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Twenty-one percent of females and 35% of males did not receive instruction about methods of birth control from either formal sources or a parent.Declines in receipt of formal sex education and low rates of parental communication may leave adolescents without instruction, particularly in nonmetropolitan areas.

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National public health goals [5] and numerous medical and public health organizations [6,7] recommend that adolescents receive sex education on a range of topics.

However, past research has found increasing gaps in sex education; analyses of data from the National Surveys of Family Growth (NSFG) indicate that from 1995 to 2006–2008, the proportion of U. teens who had received formal instruction about birth control methods declined (males, 81% to 62%; females, 87% to 70%) [8,9].

More effort is needed to understand this decline and to explore adolescents’ potential other sources of reproductive health information.

Providing adolescents with sexual health information is an important means of promoting healthy sexual development and reducing negative outcomes of sexual behaviors [1–4].

There was a significant decline in males’ reports of instruction about birth control (61% to 55%).

Both genders had significant increases in the share reporting formal instruction in saying no to sex without instruction about birth control (22% to 28% females, 29% to 35% males).We limited the analyses to respondents aged 15–19 years at the time of the interview, resulting in samples of 2,284 and 1,037 females and 2,378 and 1,088 males in 2006–20–2013, respectively.Formal instruction: in both surveys, respondents were asked “Before you were 18, did you ever have any formal instruction at school, church, a community center or some other place about” the following topics: “how to say no to sex,” “methods of birth control,” “sexually transmitted diseases,” and “how to prevent HIV/AIDS.” Additionally, in the 2011–2013 survey, respondents were also asked about formal instruction on “waiting until marriage to have sex,” “where to get birth control,” and “how to use a condom.” The survey added these latter topics to address concerns that the earlier survey’s measures did not provide adequate information about the specific instructional content.All analyses accounted for the complex survey design of the NSFG data using the Among the weighted sample of respondents aged 15–19 years in 2006–20–2013, the majority were non-Hispanic white, aged 15–17 years and attended religious services often when they were aged 14 years ().About one-third resided in a central city, half in other metropolitan areas, and the remaining share in nonmetropolitan statistical areas.Respondents answering that they had received instruction in a particular topic received follow-up questions about whether instruction occurred before the first vaginal intercourse.

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