Context: Since the late 1980s, both the political context surrounding sexuality education and actual teaching approaches have changed considerably. However, little current national information has been available on the content of sexuality education to allow in-depth understanding of the breadth of these changes and their impact on current leaching. Methods: In 1999, a nationally representative survey collected data from 3,754 teachers in grades 7-12 in the five specialties most often responsible for sexuality education. Results from those teachers and from the subset of 1, 767 who actually taught sexuality education are compared with the findings from a comparable national survey conducted in 1988. Results: In 1999. 93% of all respondents reported that sexuality education was taught in their school at some point in grades 7-12; sexuality education covered a broad number of topics, including sexually transmitted diseases (STDs), abstinence, birth control, abortion and sexual orientation. Some topics-how HIV is transmitted, STDs, abstinence, how to resist peer-pressure to have intercourse and the correct way to use a condom-were taught at lower grades in 1999 than in 1988. In 1999, 23% of secondary school sexuality education teachers taught abstinence as the only way of preventing pregnancy and STDs, compared with 2% who did so in 1988. Teachers surveyed in 1999 were more likely than those in 1988 to cite abstinence as the most important message they wished to convey (41% vs. 25%). In addition, steep declines occurred between 1988 and 1999, overall and across grade levels, in the percentage of teachers who supported teaching about birth control, abortion and sexual orientation, as well as in the percentage actually covering those topics. However; 39% of 1999 respondents who presented abstinence as the only option also told students that both birth control and the condom can be effective. Conclusions: Sexuality education in secondary public schools is increasingly focused on abstinence and is less likely to present students with comprehensive teaching that includes necessary information an topics such as birth control, abortion and sexual orientation. Because of this, and in spite of some abstinence instruction that also covers birth control and condoms as effective methods of prevention, many students are not receiving accurate information on topics their teachers feel they need.
