General Articles

Sexuality Education Curricula

17 Days (formerly What Could You Do?)
17 Days is an evidence-based STD risk-reduction program that uses an interactive video to encourage safer sexual behaviors among female high school students. The program is designed as a one-on-one intervention, with each participant viewing the video individually. It aims to increase participants’ knowledge of STDs along with reducing their sexual risk behavior and risk of STD infection. The video includes vignettes featuring ethnically diverse young women involved in realistic scenarios related to sexual risk behavior, where the viewer must choose what action the character should take from different options. The vignettes give viewers the opportunity to practice how they would respond in different situations. The video covers sexual situations, risk reduction, reproductive health, and STDs. In addition, the video associates condom use with positive outcomes, such as pleasure and reassurance. 17 Days can be used in a physician’s office or clinic setting and could potentially be used in other settings, such as schools, as long as there was enough privacy for the viewer. An evaluation of the program published in Social Science & Medicine found that, at a six-month follow-up to the intervention, participants were almost twice as likely not to have been diagnosed with an STD as those in the control group.

Aban Aya Youth Project
Aban Aya Youth Project is an evidence-based social development program designed for African-American youth in grades five through eight. The program’s name is derived from the Ghanian words aban, meaning “fence,” signifying social protection, and aya, meaning “the unifying fern,” which signifies self-determination. The Aban Aya Youth Project consists of two components: a social development, classroom-based curriculum that focuses on reducing risky behaviors and a school/community intervention, which includes community and parent engagement. The curriculum, designed to be implemented over the course of four years, emphasizes abstinence from sexual activity, avoiding drug and alcohol use, and nonviolent conflict resolution. The curriculum draws upon African-American cultural values and uses culturally based teaching methods, such as storytelling, along with African- American history and literature. An evaluation of the program published in the Archives of Pediatrics and Adolescent Medicine found that, at three-year follow-up, male program participants were significantly less likely to report having had recent sexual intercourse than peers in a control group. In addition, program participants showed an increase in the rate of condom use compared to those in the control group.

All4You! is an evidence-based pregnancy-, STD-, and HIV-prevention program designed for students ages 14–18 attending alternative high schools. It is adapted from two existing evidence-based programs, Be Proud! Be Responsible! and Safer Choices. The program, which includes both classroom instruction and a service learning component, aims to reduce the frequency of unprotected sex among participants. The 14-session classroom curriculum consists of nine lessons, which address STD-, HIV- and pregnancy-prevention; the risk of STD transmission and unintended pregnancy; negotiation skills; and condom-use skills, among other topics. All4You! includes interactive activities such as role-playing, condom demonstration, group discussion, and educational games. The service learning component engages participants in volunteer activities. An evaluation of the program published in AIDS Education and Prevention compared the behavior of participants to that of peers in a control group six months after the intervention. Program participants reported a significantly lower frequency of having sex without a condom in the previous three months, were significantly more likely to report having used a condom at last sexual intercourse, and reported a significantly lower frequency of sexual intercourse in the previous three months than participants in the control group.

ASPIRE: Live your life, be free

ASPIRE is a fear-based curricula that takes an ideological approach to sexuality education that promotes abstinence until marriage to the exclusion of providing full and complete information to young people. Such programs have not been proven effective in impacting sexual behavior. At best these programs are ineffective and at worst they may be harmful to youth. ASPIRE is based on one set of values and opinions—that marriage should be everyone’s ultimate goal and that sex outside of marriage is wrong—which it tries to pass off as universally held truths. In an effort to convince students that these opinions are facts, the curriculum provides incomplete and biased information, promotes fear and shame, and undermines young people’s confidence in their own decision-making abilities. For example, students are asked which life decision—college, career, or marriage—will have the most impact on their life. The answer is marriage, because “College is for a few years, and you may have a number of careers. But marriage is for life.”

Basic Training
Basic Training is a curriculum created by the Center for Relationship Education (formerly WAIT Training), an AOUM industry leader and publisher of the well-known AOUM curriculum, WAIT Training. Basic Training focuses on “puberty science” for students in fourth, fifth, and sixth grade. WAIT Training is an AOUM curriculum that uses fear- and shame-based tactics to promote abstinence as the only appropriate behavior outside of marriage. SIECUS reviewed the most recent edition of WAIT Training and found that, similar to previous editions, it includes little medical or biological information about puberty and reproduction. Instead, it contains information and statistics promoting the benefits of marriage, activities and skill-building exercises for developing healthy relationships, and information on STDs, including HIV. It also contains messages promoting biased views of gender, sexual orientation, and family structure. For example, WAIT Training explains, “When it comes to sex, men are like microwaves and women are like crockpots…[M]en respond sexually by what they see and women respond sexually by what they hear and how they feel about it.”

Be Proud! Be Responsible!
Be Proud! Be Responsible! is an evidence-based HIV-prevention curriculum originally designed for urban, African-American males ages 13–18. The curriculum seeks to provide young people with the knowledge, motivation, and skills necessary to reduce their risk of contracting HIV or other STDs, and causing unintended pregnancy.
It also aims to impact sexual behavior by equipping youth with negotiation, refusal, and condom-use skills. The curriculum uses a “sense-of-community” approach that emphasizes how HIV/AIDS has affected inner-city communities and discusses the importance of protecting the community in order to instill accountability, sexual responsibility, and a sense of pride in participants. Although the five-hour, six-session intervention was originally designed for use with small groups of six to 12 participants, the curriculum has been used with larger groups and is appropriate for both school- and community-based settings. An evaluation of the program published in the American Journal of Community Psychology found that the intervention reduced the number of female sexual partners participants had as well as the number of non-monogamous female sexual partners (those who were simultaneously involved with other male partners). In addition, the study found that the intervention decreased the frequency of vaginal and heterosexual anal intercourse, and increased condom use among participants.

Be Proud! Be Responsible! Be Protective!
Be Proud! Be Responsible! Be Protective! is an evidence-based program that targets pregnant and parenting teens and focuses on the concept of maternal protectiveness to encourage adolescent mothers and soon-to-be mothers to make healthy sexual decisions, take responsibility and be accountable for their sexual activity, and decrease risky sexual behavior. The curriculum is an adaptation of Be Proud! Be Responsible! , an evidence-based HIV-prevention curriculum designed for African-American males. Be Proud! Be Responsible! Be Protective! discusses the impact of HIV/AIDS on inner-city communities and particularly addresses its impact on pregnant women and their children, providing information on preventing transmission during pregnancy and the postpartum period. The curriculum consists of eight one-hour lessons and uses interactive activities, group discussion, and videos to educate participants. It covers such topics as HIV risk and prevention, family planning and parenting, communication, attitudes and beliefs about HIV/AIDS and safer sex, condom use skills, stress and emotion management, and staying healthy. The intervention can be delivered in four two-hour sessions or over the course of eight days and is appropriate for use in school-based settings. An evaluation of the program published in Family and Community Health found, at a six-month follow-up, that program participants reported having significantly fewer sexual partners during the previous three months than participants in the control group.

Be Yourself/Sé tu mismo
Be Yourself/Sé tu mismo is a culturally relevant, theory-based, positive youth development intervention that consists of an eight-week curriculum, a social media and text messaging component, a weekend retreat, and the development of an individual action plan. The program aims to delay sexual initiation, increase contraceptive use, and prevent teen pregnancy among participants.

Being a Responsible Teen (BART)
BART is an evidence-based HIV/AIDS-prevention education curriculum designed for African-American youth ages 14–18. BART teaches students to reduce sexual risk taking by promoting safer sex practices while also teaching that abstinence is the most effective way to prevent HIV and unintended pregnancy. The eight-session curriculum combines education with behavioral skills training on assertion, refusal, self-management, problem solving, risk recognition, and correct condom use. BART includes interactive activities, group discussions, and role plays developed by teens. It is designed for implementation in community-based settings and with single-sex groups. An evaluation of the program published in the Journal of Consulting and Clinical Psychology found that it increased participant knowledge of HIV and AIDS and increased participants’ ability to manage the pressure to engage in unprotected sex as well as to provide information to their peers regarding safe sexual practices. The program was also found to delay the initiation of sexual intercourse, reduce the frequency of sex and the incidence of unprotected sex, and reduce the incidence of unprotected anal sex. Among male participants, the program was found to increase condom use

Botvin Life Skills Training
Botvin Life Skills Training is a substance abuse and violence prevention program designed to promote positive health and personal development for youth. Based on the Life Skills Training curriculum, the objectives of this program are to help adolescents navigate life challenges and prepare them for the independence and responsibilities that they will encounter as young adults. The Life Skills Training program aims to develop personal, interpersonal, and drug resistance skills. The curriculum is designed to help “students develop strategies for making healthy decisions, strengthen their communication skills and learn how to build healthy relationships.”

Children’s Aid Society—Carrera Adolescent Pregnancy Prevention Program (CAS—Carrera)
Children’s Aid Society—Carrera Adolescent Pregnancy Prevention Program (CAS—Carrera) is an evidence-based positive youth development program designed for students in grades six through twelve. The program consists of seven integrated components that can be delivered in an after- or in-school setting over the course of a year. These units include Education, Job Club, Family Life and Sexuality Education, Mental Health, Medical and Dental Services, Self Expression, and Lifetime Individual Sports. The program uses a positive youth development approach to increase developmental competency and identity formation among participants in order to encourage youth to avoid early parenthood and risky sexual behavior. CAS—Carrera runs six days a week throughout the academic year and also includes a summer program component. An evaluation of the program published in Perspectives on Sexual and Reproductive Health found that, at a three-year follow-up, female participants were significantly less likely to report a pregnancy or report being sexually active than participants in the control group.

Choices is a curriculum that aims to teach youth about making well-thought-out decisions in a discussion-learning group setting. In addition to learning decision making skills, participants explore how their decisions may affect other people. Stories from the Chicken Soup for the Soul books are used in Choices as a way to begin conversations.

Choosing the Best
Choosing the Best is one of the more popular AOUM programs in the country. The series is comprised of a number of curricula for students from sixth grade through high school: Choosing the Best WAY (sixth grade), Choosing the Best PATH (seventh grade), Choosing the Best LIFE (eighth grade), Choosing the Best JOURNEY (ninth and 10th grades), and Choosing the Best SOULMATE (11th and 12th grades). The series has been recently revised and the information about STDs is now medically accurate. However, Choosing the Best curricula continue to promote heterosexual marriage, rely on messages of fear and shame, and include biases about gender, sexual orientation, and pregnancy options. For example, Choosing the Best PATH asks students to brainstorm the “emotional consequences” of premarital sex. Suggested answers include “guilt, feeling scared, ruined relationships, broken emotional bonds.”

Circle of Life
Circle of Life is a culturally competent, HIV-prevention education curriculum designed for use with Native American youth. The curriculum incorporates traditional symbols and storytelling specific to Native American culture in order to increase knowledge, skills, and behavior change among participants. Lessons discuss concepts of family and community in an effort to instill pride and a commitment to preventing the spread of HIV in their communities. Circle of Life also teaches caring and compassion for HIV-positive individuals.

¡Cuídate! is an evidence-based HIV-prevention curriculum adapted from the evidence-based curriculum, Be Proud! Be Responsible!, and tailored for use with Latino youth ages 13–18. The curriculum provides information about HIV and its transmission, addresses values and beliefs related to HIV and safer sex, and includes activities aimed to increase skills and self-efficacy for condom use, negotiating abstinence, and safer sex. The intervention consists of six one-hour lessons and is designed for use with small, mixed-gender groups. It draws upon cultural beliefs, such as the importance of family and the responsibility of a man to care for his family, in order to provide messages that resonate with participants. The curriculum consists of educational games, small-group discussions, videos, learning exercises, and skill-building activities. An evaluation of the curriculum published in the Archives of Pediatrics & Adolescent Medicine found that it reduced the frequency of sexual intercourse, number of sexual partners, and incidence of unprotected sex, while increasing condom use among participants.

Discovering Dignity
Discovering Dignity was developed by the Abstinence Division of To Our Children’s Future With Health, Inc. (TOCFWH). Its mission is to “provide comprehensive multi-intervention strategies to educate preteens/teens and their families about the social, psychological and health gains to be realized from abstaining from sexual activity, violence, alcohol, tobacco and other drug use, and to increase participants’ practice of healthy behaviors.” Discovering Dignity is a 52-hour program delivered to students in grades 5 through 12 by community- and faith-based organizers who are trained as “Certified Abstinence Education Facilitators” by TOCFWH.

Draw the Line/Respect the Line
Draw the Line/Respect the Line is an evidence-based program designed to teach youth in grades six through eight to postpone sexual involvement while providing information about condoms and contraception. The school-based curriculum consists of 19 sessions divided between grades six through eight and includes group discussions, small group activities, and role playing exercises focused on teaching youth how to establish and maintain boundaries regarding sexual behavior. Lessons for sixth grade students address using refusal skills; lessons for the seventh grade focus on setting sexual limits, the consequences of unprotected sex, and managing sexual pressure; and eighth grade students practice refusal and interpersonal skills and receive HIV/STD-prevention education. The program also includes individual teacher consultations and parent engagement through homework activities. Although it is designed for use in the classroom, the program may also be delivered in a community-based setting. An evaluation of the program published in the American Journal of Public Health found—at one-, two-, and three-year follow-ups—that male participants were significantly less likely to report ever having had sexual intercourse or having had sexual intercourse during the previous 12 months compared to participants in the control group.

FatherWorks is “a comprehensive intervention” designed to reduce the incidence of repeat fatherhood among young men, which provides participants with the “motivation, opportunities and skills needed to change risk behavior.” The program includes parenting and co-parenting education, case-management services, clinical group and individual therapy services, sex education, and vocational and employment opportunities. Other services include anger-management education, relationship skills, financial literacy, activities involving participants’ children, and emergency financial assistance. A trial is underway that includes 330 Latino and African-American young men in Hartford and Hartford County, ages 15–24, who have fathered a child with a woman under the age of 21.

FOCUS is an evidence-based intervention that addresses such issues as responsible behavior, relationships, and HIV/STD and pregnancy prevention in order to encourage young women to practice healthy behavior and responsible decision making.
The program is appropriate for use with young women ages 17–22 in school- or community-based settings, including clinics. FOCUS consists of four two-hour sessions. Session 1 provides information about STDs, including HIV, and unintended pregnancy and addresses the consequences of risky sexual behavior. Session 2 discusses contraception and barrier methods and teaches communication and condom negotiation skills. Session 3 discusses the signs and symptoms of STD infection, including HIV/AIDS. Session 4 addresses the impact of alcohol use on sexual decision making. The sessions are primarily lecture- and discussion-based, but also incorporate some interactive activities, such as role plays. An evaluation of the program published in Preventive Medicine found that, at a 14-month follow-up, program participants who had been sexually inexperienced at the start of the intervention were significantly less likely to report having had multiple sexual partners at the time of the follow-up. The intervention was also found to be effective in reducing the number of unintended pregnancies and STD infections among participants compared to those in the control group.

Fourth R—Alaska Perspectives
Fourth R—Alaska Perspectives is an adaptation of The Fourth R: Relationship Based Violence Prevention, a Canadian curriculum and comprehensive school health program focused on reducing violence, substance abuse, and sexual risk behavior among youth. The concept of the “Fourth R” is to elevate teaching about relationships in school to the level of the other three R’s: Reading, wRiting, and aRithmetic. The curriculum is a medically accurate and evidence-based intervention that includes information on adolescent growth and development, healthy relationships, violence prevention, abstinence, contraception, and healthy sexuality, among other topics. Fourth R—Alaska Perspectives is specifically adapted from The Fourth R—Aboriginal Perspectives, which, along with the core content, addresses the unique cultural needs of Alaska Native youth.

Game Plan
SIECUS reviewed Game Plan and found that, in order to convince high school students to remain abstinent until marriage, the curriculum relies on messages of fear and shame, inaccurate and misleading information, and biased views of marriage, sexual orientation, and family structure. In addition, Game Plan fails to provide important information on sexual health, including how students can seek testing and treatment if they suspect they may have an STD. Finally, the format and underlying biases of the curriculum do not allow for cultural, community, and individual values, and discourage critical thinking and discussions of alternate points of view in the classroom.
For example, Game Plan compares sex to fire and says: “In a fireplace, fire is beautiful and gives warmth to a home. Outside of the fireplace, it can cause serious harm. What about sex? In a marriage relationship, sex can be beautiful. Outside of marriage, it can cause serious harm.”

Gender Matters
Gender Matters is delivered to low-income, African-American and Latino youth who participate in the city of Austin’s Summer Youth Employment Program. It consists of three components: 1) educational workshops provided during the summer program, 2) a year-long social media campaign, and 3) community-wide educational events developed by the program participants. The program’s overall goals are to reduce unintended teenage pregnancy by delaying sexual initiation among youth who are sexually inexperienced, increasing the use of contraception among sexually active youth, and increasing the proportion of youth who seek reproductive health care. Approximately 200 young people will receive the intervention annually. EngenderHealth has partnered with the Columbia University Mailman School of Public Health to evaluate the program.

Girls, Inc. Preventing Adolescent Pregnancy
Girls, Inc., Preventing Adolescent Pregnancy is a program that aims to help “girls acquire the knowledge and skills for taking charge of and making informed decisions about their sexual health.” It allows participants to explore their values, practice responses in different scenarios, and identify ways and reasons to avoid early pregnancy and STDs, including HIV. The component, Growing Together is intended for girls ages 9 to 11 and a parent/adult. It addresses puberty, sexual development, and values and expectations for teen sexual behavior. Growing Together includes five workshops designed to “help parents and their daughters learn new information and develop the skills they need to talk about sexuality issues.”

The Grassroots Project
The Grassroots Project is the only sexual-health program for DC youth that is designed, initiated, and managed completely by young people. The Grassroots Project uses university-athlete role models and an innovative sports-based curriculum to provide comprehensive sexual health education and life skills interventions to predominantly African-American youth ages 12–14 in neighborhoods that have the highest prevalence of HIV, STDs, and pregnancies (wards 1, 5, 6, 7, and 8). Since 2009, The Grassroots Project has trained 427 varsity athletes from Howard University, Georgetown University, and George Washington University as sexual health educators.

Healthy Futures
Healthy Futures is an AOUM curriculum designed for middle school and high school students. It offers resources to teens to help them “learn about healthy relationships, decision-making, sexual health, goal-setting and other topics through classroom presentations, online resources and peer education.” Students hear the statement “the choices you make now will affect you later,” repeated throughout both the middle and high school curricula, reinforcing the theme that the “decisions youth make, both big and small, can have a significant impact” on their lives.

Healthy Relationships
Healthy Relationships is a new approach to abstinence education in Kansas, focused on teaching youth in the foster care system about healthy relationships. The curriculum focuses on addressing “poor decision making, lack of connection with stable adult figure, low self-esteem, lack of goals or positive outlook for future, alcohol and drug involvement, a misconception of what love is due to past sexual abuse trauma, and the belief of some foster youth that a baby will provide them with the unconditional love they so desperately seek.” Healthy Relationships aims to increase foster/adoptive/kinship parent-child connectedness.

Heritage Keepers
SIECUS reviewed Heritage Keepers, Abstinence Education I and found that it contains very little information about important topics in human sexuality such as puberty, anatomy, and sexual behavior. Even topics that are frequently discussed in detail in other AOUM programs, such as condoms and STDs, receive very little mention. Instead, the curriculum devotes most of its lessons to the importance of marriage and abstinence before marriage. It relies on messages of fear and shame and promotes biased views of gender, marriage, and pregnancy options.

It’s That Easy!: A Guide to Raising Sexually Healthy Children
It’s That Easy!: A Guide to Raising Sexually Healthy Children is an initiative developed by Teenwise Minnesota (formerly the Minnesota Organization on Adolescent Pregnancy, Prevention and Parenting) that serves to “[empower] parents to connect with their kids, share their family’s values and engage in meaningful conversations about sex.”
It’s That Easy! consists of a two-day parent educator training that provides information to educators on theories, research, and best practices for promoting healthy sexual development. The training addresses such topics as the role of parents as sexuality educators, identifying individual and cultural values as well as morals and beliefs, the power of parent-child connectedness, child and adolescent growth and development, and the influence of the media and popular culture. Along with the training, parent educators receive a resource manual with sample activities and lesson plans in order to help them tailor trainings for parents in their community.

It’s Your Game: Keep it Real
It’s Your Game: Keep it Real is an evidence-based HIV-, STD-, and pregnancy-prevention curriculum designed for seventh and eighth grade students. The curriculum consists of 24 classroom-based lessons designed to encourage participants to delay sexual initiation and to use condoms and contraception if and when they become sexually active. It incorporates group activities, computer-based sessions, role modeling, journaling, and group discussion and addresses how to set personal limits for risk behaviors, how to be aware of vulnerable situations that may challenge those limits, and how to use refusal and other skills to maintain limits. Topics addressed in seventh grade include healthy friendships, setting personal limits, human growth and development, and refusal skills, among others. Eighth grade topics include healthy dating relationships, the importance of STD and pregnancy testing, and skills for using condoms and contraceptives. An evaluation of the curriculum published in the Journal of Adolescent Health found, at a ninth grade follow-up, that students who were sexually inexperienced at the start of the program were significantly less likely to report having initiated sex than sexually inexperienced participants in the control group.

Life Planning Education
A 12-session curriculum, Life Planning Education: A Youth Development Program, developed by Advocates for Youth. The family-life education curriculum addresses such topics as values, self-esteem, sexuality, relationships, reducing sexual risk, violence prevention, community responsibility, parenting, and career development and includes skill-building exercises. Youth participants who complete the 12-week session have the opportunity to participate in the Youth Activist Network, an after-school youth group that engages young people in community advocacy activities. In part, the group works with local pharmacists and health care providers to expand adolescent access to reproductive health care and improve the services provided to young people. Plan Talk Philadelphia also includes particular activities for male youth. The overall goal of the program is to reduce rates of teen pregnancy and STDs, including HIV, among the target population.

Love Notes
Love Notes is a research-based curriculum for at-risk young people ages 16–24, including those who are pregnant or parenting. It “encourages youth to cultivate a vision for good love and builds the base of knowledge and skills necessary to form and maintain healthy relationships.” Love Notes consists of 15 lessons that focus on communication skills and healthy relationship development.

Love U2 Relationship Smarts Plus
Love U2 Relationship Smarts Plus is part of the Love U2 abstinence-only-until-marriage (AOUM) curricula series that also includes Love U2 Dating Smarts, Love U2 Baby Smarts, Love U2 Communication Smarts, and Love U2 Becoming Sex Smart. It is described as a “series of units that help young people acquire practical skills for emotionally healthy and ethically sound relationships.” The curricula series is produced and distributed by The Dibble Institute for Marriage Education, a nonprofit organization based in Berkeley, California, that focuses o