What is the current situation with abstinence education in the US?

Despite federal financial support the picture of what takes place in schools and colleges across the United States is difficult to piece together since most policies on sex education are decided at state level and even then school districts may enjoy a considerable degree of latitude to determine exactly what form provision takes within this policy context.

However, a survey in 1999 found that all school districts with a sex education policy required that abstinence be taught and around 4 in 5 required that it be promoted as the best option for young people. About 35% not only required abstinence to be covered but either did not allow discussion of contraceptives or allowed discussion only of their failure rates. The other 51% required that abstinence be taught as the preferred option, but also allowed discussion of contraception as an effective means of protection. Only 14% had a policy of teaching abstinence as part of a comprehensive programme.

Recent research has suggested that while overall abstinence education continues to grow in influence, some states are actively seeking to consolidate comprehensive provision. As of May 2007, ten states had chosen not to receive federal funding for abstinence education 62. New York followed suit in September 2007.

Which view is in the ascendancy?

There is no doubt that abstinence-based approaches have gathered political and financial support in the United States where they have become strongly associated with the moral and religious inclinations of the Republican Party and the Presidency of George W. Bush 54 55.

As a result, the current situation is that of the $1.5 billion spent on abstinence education since 1982 more than 80% has been spent under the current Presidency 56. Approximately $204 million was granted in the President's 2007 Budget to abstinence-only education programmes 57.

The bulk of this funding has been available annually since 1996 when an amendment to health and welfare legislation affecting support to families initiated an annual cycle of federal funding to abstinence education 58. From this point funding became available to states if they matched the Government grant with some money of their own. This money then became available to organisations through several funding strands if they agreed to use it for work that meets the following eight characteristics defining abstinence education as that which:

* Has as its exclusive purpose teaching the social, psychological, and health gains to be realized by abstaining from sexual activity;
* Teaches abstinence from sexual activity outside marriage as the expected standard for all school-age children;
* Teaches that abstinence from sexual activity is the only certain way to avoid out-of-wedlock pregnancy, sexually transmitted diseases, and other associated health problems;
* Teaches that a mutually faithful, monogamous heterosexual relationship in the context of marriage is the expected standard of human sexual activity;
* Teaches that sexual activity outside of the context of marriage is likely to have harmful psychological and physical effects;
* Teaches that bearing children out of wedlock is likely to have harmful consequences for the child, the child's parents, and society;
* Teaches young people how to reject sexual advances and how alcohol and drug use increases vulnerability to sexual advances; and
* Teaches the importance of attaining self-sufficiency before engaging in sexual activity.

The situation is the UK is rather different in that abstinence education has no support in public policy and receives no funding from government, although there is an expectation that sex educators in schools will emphasise the potential benefits of delaying or abstaining from sexual activity alongside providing information about contraception, sexual health services, sexuality and gender issues 59.

So can we decide whether one approach is better than the other?

It is very important to note that debates about research into the effectiveness of different types of sex education, and criticisms of the extent to which programmes contain factual inaccuracies and are guilty of stereotyping, do not always represent objective attempts to weigh the evidence that these studies have produced. While the debate between supporters of both approaches has populated these areas of difference it is not in pursuit of a resolution of their differences but rather a definitive answer that suits their moral agenda. There is no doubt that, whatever evidence is assembled, people who hold particular strong moral views are unlikely to give up supporting their preferred approach regardless of whether it works or whether someone else thinks it presents a distorted picture of the facts.

What is the difference in the content of abstinence-based and comprehensive programmes of sex education?

Another way in which the debate gets framed is in relation to differences in beliefs about what the 'real facts' are that young people should be presented with in the context of sex education. Many supporters of abstinence-based sex education say that comprehensive programmes are too positive about the protective potential of contraceptives and understate their failure rate and the risks of contracting HIV or another STI 37. In addition, they criticise programmes of comprehensive sex education for placing too little emphasis on abstinence and sending young people a mixed message by referring both to abstaining from or delaying when they first have sexual intercourse, and the benefits of using contraception.

Some reviews of abstinence -based programmes suggest factual inaccuracies.

For their part critics of abstinence-based programmes have said that they are too negative about the effectiveness of contraception and sometimes include inaccurate information about failure rates. Proponents of abstinence-based approaches have been accused of overstating condom failure rates, exaggerating the risks of infection with HIV and other STIs, reinforcing gender and sexuality stereotypes, and presenting sex and sexuality in an overly negative way.

The criticisms levelled against comprehensive programmes of sex education are difficult to sustain because research suggests that in practice many sex educators are very concerned not to present sex in too positive a light and tend to avoid coverage of sensitive and potentially embarrassing subjects like homosexuality and abortion. Young people consistently report that the underlying message is that they should not have sex. Moreover, much of the evidence for the ineffectiveness of condoms and other contraceptives cited by critics of comprehensive programmes is highly suspect, being based on poor quality research or the outcome of a partial reading of its results.

In contrast, those criticisms levelled at abstinence-based approaches do seem to have a firmer foundation. Some reviews of programme materials suggest factual inaccuracies - such as massively overestimating the prevalence of HIV and STIs and the failure rates of condoms when properly used - are common. These reviews have also shown that these programmes tend to project stereotypes about gender, repress information about positive aspects of sexual relationships, and overstate the emotional risks and dangers associated with sex.
Is it realistic to encourage abstinence until marriage?

The premise on which abstinence education is founded - that it is reasonable to wait until marriage before having sex for the first time and then be faithful to that one partner for life - may well be unrealistic for many young people because it fails to reflect the nature of modern, industrial societies in which people marry later in life, if at all. And with the high frequency of breakdown in marriage, people are very likely to have several sexual partners over their lifetime. Across the US, the UK and the rest of Europe data on sexual lifestyles consistently show that the age at which people first marry has risen to around 30 years old and that about a fifth of marriages end in divorce or separation within five years 50 51. Yet while the age at which people marry has risen, the age at which they first have sexual intercourse has been falling to around 16 years old, and a diminishing minority of people report that their first sexual partner was also their marriage partner.

But which method is best in sex education?

One of the ways in which the debate between supporters of abstinence and comprehensive approaches to sex education has been framed is in terms of which is the most effective.

Although at first glance the evidence can seem confusing, with claims coming from both groups about the proven effectiveness of programmes embodying their values, when only the most reliable studies are taken into account the position is clear 20. There is good evidence, from studies of programmes implemented in the US, UK and other European countries and countries in Africa and Asia 21 22 23 24 25 26 27 28, that comprehensive sex education can reduce behaviours that put young people at risk of HIV, STIs and unintended pregnancy. Studies have repeatedly shown too that this kind of sex education does not lead to the earlier onset of sexual activity among young people and, in some cases, will even lead to it happening later.

In contrast there is no such robust evidence for the effectiveness of abstinence education. Almost all the studies that have claimed to show any positive outcomes are not well-enough designed to sustain these claims 29 30 31 so it is not possible to infer whether they work or not from the research reports.
So, what does the research evidence show about the effects of abstinence-based approaches?

The research that is available currently shows at best mixed outcomes for abstinence-based approaches to sex education, benefiting some young people in the short term but placing them at greater risks later. For example, two studies suggest that for some young people making pledges to abstain from sexual intercourse until marriage does lead to delay in the timing of their first sexual intercourse. But these young people tend to hold strong religious beliefs and enjoy being an exclusive group among peers who do not take abstinence pledges. As the researchers note this means that pledging abstinence is not appropriate for young people who do not hold strong religious views and, moreover, if lots of young people are involved in making pledges (as using abstinence education as a method of sex education requires) the sense of being special will be dissipated 32. In addition, while an abstinence pledge may work for some groups of young people as a way of delaying when they have sexual intercourse, the majority still have sex before they are married and when they do they report using condoms less often than 'non-pledgers' and are more likely to substitute anal or oral sex for vaginal sexual intercourse 33 34.

In April 2007 a company called Mathematica Policy Research published the results of a Congressionally mandated evaluation of federally funded abstinence-based programmes in American schools 35. The investigation, which looked at four programmes offering a range of settings and strategies, found that rates of abstinence and unprotected sex in students who took part in the programmes were virtually identical to rates among students who had been randomly assigned to not take part. The ages at first sexual intercourse were also nearly identical, as were the numbers of sexual partners. It appears that the programmes had no impact on how the students behaved.

With regards to HIV prevention, a systematic review of all relevant studies 36, published in October 2007, concluded, "Evidence does not indicate that abstinence-only interventions effectively decrease or exacerbate HIV risk among participants in high-income countries; trials suggest that the programs are ineffective." Nevertheless the authors stressed the paucity of robust data and the need for more rigorous trials. They noted that most studies have been conducted among American youth, which may limit the generalisability of their findings.

So why is there so much disagreement in sex education?

Despite the similarities in some of the things that supporters of abstinence-based and comprehensive approaches believe about sex education and what it can achieve in terms of young people's sexual health, it is probably overly optimistic to think that it is possible to build consensus on a single approach. This is because these superficial similarities mask profound differences in the values and attitudes which inform the views of supporters of abstinence-based and comprehensive sex education.

Many supporters of abstinence-based sex education have a background in or connection to Christian organisations that have strong views about sex and sexuality. Not only do they often believe that sex should only take place in the context of marriage, but some are also opposed to same-sex relationships and abortion 10. As a result of the strong faith basis for their beliefs about sex, supporters of abstinence education see the main objective as being to equip (and encourage) young people to refuse or avoid sex altogether, and they may exclude from their programmes any other information that they believe conflicts with this view. This may result in an abstinence-only course failing to include basic information about what activities transmit HIV and how such transmission can be avoided.

As a result of the strong faith basis for their beliefs about sex, supporters of abstinence education see the main objective as being to equip (and encourage) young people to refuse or avoid sex.

Even where supporters of abstinence-based sex education disavow a strong religious basis for their beliefs about what young people should be taught, they often highlight issues about fidelity to one partner, and reject provision of information about steps young people can take to protect themselves against disease and unintended pregnancy because they argue that to do so sends a mixed message 11.

In contrast, most supporters of comprehensive sex education regard having sex and issues to do with sexuality as matters of personal choice that should not be dictated by religious or political dogmas. Working from an understanding of human rights, which means that people are entitled to access information about matters that affect them and the decisions that they make, they see sex education as being about providing young people with the means by which they can protect themselves against abuse and exploitation as well as unintended pregnancies, sexually transmitted diseases and HIV/AIDS 12 13 14 15. They argue that without access to information about all aspects of sex and sexuality making these decisions freely is impossible 16. While they think that is important that sex education is sensitive to faith issues, they assert that it should not be based on any set of specific religious values 17 18.

These fundamentally different views about sex and sexuality mean that supporters of abstinence-based and comprehensive approaches to sex education see the 'problem' of what to do about young people and sex quite differently and therefore reach quite different conclusions about the 'solution'. If, as supporters of comprehensive sex education tend to believe, the underlying premise of sexual health interventions is to meet social and utilitarian ideals then the solutions that are proposed are more likely to include earlier and more comprehensive sex education, more liberal abortion laws and freely available contraception. By contrast if, as supporters of abstinence-based approaches feel, the underlying motive has a strong religious dimension then the solutions are more likely to revolve around abstinence campaigns and be characterised by reluctance to promote contraception 19.

Can abstinence-based and comprehensive approaches to sex education be combined?

Some people have argued that is it possible to combine the main elements of both comprehensive and abstinence-based approaches to sex education in one approach. These people point out that supporters of both abstinence-based and comprehensive approaches share the view that sex education plays an important role in HIV prevention and both approaches emphasise the potential benefits of delaying having sexual intercourse in terms of helping young people avoid HIV, other STIs and unintended pregnancies. On the basis of this it has been argued that abstinence-based and comprehensive approaches can be reconciled into one inclusive approach which is sometimes called abstinence-plus

In abstinence-plus sex education, although the main emphasis is on abstaining from sex as the preferred choice of protection, young people are also provided with information about contraception and disease prevention so that they can protect themselves when they do become sexually active 6. Abstinence-plus approaches include programmes such as the Reducing the Risk and APAUSE (Added Power And Understanding in Sex Education) which have been developed in the US and UK, respectively 7 8 9. Both these programmes comprise school-based curricula which explicitly emphasise that students should avoid unprotected intercourse, either by not having sex or (for students who choose to have sex) by using contraceptives.

What is an abstinence-based approach to sex education?

An abstinence-based approach to sex education focuses on teaching young people that abstaining from sex until marriage is the best means of ensuring that they avoid infection with HIV, other sexually transmitted infections and unintended pregnancy. As well as seeing abstinence from sex as the best option for maintaining sexual health, many supporters of abstinence-based approaches to sex education also believe that it is morally wrong for people to have sex before they are married.

Abstinence approaches are represented in programmes such as Project Reality and True Loves Waits (both developed in the US), which aim to teach young people that they should commit to abstain from sex until marriage

How does this differ from comprehensive sex education?

The main difference between abstinence-based and comprehensive approaches to sex education is that comprehensive approaches do not focus either solely or so closely on teaching young people that they should abstain from sex until they are married. And although they do explain to young people the potential benefits of delaying having sex until they are emotionally and physically ready, they also make sure that they are taught how to protect themselves from infections and pregnancy when they do decide to have sex.

Examples of what programmes of comprehensive sex education comprise include SHARE (Sexual Health and Relationships: Safe, Happy and Responsible) in the UK and the guidelines produced by SIECUS (Sexuality Information and Education Council of the United States) in the US

Taking Sex Education Forward

Providing effective sex education can seem daunting because it means tackling potentially sensitive issues. However, because sex education comprises many individual activities, which take place across a wide range of settings and periods of time, there are lots of opportunities to contribute.

The nature of a person's contribution depends on their relationship, role and expertise in relation to young people. For example, parents are best placed in relation to young people to provide continuity of individual support and education starting from early in their lives. School-based education programmes are particularly good at providing information and opportunities for skills development and attitude clarification in more formal ways, through lessons within a curriculum. Community-based projects provide opportunities for young people to access advice and information in less formal ways. Sexual health and other health and welfare services can provide access to specific information, support and advice. Sex education through the mass media, often supported by local, regional or national Government and non-governmental agencies and departments, can help to raise public awareness of sex health issues.

Because sex education can take place across a wide range of settings, there are lots of opportunities to contribute.

Further development of sex education partly depends on joining up these elements in a coherent way to meet the needs of young people. There is also a need to pay more attention to the needs of specific groups of young people like young parents, young lesbian, gay and bisexual people, as well as those who may be out of touch with services and schools and socially vulnerable, like young refugees and asylum-seekers, young people in care, young people in prisons, and also those living on the street.

The circumstances and context available to parents and other sex educators are different from place to place. Practical or political realities in a particular country may limit people's ability to provide young people with comprehensive sex education combining all the elements in the best way possible. But the basic principles outlined here apply everywhere. By making our own contribution and valuing that made by others, and by being guided by these principles, we can provide more sex education that works and improve the support we offer to young people.




Sex education is an important part of effective HIV prevention. It is generally accepted that it enables people to acquire knowledge and develop skills that they can use to protect and promote their sexual health through minimising the risks that they might face in the course of their sexual experiences. In recent years there has been discussion about what form sex education should take and the advantages and disadvantages of adopting an abstinence-based approach as an alternative to a more comprehensive approach. This discussion has assumed added significance with an increasing emphasis on the provision of funding for abstinence-based approaches to sex education in the United States and, now, through funds made available through PEPFAR (President's Emergency Plan For AIDS Relief), the prospect of advocates of abstinence-based approaches exporting their programmes of sex education to some of the parts of the world worst affected by HIV and AIDS.

SEMUDA mungkin anak mestinya diberi pendidikan seks

SEMUDA mungkin anak mestinya diberi pendidikan seks. Asosiasi Keluarga Berencana di Inggris mengungkapkan bahwa mulai usia empat tahun anak sebaiknya diberi pendidikan seks. Ini dimaksudkan untuk menekan angka aborsi dan infeksi penyakit menular seksual di antara para remaja.



Asosiasi ini berpendapat, bahwa pendidikan yang bertingkat mengenai seksualitas akan membantu anak-anak untuk paham dengan alat reproduksi dan yang terkait dengan seksualitasnya. Departemen Anak, Sekolah dan Keluarga mengatakan bahwa anak-anak mesti diajari mengenal bagian tubuhnya dan perbedaan-perbedaan mendasar antara seksualitas pria dan wanita juga hubungan di antara keduanya.



Sampai saat ini pemerintah tidak memberikan informasi yang memadai mengenai seks dan hubungan antarmanusia. Karena itu "Banyak anak muda melakukan hubungan seks untuk mencari tahu bagaimana rasanya," ungkap Simon Blake, Direktur eksekutif Asosiasi Keluarga Berencana Inggris.



Menurut Simon, banyak buktinya ketika seorang anak mengenal pendidikan seks dan hubungan antarmanusia sejak awal, sebelum seorang anak mengalami masa pubertas, sebelum mereka merasakan atrakasi seksual, mereka akan menunda hubungan seks atau tidak buru-buru ingin melakukan hubungan seks.



"Mereka lebih sadar untuk menggunakan kontrasepsi dan menjalankan seks secara aman."Seorang remaja usia enam belas tahun, sebut saja Bethany dari Norwich menyebutkan bahwa dia tidak mengerti konsekuensi melakukan hubungan seks di usia muda.



"Saya tidak tahu bahwa saya bakal bisa hamil," ujarnya. "Saya pikir pengenalan seksualitas dalam pendidikan seks akan membatu kami seperti saya menghadapi hal ini."



Lembaga sosial ini menyebutkan bahwa pendidikan seks dasar yang diberikan dalam pelajaran ilmu pengetahuan saat ini tidak cukup memadai. Mereka menginginkan adanya kurikulum khusus mengenai seks dan hubungan antarmanusia sebagai mata pelajaran wajib di sekolah-sekolah Inggris setara dengan mata pelajaran lain seperti matematika, bahasa Inggris.



Departemen Anak, Sekolah dan Keluarga mengatakan bahwa pendidikan seks dan hubungan antarmanusia yang efektif merupakan hal yang esensial untuk anak muda agar mereka memiliki pilihan yang aman dan menyehatkan atas hidupnya. Dan tentu saja agar kehamilan di usia muda dan infeksi penyakit menular dapat dicegah.



Seorang juru bicara departemen menambahkan bahwa para penasihat pemerintahan akan merekomendasikan kebijakan ini kepada pemerintah untuk menjadi sebuah kebijakan baru bulan depan.


Sumber: kompas.com

Senin, 7 Juli 2008 | 23:01 WIB

Effective school-based sex education

School-based sex education can be an important and effective way of enhancing young people's knowledge, attitudes and behaviour. There is widespread agreement that formal education should include sex education and what works has been well-researched. Evidence suggests that effective school programmes will include the following elements:



* A focus on reducing specific risky behaviours;

* A basis in theories which explain what influences people's sexual choices and behaviour;

* A clear, and continuously reinforced message about sexual behaviour and risk reduction;

* Providing accurate information about, the risks associated with sexual activity, about contraception and birth control, and about methods of avoiding or deferring intercourse;

* Dealing with peer and other social pressures on young people; providing opportunities to practise communication, negotiation and assertion skills;

* Uses a variety of approaches to teaching and learning that involve and engage young people and help them to personalise the information;

* Uses approaches to teaching and learning which are appropriate to young people's age, experience and cultural background;

* Is provided by people who believe in what they are saying and have access to support in the form of training or consultation with other sex educators.



Formal programmes with these elements have been shown to increase young people's levels of knowledge about sex and sexuality, put back the average age at which they first have sexual intercourse and decrease risk when they do have sex. All the elements are important and inter-related, and sex education needs to be supported by links to sexual health services, otherwise it is not going to be so effective. It also takes into account the messages about sexual values and behaviour young people get from other sources, like friends and the media. It is also responsive to the needs of the young people themselves - whether they are girls or boys, on their own or in a single sex or mixed sex group, and what they know already, their age and experiences.

Who should provide sex education?

Different settings provide different contexts and opportunities for sex education. At home, young people can easily have one-to-one discussions with parents or carers which focus on specific issues, questions or concerns. They can have a dialogue about their attitudes and views. Sex education at home also tends to take place over a long time, and involve lots of short interactions between parents and children. There may be times when young people seem reluctant to talk, but it is important not to interpret any diffidence as meaning that there is nothing left to talk about. As young people get older advantage can be taken of opportunities provided by things seen on television for example, as an opportunity to initiate conversation. It is also important not to defer dealing with a question or issue for too long as it can suggest that you are unwilling to talk about it.

In school the interaction between the teacher and young people takes a different form and is often provided in organised blocks of lessons. It is not as well suited to advising the individual as it is to providing information from an impartial point of view. The most effective sex education acknowledges the different contributions each setting can make. School programmes which involve parents, notifying them what is being taught and when, can support the initiation of dialogue at home. Parents and schools both need to engage with young people about the messages that they get from the media, and give them opportunities for discussion.

In some countries, the involvement of young people themselves in developing and providing sex education has increased as a means of ensuring the relevance and accessibility of provision. Consultation with young people at the point when programmes are designed, helps ensure that they relevant and the involvement of young people in delivering programmes may reinforce messages as they model attitudes and behaviour to their peers.

When should sex education start?

Sex education that works starts early, before young people reach puberty, and before they have developed established patterns of behaviour.15 16 17 The precise age at which information should be provided depends on the physical, emotional and intellectual development of the young people as well as their level of understanding. What is covered and also how, depends on who is providing the sex education, when they are providing it, and in what context, as well as what the individual young person wants to know about.

It is important not to delay providing information to young people but to begin when they are young. Providing basic information provides the foundation on which more complex knowledge is built up over time. This also means that sex education has to be sustained. For example, when they are very young, children can be informed about how people grow and change over time, and how babies become children and then adults, and this provides the basis on which they understand more detailed information about puberty provided in the pre-teenage years. They can also when they are young, be provided with information about viruses and germs that attack the body. This provides the basis for talking to them later about infections that can be caught through sexual contact.

Providing basic information provides the foundation on which more complex knowledge is built up over time.

Some people are concerned that providing information about sex and sexuality arouses curiosity and can lead to sexual experimentation. However, in a review of 48 studies of comprehensive sex and STD/HIV education programmes in US schools, there was found to be strong evidence that such programmes did not increase sexual activity. Some of them reduced sexual activity, or increased rates of condom use or other contraceptives, or both.18 It is important to remember that young people can store up information provided at any time, for a time when they need it later on.

Sometimes it can be difficult for adults to know when to raise issues, but the important thing is to maintain an open relationship with children which provides them with opportunities to ask questions when they have them. Parents and carers can also be proactive and engage young people in discussions about sex, sexuality and relationships. Naturally, many parents and their children feel embarrassed about talking about some aspects of sex and sexuality. Viewing sex education as an on-going conversation about values, attitudes and issues as well as providing facts can be helpful. The best basis to proceed on is a sound relationship in which a young person feels able to ask a question or raise an issue if they feel they need to. It has been shown that in countries like The Netherlands, where many families regard it as an important responsibility to talk openly with children about sex and sexuality, this contributes to greater cultural openness about sex and sexuality and improved sexual health among young people.19

The role of many parents and carers as sex educators changes as young people get older and young people are provided with more opportunities to receive formal sex education through schools and community-settings. However, it doesn't get any less important. Because sex education in school tends to take place in blocks of time, it can't always address issues relevant to young people at a particular time, and parents can fulfill a particularly important role in providing information and opportunities to discuss things as they arise.20

So what information should be given to young people?

Young people get information about sex and sexuality from a wide range of sources including each other, through the media including advertising, television and magazines, as well as leaflets, books and websites (such as www.avert.org) which are intended to be sources of information about sex and sexuality. Some of this will be accurate and some inaccurate. Providing information through sex education is therefore about finding out what young people already know and adding to their existing knowledge and correcting any misinformation they may have. For example, young people may have heard that condoms are not effective against HIV/AIDS or that there is a cure for AIDS. It is important to provide information which corrects mistaken beliefs. Without correct information young people can put themselves at greater risk.

Information is also important as the basis on young people can developed well- informed attitudes and views about sex and sexuality. Young people need to have information on all the following topics:

* Sexual development
* Reproduction
* Contraception
* Relationships

They need to have information about the physical and emotional changes associated with puberty and sexual reproduction, including fertilisation and conception and about sexually transmitted diseases, including HIV/AIDS. They also need to know about contraception and birth control including what contraceptives there are, how they work, how people use them, how they decide what to use or not, and how they can be obtained. In terms of information about relationships they need to know about what kinds of relationships there are, about love and commitment, marriage and partnership and the law relating to sexual behaviour and relationships as well as the range of religious and cultural views on sex and sexuality and sexual diversity. In addition, young people should be provided with information about abortion, sexuality, and confidentiality, as well as about the range of sources of advice and support that is available in the community and nationally.

Forming attitudes and beliefs

Young people can be exposed to a wide range of attitudes and beliefs in relation to sex and sexuality. These sometimes appear contradictory and confusing. For example, some health messages emphasis the risks and dangers associated with sexual activity and some media coverage promotes the idea that being sexually active makes a person more attractive and mature. Because sex and sexuality are sensitive subjects, young people and sex educators can have strong views on what attitudes people should hold, and what moral framework should govern people's behaviour - these too can sometimes seem to be at odds. Young people are very interested in the moral and cultural frameworks that binds sex and sexuality. They often welcome opportunities to talk about issues where people have strong views, like abortion, sex before marriage, lesbian and gay issues and contraception and birth control. It is important to remember that talking in a balanced way about differences in opinion does not promote one set of views over another, or mean that one agrees with a particular view. Part of exploring and understanding cultural, religious and moral views is finding out that you can agree to disagree.

Attempts to impose narrow moralistic views about sex and sexuality on young people through sex education have failed.

People providing sex education have attitudes and beliefs of their own about sex and sexuality and it is important not to let these influence negatively the sex education that they provide. For example, even if a person believes that young people should not have sex until they are married, this does not imply withholding important information about safer sex and contraception. Attempts to impose narrow moralistic views about sex and sexuality on young people through sex education have failed.11 12 Rather than trying to deter or frighten young people away from having sex, effective sex education includes work on attitudes and beliefs, coupled with skills development, that enables young people to choose whether or not to have a sexual relationship taking into account the potential risks of any sexual activity.

Effective sex education also provides young people with an opportunity to explore the reasons why people have sex, and to think about how it involves emotions, respect for one self and other people and their feelings, decisions and bodies. Young people should have the chance to explore gender differences and how ethnicity and sexuality can influence people's feelings and options.13 14 They should be able to decide for themselves what the positive qualities of relationships are. It is important that they understand how bullying, stereotyping, abuse and exploitation can negatively influence relationships.

What skills should sex education develop?

If sex education is going to be effective it needs to include opportunities for young people to develop skills, as it can be hard for them to act on the basis of only having information.6 7 The skills young people develop as part of sex education are linked to more general life-skills. Being able to communicate, listen, negotiate, ask for and identify sources of help and advice, are useful life-skills and can be applied in terms of sexual relationships. Effective sex education develops young people's skills in negotiation, decision-making, assertion and listening. Other important skills include being able to recognise pressures from other people and to resist them, dealing with and challenging prejudice and being able to seek help from adults - including parents, carers and professionals - through the family, community and health and welfare services. Sex education that works also helps equip young people with the skills to be able to differentiate between accurate and inaccurate information, and to discuss a range of moral and social issues and perspectives on sex and sexuality, including different cultural attitudes and sensitive issues like sexuality, abortion and contraception.8 9 10

What are the aims of sex education?

Sex education seeks both to reduce the risks of potentially negative outcomes from sexual behaviour, like unwanted or unplanned pregnancies and infection with sexually transmitted diseases, and to enhance the quality of relationships. It is also about developing young people's ability to make decisions over their lifetime. Sex education that works, by which we mean that it is effective, is sex education that contributes to this overall aim.

What is sex education?

Sex education, which is sometimes called sexuality education or sex and relationships education, is the process of acquiring information and forming attitudes and beliefs about sex, sexual identity, relationships and intimacy. Sex education is also about developing young people's skills so that they make informed choices about their behaviour, and feel confident and competent about acting on these choices. It is widely accepted that young people have a right to sex education, partly because it is a means by which they are helped to protect themselves against abuse, exploitation, unintended pregnancies, sexually transmitted diseases and HIV/AIDS.