(76) Let’s Talk About Sex: College Students’ Experiences of School-Based Sex Education in Hawaii – A Qualitative Study

Background: Medically accurate, comprehensive sex education has many benefits, including lower rates of sexually transmitted infections, unintended pregnancy, and intimate partner violence. This descriptive study aimed to understand the current strengths and weaknesses of school-based sex education and gather insights for future improvement.

Methods: We conducted semi-structured focus groups with students aged 18 or 19 who graduated from a high school in Hawaii and were currently enrolled at University of Hawaii college campuses. Participants were recruited via social media and email fliers distributed to University of Hawaii undergraduate instructors. Focus groups were led by an obstetrician-gynecologist and focused on participants’ experiences with sex education, including content, instructors, information sources, and teaching approaches. Focus groups continued until thematic saturation was reached and were analyzed using a grounded theory approach through the iterative content analysis process using the qualitative software ATLAS.ti Mac (Version 22.0.6.0). This study was approved by the University of Hawaii Institutional Review Board (CHS #2017-00770).

Results: We interviewed a total of 24 young people in 8 focus groups. We identified seven major themes: (1) Discussing sex with parents was embarrassing and awkward, even when parents were open to the discussion; (2) Sex education was not inclusive of lesbian, gay, bisexual, transgender, and queer individuals; (3) Teaching techniques varied, with more memorable techniques including props, demonstrations, and gender separation; (4) Sex education content centered on abstinence brought out feelings of shame and fear in students; (5) Students were resourceful, seeking information from other sources, particularly the internet, when not in the curriculum; (6) instructors should be comfortable, knowledgeable, and educated on the subject matter; and (7) comprehensive sex education should be age-appropriate, inclusive, medically accurate, and provided throughout the educational curriculum.

Conclusions: These results demonstrate that sex education remains narrow in scope, focused on abstinence, limited to heterosexual relationships, and minimally useful for students, both when they receive it and into the future. Students desire medically accurate sex education provided by knowledgeable instructors that includes attention to non-heterosexual relationships and is provided through the school curriculum with age-appropriate content. These insights highlight the role that young people can play in improving school-based sexual health education to better address their reproductive needs.