dedicated public STD clinics. Ideally, all adolescents should be immunized before they become sexually active.
Therefore, the committee makes the following recommendations:
- All school districts in the United States should ensure that schools provide essential, age-appropriate STD-related services, including health education, access to condoms, and readily accessible and available clinical services, such as school-based clinical services, to prevent STDs. Ultimately, parents, teachers, health professionals, and others in the community should decide what kinds of instruction and services are most appropriate for specific grade levels. Specifically, school districts should:
- require that information regarding the prevention of STDs, including HIV infection, and unintended pregnancy be part of required health education instruction for all students. Such instruction should be part of a comprehensive health education curriculum that is sequential, age appropriate, and given every year. Instruction regarding STDs, including HIV infection, and unintended pregnancy should start before adolescents in the school become sexually active. Because the quality of health education in schools is currently variable, schools should modify and implement model programs, such as those identified and evaluated by the CDC or other organizations. Public health departments and nongovernmental, voluntary organizations should assist departments of education in developing or modifying health education curricula for local needs and in evaluating and disseminating effective school-based curricula and other interventions to reduce high-risk sexual behaviors. In addition, state and local departments of education should support or provide training for teachers and school administrators involved in instructing or advising students regarding STDs;
- ensure that condoms are available to students as part of a comprehensive STD prevention program. Condoms should be made available along with information regarding sexual decision-making, including delaying of sexual intercourse. Condom availability programs should also include instruction on proper use of the condom and should have an evaluation component to assess effectiveness. Local health departments, health plans, and other private sector organizations should form partnerships with schools to establish and maintain these and other STD prevention programs; and
- ensure that school-based and school-linked health clinics provide STD-related clinical services, such as counseling for high-risk sexual behaviors; screening, diagnosis, and treatment of STDs; and hepatitis B immunization for all students. Health plans should develop collaborative agreements with school-based and school-linked clinics, including payment for confidential STD-related services for plan enrollees that are provided by such clinics. Schools should work with local health plans to ensure fair reimbursement rates and confidentiality of