School-Based HIV-Prevention Education - United States, 1994

Article excerpt

Many U.S. adolescents engage in behaviors that increase their risk for HIV infection and AIDS.[1] Because 95% of all youth ages 5-17 are enrolled in school,[2] school health programs can be an efficient method to help prevent these behaviors.[3] Previous studies have examined selected characteristics of HIV education in the United States.[4-6] However, none provide a comprehensive assessment of HIV education policies and programs nationwide. In 1994, CDC conducted the School Health Policies and Programs Study (SHPPS), which assessed five components of the school health program: health education, physical education, health services, food service, and health policies. To provide a comprehensive assessment of HIV prevention education programs nationwide in 1994, CDC analyzed data from the health education component of the study. This report summarizes the findings, which indicate that although HIV-prevention education has been widely implemented in U.S. schools, improvement in these programs is needed.

SHPPS assessed the school health education component at the state, district, school, and classroom levels. Questionnaires were mailed to the state education agency in all 50 states and the District of Columbia and to a nationally representative sample of 502 school districts. In addition, personal interviews were conducted with personnel from a nationally representative sample of 766 public and private middle/junior and senior high schools and with 1,643 randomly selected health education teachers in those schools. Personnel from all 51 state education agencies and 406 (81%) of the 502 sampled districts completed the state and district questionnaires, respectively. Personnel from 607 (79%) of the 766 sampled schools completed the school-level interview and 1,040 (63%) of the 1,643 sampled classroom teachers completed the teacher interview.

Teachers were asked about the primary focus of the courses in which they taught health education. Of the 1,027 teachers who responded to this question, nearly half (46.9%) taught courses that focused primarily on health education topics. In this analysis, these teachers are referred to as health education teachers in health education classes. The other teachers (53.1%) taught courses that included some health education content, but focused primarily on another subject such as biology. These teachers are referred to as health education teachers in other subjects. Data from school districts, schools, and classroom teachers were weighted to provide national estimates. SUDAAN was used to compute 95% confidence intervals (CIs).

In 1994, HIV-prevention education was required in 78.7% of states and 83.0% (95% CI = [+ or -] 5.3%) of school districts. The topic was taught in a required course in 85.6% (95% CI = [+ or -] 4.2%) of all middle/junior and senior high schools (Table 1). Similar percentages of middle/junior and senior high schools included the following topics in their curricula: HIV prevention, alcohol and other drug-use prevention (AOD), dietary behaviors and nutrition, physical activity and fitness, sexually transmitted disease prevention, and tobacco-use prevention. Topics included in curricula less often than HIV prevention were conflict resolution and violence prevention, injury prevention and safety, pregnancy prevention, and suicide prevention.

Table 1 Percentage of States and School Districts that Required Teaching of Selected Health Education Topics and Percentage of Middle/Junior and Senior High Schools that Included Each Topic in a Required Course, by Topic -- United States, School Health Policies and Programs Study, 1994(*)

                             requiring topic   School districts
                               (N = 51)        requiring topic
Topic                               %           %     95%     CI
Alcohol- and other drug use
prevention                        75.0        86. …