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108. A Latent Class Analysis of Sexuality Education Type and Effect on Sexual Health Outcomes Among Adolescents in the United States: Results from a Nationally Representative Study

      Purpose

      Although school-based sexuality education (sex ed) is known to widely vary in content across the United States, no nationally representative research examines the types of sex ed received by adolescents. We used latent class analysis (LCA) to examine patterns of sex ed in a nationally representative sample of U.S. adolescents 14-17 years of age.

      Methods

      Data were derived from an adolescent subsample (N=614, ages 14-17) of the 2016 National Survey of Porn Use, Relationships, and Sexual Socialization (Iposos Research: Menlo Park, CA, USA). LCA (MPlus v.1.8.6) was used to identify and classify patterns in receipt (no/yes) of 15 different sexual health topics in school (condom/contraception, STIs, pornography, sexual pleasure, anatomy, sexual communication with partner/parents/doctor, sexual assault/consent, gender and sexual identity, how to say yes/no to sex). We then used weighted multinomial logistic regression (SPSS, v. 28.0; all p<.05) to evaluate the odds of: 1) class membership [referent: no form of sex ed] as a function of background measures: gender (male/female), school grade (9th[referent]/10th/11th/12th), sexual minority (no/yes), ethnicity (white/minority), school type (public/non-public), metropolitan location (urban/rural), region (midwest/south/west/northeast[referent]); and 2) sex ed typology on sexual health outcomes: condom use at last sex (yes/no), sexting (yes/no), relationship happiness (very unhappy - perfect), and recency (never - past 30 days) of kissing, solo masturbation, performative oral sex, receptive oral sex, vaginal sex, receptive anal sex, anal use of sex toys.

      Results

      LCA results supported a 6-class solution of sex ed: Comprehensive (CSE: 13.3%; all topics reported), Partially Comprehensive (PCSE: 23.5%), STIs/condoms/OCPs/anatomy (SCOASE: 22.39%), STIs/condoms/OCPs (SCOSE: 21.66%), STIs/anatomy only (SASE: 6.78%), and no form of sex ed (NoSE: 12.3%[referent]). CSE was more common in older grades and metropolitan areas (OR=1.41-5.26). SCOSE was more likely among White, metropolitan, non-public, and Midwestern students (OR=2.21-4.59). PCSE was more likely in non-public schools (OR=6.71). Adolescents receiving CSE, SCOASE or SCOSE (OR=0.23-0.43) had more recent kissing experience; those with CSE, PC or SCOASE (OR=0.35-0.38) had more recent experience with solo masturbation. Adolescents receiving SCOASE had more recent receptive oral sex (OR=0.35). More recent sexting was associated with receiving CSE or SCOASE (OR=3.50-4.79). Class membership was not linked to condom use, number of past year partners or relationship outcomes.

      Conclusions

      LCA supports six classes of sexuality education ranging from none to comprehensive with varying associated sexual behaviors. Further research evaluating the role of sex ed on sexual health outcomes in adolescents is warranted.

      Sources of Support

      None.