Despite strong support from key stakeholders for sex-ed that goes beyond abstinence, abstinence remains the primary focus of sex-ed across the Deep South, failing to harness sex-ed as a real tool for change.
The systematic review identified 37 studies across five Deep South states examining school-based sex education for youth under 25 years old.
Four main themes emerged from the included studies: Attitudes, Policies, Curricula, and Impact.
Surveyed parents and constituents supported sex education that incorporates abstinence alongside other health topics.
Sex education policies and curricula in the Deep South overwhelmingly emphasized abstinence, with only a minority of schools addressing other critical sex-ed topics.
Some sex education interventions impacted students' knowledge or behavioral intentions, while others failed to alter adolescents' sexual health behaviors.
Adolescents in the Deep South experience disproportionately high rates of sexually transmitted infections, providing the public health context for this review.
The authors conclude that studies and advocacy efforts are needed to understand why sex education in the Deep South is not being harnessed as a real tool for change.
This research systematically reviewed 37 studies published between 2002 and 2022 to examine how sex education is taught in five Deep South states — Alabama, Georgia, Louisiana, Mississippi, and South Carolina — where teenagers have some of the highest rates of sexually transmitted infections (STIs) in the United States. The researchers looked at what people think about sex education, what policies govern it, what is actually taught, and what effect it has on young people's knowledge and behavior. The review found a striking gap between what parents and community members say they want and what schools actually deliver. Surveyed adults supported sex education that covers a range of topics including STIs, HIV, and contraception — not just abstinence. However, school policies and curricula overwhelmingly focused on abstinence, with only a minority of schools covering these other critical health topics. Some programs did improve students' knowledge or intentions, but many failed to change actual sexual health behaviors. This research suggests that the Deep South is missing an opportunity to use sex education as a meaningful tool to reduce high STI rates among young people. The authors argue that there is a disconnect between what communities want their children to learn and what schools are teaching, and that more research and advocacy are needed to understand and address why comprehensive sex education has not been implemented despite apparent public support for it.
Shea S, Mowen A, Kissinger P. (2025). What We Fail to Teach: A Systematic Review of Sexual Health Education in the Deep South.. Sexually transmitted diseases. https://doi.org/10.1097/OLQ.0000000000002172