There also was a significant decline in males’ reports of receiving formal instruction about birth control. • The share of adolescent females receiving formal instruction about how to say no to sex but receiving no instruction about birth control methods increased from 22% to 26% between 2006–20–2013. The share of adolescent males receiving similar instruction also increased during this time period, from 29% to 35%. • Declines in formal sex education were concentrated among adolescents residing in rural areas. For example, the share of rural teens receiving instruction about birth control declined from 71% to 48% among females, and 59% to 45% among males. • Formal instruction may not be skills-based; only 50% of teen females and 58% of teen males received formal instruction about how to use a condom. • Many sexually experienced teens (43% of males and 57% of females) do not receive formal instruction about contraception before they first have sex; fewer received instruction about where to get birth control (31% males, 46% females). • According to the Centers for Disease Control and Prevention, instruction on sexual health topics including human sexuality, HIV or STD prevention and pregnancy prevention is more commonly required in high school than in middle or elementary school. • In 2014, 72% of U. public and private high schools taught pregnancy prevention; 76% taught abstinence as the most effective method to avoid pregnancy, HIV and other STDs; 61% taught about contraceptive efficacy; and 35% taught students how to correctly use a condom as part of required instruction. • At the middle school level, 38% of schools taught pregnancy prevention; 50% taught abstinence as the most effective method to avoid pregnancy, HIV and other STDs; 26% taught about contraceptive efficacy; and 10% taught students how to correctly use a condom as part of required instruction. • Among schools requiring instruction about pregnancy prevention, the average class time for this topic was 4.2 hours in high schools and 2.7 hours in middle schools. • Eighty-eight percent of schools allow parents to exclude their children from sexual health education. • The share of schools providing sexual health education declined from 2000-2014, across topics ranging from puberty and abstinence to how to use a condom.  Adolescents may receive information about sexual health topics from a range of sources beyond formal instruction. Washington, DC: Pew Internet & American Life Project, 2015. Here we consider the role of parents, health care providers and the media as potential sources of sexual health information for teens.
The three main types of programs are abstinence-only, abstinence-plus, and comprehensive sex education.• “Formal” sexual health education is instruction that takes place in a school, youth center, church or other community setting. “Emerging Evidence, Lessons and Practice in Comprehensive Sexuality Education, a global review.” UNESCO, 2015. This type of instruction provides a central source of information for teens. Sexuality Information and Education Council of the United States, In Good Company: Who Supports Comprehensive Sexuality Education? Office of Adolescent Health, Evaluation and performance measurement. Abstinence-only sex education emphasizes abstinence from sexual activity prior to marriage and rejects methods such as contraception.The difference between the two approaches, and their impact on the behavior of adolescents, remains a controversial subject in the United States.