• Between 2006–20–2013, there were significant declines in adolescent females’ reports of having received formal instruction about birth control, STDs, HIV and AIDs, and saying no to sex.There was also a significant decline in adolescent males’ reports of having received formal instruction about birth control.• In 2011–2013, more than 80% of adolescents aged 15–19 had received formal instruction about STDs, HIV and AIDS or how to say no to sex.

• “Abstinence education” programs that promote abstinence-only-until-marriage—now termed “sexual risk avoidance” by proponents—have been described as “scientifically and ethically problematic.” They systematically ignore or stigmatize many young people and do not meet their health needs.

• Proponents of “sexual risk avoidance” programs have appropriated the terms “medically accurate” and “evidence-based,” though experts in the field agree that such programs are neither complete in their medical accuracy nor based on the widely accepted body of scientific evidence.

• Within each state, relatively few high schools offered instruction on HIV, STDs or pregnancy prevention specifically relevant to lesbian, gay, bisexual, transgender, queer or questioning (LGBTQ) youth in 2014; the proportion ranged from 11% in South Dakota to 56% in Vermont.

Adolescents may receive information about sexual health topics from a range of sources beyond formal instruction.

• There has been a shift toward evidence-based interventions in the United States over the last few decades.

The first dedicated federal funding stream for evaluation of adolescent sexual health programs was established in 2010 and has contributed to improvement in the quality and quantity of evaluation research.

• Both the American Medical Association and the American Academy of Pediatrics recommend that adolescents’ primary care visits include time alone with health care providers to discuss sexuality and receive counseling about sexual behavior.

• Despite these recommendations, only 45% of young people aged 15–17 reported in 2013–2015 that they spent time alone with a doctor or other health care provider during their most recent visit in the previous year.

• “Formal” sexual health education is instruction that generally takes place in a structured setting, such as a school, youth center, church or other community-based location.

This type of instruction is a central source of information for adolescents.

Digital media offer opportunities for youth to confidentially search for information on sensitive topics, and thus are a likely source of sexual health information for young people.