abstinence-plus curriculums are sufficient, but there are significant differences between these curriculums and one that is fully comprehensive. According to the Social Security Act, abstinence-only teaches that abstinence from sexual activity outside marriage is the expected standard for all school-age children. Abstinence-plus goes a step further to include harm reduction and avoidance, such as safe sex and birth control, and it touches on HIV. However, much research conducted on abstinence-based curriculums proves that neither type of curriculum is effective, and both could potentially do real harm to young people.
In any case, it is important to provide context for the role of comprehensive sex education in HIV prevention. Significant research has proven that comprehensive sex education is a much more effective HIV prevention tool according to several key findings. Fully comprehensive curriculums have improved the knowledge of young people, leading to an increase in condom use and a decrease in multiple partners. They have also increased self-efficacy for HIV protection and have been shown to delay the sexual debut of young people.
States such as California see the benefit of fully comprehensive sexual health education and did not wait for a federal mandate to value and protect the bodies of young people. In 2016, the state passed legislation requiring all school districts to ensure that young people receive integrated, comprehensive, accurate, and unbiased sexual health and HIV prevention instruction. Its curriculum encompasses important topics such as healthy relationships, body image, gender, and sexual orientation. And, according to the California Department of Education, these topics provide the knowledge and skills necessary to have healthy, positive, and safe relationships and behaviors.
Although California is one of only 13 states to mandate youth access to medically accurate life-changing sexual health knowledge, I am hopeful that it will not be the last to do so. As an advocate for young people's right to comprehensive sex education and for ending the HIV epidemic in the U.S., I strongly believe that comprehensive sex education should be prioritized by HIV service organizations and state and local health departments as they delve deep to address HIV in their cities or states. Collaborating with local- and state-level policymakers to draft and sponsor legislation is a must, and it should be of interest to any advocate or agency passionate about getting to zero.
Comprehensive sex education should not be made into a religious or moral issue when our children's bodies are at stake. It is a public health issue that deserves a radical public health response. It is not an issue that needs to be overly politicized to seize a vote; it is an issue that should mean something to all of us advocates, parents, teachers, and politicians, as well as to anyone who fights tirelessly to do good for all people regardless of age, geography, or religious beliefs.