All ETDs from UAB

Advisory Committee Chair

Nicole Wright

Document Type


Date of Award


Degree Name by School

Master of Science in Public Health (MSPH) School of Public Health


Background: Sexual health education is associated with better outcomes among adolescents proper use of contraception, STI prevention methods, and lower rates of teenage pregnancy and STIs. In Alabama, sexual health education is not mandated in public schools. It is unknown how the lack of mandated sexual education has impacted trends in the sexual health of Alabama high school students. Methods: Using 2011-2021 data from the Youth Risk Behavior Survey (YRBS), this study evaluated trends in sexual behaviors, including: 1) sexual history, 2) current sexual activity, 3) risky or protective sexual behaviors, and 4) history of HIV testing, over time among Alabama high school students. Chi-Square tests were used to evaluate differences in demographics and sexual health variables over time. Logistic and linear regressions were used to examine trends in the sexual health variables over the study period, with interaction terms between the demographic variables and study year to evaluate if trends over time differed by demographic factors. Results: The 2011-2021 YRBS data included 6,956 students from Alabama, with no significant differences in the study population based on sex (p=1.000), race (p=0.624), or grade (p=1.000) over the study period.. There were significant declines in reported rates of students ever having sexual intercourse (OR 0.89; 95% CI 0.87-0.91), being currently sexually active (OR: 0.90, 95% CI: 0.87-0.92), and HIV testing (OR: 0.91; 95% CI: 0.85-0.98), and a significant increase in the number of students reporting only one lifetime sexual partner (Beta: 1.45; p-value: 0.008) over the study period. There were no significant changes in reported age at first sexual intercourse, use of drugs or alcohol before last sexual intercourse, condom use, or birth control pill use. Conclusion: This study observed declines in reported rates of students ever having sexual intercourse, being currently sexually active, and having ever been tested for HIV, but overall there was little improvement in the state of sexual health among adolescents within Alabama in recent years. Future research is needed to examine the barriers regarding sexual health education and access to resources for this population, as well as possible interventions to combat these barriers.

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