HIV education and health education in the United States: a national survey of local school district policies and practices.

To determine the extent to which HIV education and health education policies and practices are required by school districts in the United States, a national probability sample of public school districts was surveyed by mail in 1990. Of 2,150 districts selected, 78.1% responded. HIV education was required by 66.9% of districts. Of these, the percentage requiring HIV education increased by grade level from 29.7% in kindergarten to 82.3% in 7th grade, then declined to 37.3% by 12th grade. Districts that required HIV education most often addressed HIV-related prevention skills in the upper grade levels. Similar to requirements for HIV education, health education requirements also declined from 7th to 12th grade, reaching even lower levels than HIV education by the last two years of high school. These declines are of particular concern given that students are most likely to engage in risk behaviors when HIV and health education is least likely to be required. Other practices and policies that support HIV and health education also were lacking in many districts.