The purpose of this study was to assess changes in knowledge and attitudes before and after a large-scale sex education curriculum that was implemented by an academic medical center.

Middle school students were surveyed regarding demographics, knowledge, attitudes, and behaviors. All grade levels at each campus completed a presurvey on the same day before any of the 2-week curricula were received. Postsurveys were taken on the day after the last lesson.

Surveys were completed by 26,125 students before and 24,550 students after a sex education curriculum. Knowledge improved (P < .001) for all grades, based on paired comparisons for each group. Although most students chose the option to wait until after high school graduation to have sex, significantly more students held this opinion after the program (P < .0001). Variables that were associated with the attitude of delaying sex included making a pledge (odds ratio, 7.4; 95% CI, 6.7-8.2), original parents still married (odds ratio, 1.6; 95% CI, 1.1-2.1), attending weekly religious/church services (odds ratio, 1.5; 95% CI, 1.3-1.6), and watching 0 to 2 hours of television on school nights (odds ratio, 1.4; 95% CI, 1.2-1.5). Self-reported “less than C” students showed the least knowledge improvement and the belief that teens should “have sex whenever they want” at a greater percentage than other academic levels.

Implementation of a sex education curriculum by an academic medical center to adolescents resulted in increased knowledge and a shift in attitude toward delaying sexual activity.