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Adolescent Sexual Behavior in Texas: Implications for Policy and Practitioners

Christine Markham, Melissa Peskin, Belinda F. Hernandez, Kimberly Johnson, Robert C. Addy, Paula Cuccaro, Ross Shegog, and Susan Tortolero, “Adolescent Sexual Behavior: Examining Data from Texas and the U.S.,” Journal of Applied Research on Children: Informing Policy for Children at Risk (October 2011).
Researchers at the University of Texas Health Science Center at Houston compared adolescent sexual risk behavior data from national, state, and local sources. In addition to data from the 2009 middle and high school CDC-funded Youth Risk Behavior Study (YRBS), the researchers reviewed results from the University of Texas All About Youth study conducted in 15 urban Texas middle schools.1 The purpose was to formulate policy and program recommendations to assist Texas adolescent health specialists to develop effective, evidence-based strategies.    
Key Findings:
  • “In Texas middle schools, 269,389 students are estimated to be sexually experienced – approximately one quarter (26%) of the total middle school population. In Texas high schools, 698,512 students are estimated to be sexually experienced – over half (52%) of the total high school population.” 2
  • Texas middle and high school students generally engage in sexual risk behaviors at higher rates than their peers nationally.
  •  9 out of 10 Texas middle and high schools are implementing sexual health education programs that are not evidence-based; many use state-approved textbooks that omit medically-accurate information on contraception and condoms. Texas law “requires healthcare providers to notify law enforcement officials of all patients under age 17 whom they suspect are sexually active.” 3
Texas has long stood out among U.S. states for its comparatively high levels of unintended teen pregnancy, sexually transmitted infections, and political opposition to medically-accurate, evidence-based approaches to sexual health promotion. Sexuality educators in Texas have struggled to advance more comprehensive and inclusive programs both in public schools as well as in clinical health service settings.
Although Texas poses a unique challenge for adolescent health specialists, promising practices in sexuality education can be found throughout the state. The University of Texas Health Science Center at Houston has applied its research to the development of interventions which address the realities of Texas adolescents. Given that most Texas school districts have yet to try evidence-based interventions, there are numerous opportunities to build local stakeholder support for medically-accurate, inclusive sexuality education curricula.
1 “All About Youth: Evaluation of Abstinence-Only and Abstinence-Plus Programs to Prevent HIV, STD, and Pregnancy among Middle School Students.” University of Texas Prevention Research Center. <>
2 Markham C, Peskin M, Hernandez BF, Johnson K, Addy RC, Cuccaro P, Shegog R, Tortolero S  (2010). Adolescent sexual behavior: examining data from Texas and the U.S. Journal of Applied Research on Children: Informing Policy for Children at Risk 2(2): 1-30. <>
3 p. 20.