As of 2024, 39 states and the District of Columbia mandate some form of sex education or HIV instruction, but only about 18 require the content to be medically accurate, according to the Guttmacher Institute.
Federal funding has supported both approaches: the Title V Sexual Risk Avoidance Education program funds abstinence-focused curricula, while the Personal Responsibility Education Program funds curricula that include contraception.
The U.S. teen birth rate fell from 61.8 births per 1,000 females aged 15–19 in 1991 to 13.6 in 2022, according to the CDC, though researchers attribute the decline to multiple factors including contraceptive use and shifting social norms.
Supporters of comprehensive sex education cite studies, including a 2017 review in the Journal of Adolescent Health, finding it associated with delayed sexual initiation and increased contraceptive use; critics argue such studies do not isolate curriculum effects from other factors.
Curriculum decisions in the United States are primarily set at the state and local level, with no federal mandate requiring any specific sex education content in public schools.