Abstinence

Sexual abstinence is sometimes promoted as a way to avoid the risks associated with sexual contact, though STIs may also be transmitted through non-sexual means, or by involuntary sex. HIV may be transmitted through contaminated needles used in tattooing, body piercing, or injections. Medical or dental procedures using contaminated instruments can also spread HIV, while some health-care workers have acquired HIV through occupational exposure to accidental injuries with needles.
Evidence dose not support the use of abstinence only sex education. It has been found to be ineffective in decreasing HIV risk in the developed world, and dose not decrease rates of unplanned pregnancy. It is thus often recommended that those using abstinence have condoms available as a backup for protection against STIs and pregnancy.

Some groups, notably some evangelical Christians and the Roman Catholic Church, oppose sex outside marriage and object to safe-sex education programs because they believe that providing such education promotes promiscuity. Contrary to these fears, comprehensive sex education, provision of contraceptives and family planning services does not increase sexual activity. Virginity pledges and sexual abstinence education programs are often promoted in lieu of contraceptives and safe-sex education programs. This may entail exposing some teenagers to increased risk of sexually transmitted infections, because about 60 percent of teenagers who pledge virginity until marriage do engage in pre-marital sex and are then one-third less likely to use contraceptives than their peers who have received more conventional sex education.

Ineffective methods

Most methods of contraception, except for certain forms of "outercourse" and the barrier methods, are not effective at preventing the spread of STIs. This includes the birth control pills, vasectomy, tubal ligation, periodic abstinence and all non-barrier methods of pregnancy prevention.
The spermicide Nonoxynol-9 has been claimed to reduce the likelihood of STI transmission. However, a recent study by the World Health Organization has shown that Nonoxynol-9 is an irritant and can produce tiny tears in mucous membranes, which may increase the risk of transmission by offering pathogens more easy points of entry into the system. Condoms with Nonoxynol-9 lubricant do not have enough spermicide to increase contraceptive effectiveness and are not to be promoted.

The use of diaphragm or contraceptive sponge provides some women with better protection against certain sexually transmitted diseases, but they are not effective for all STIs.
The hormonal protecting methods are by no means effective against transmission of STIs, even though they are more than 95% effective against unwanted pregnancies. Most common hormonal methods are the oral contraceptive pill, depoprogesterone, the vaginal ring and the patch.
The copper intrauterine device and the hormonal intrauterine device provide an up to 99% protection against pregnancies but no protection against STIs. Women with copper intrauterine device present however a greater risk of being exposed to any type of STI, especially gonorrhea or chlamydia.

Coitus interruptus (or "pulling out"), in which the penis is removed from the vagina, anus, or mouth before ejaculation, is not safe sex and can result in STI transmission. This is because of the formation of pre-ejaculate, a fluid that oozes from the urethra before actual ejaculation, may contain pathogens such as HIV. Additionally, the microbes responsible for some diseases, including genital warts and syphilis, can be transmitted through skin-to-skin contact, even if the partners never engage in oral, vaginal, or anal sexual intercourse.

Limitations

While the use of condoms can reduce transmission of HIV and other infectious agents, it does not do so completely. One study has suggested condoms might reduce HIV transmission by 85% to 95%; effectiveness beyond 95% was deemed unlikely because of slippage, breakage, and incorrect use. It also said, "In practice, inconsistent use may reduce the overall effectiveness of condoms to as low as 60–70%".^p. 40.
During each act of anal intercourse, the risk of the receptive partner acquiring HIV from HIV seropositive partners not using condoms is about 1 in 120. Among people using condoms, the receptive partner's risk declines to 1 in 550, a four- to fivefold reduction. Where the partner's HIV status is unknown, "Estimated per-contact risk of protected receptive anal intercourse with HIV-positive and unknown serostatus partners, including episodes in which condoms failed, was two thirds the risk of unprotected receptive anal intercourse with the comparable set of partners."

Other precautions

Acknowledging that it is usually impossible to have entirely risk-free sex with another person, proponents of safe sex recommend that some of the following methods be used to minimize the risks of STI transmission and unwanted pregnancy.

• Immunization against various viral infections that can be transmitted sexually. The most common vaccines are HPV vaccine, which protects against the most common types of human papillomavirus that cause cervical cancer, and the Hepatitis B vaccine. Immunization before initiation of sexual activity increases effectiveness.
• Male circumcision and HIV: Some research has suggested that male circumcision can reduce the risk of HIV infection in some countries. The World Health Organization cites the procedure as a measure against the transmission of HIV between women and men; some African studies have found that circumcision can reduce the rate of transmission of HIV to men by up to 60%. Some advocacy groups dispute these findings. In sub-Saharan Africa, at least, condom use and behavior change programs are estimated to be more efficient and much more cost-effective than surgical procedures such as circumcision.
• Periodic STI testing has been used to reduce STIs in Cuba and among pornographic film actors. Cuba implemented a program of mandatory testing and quarantine early in the AIDS epidemic. In the US pornographic film industry, many production companies will not hire actors without tests for Chlamydia, HIV and Gonorrhea that are no more than 30 days old-and tests for other STIs no more than 6 months old. AIM Medical foundation claims that program of testing has reduced the incidence of sexually transmitted infection to 20% of that of the general population. Douching with soap and water disrupts the vaginal flora it might increase risk of infection.
• Monogamy or polyfidelity, practiced faithfully, is very safe (as far as STIs are concerned) when all partners are non-infected. However, many monogamous people have been infected with sexually transmitted diseases by partners who are sexually unfaithful, have used injection drugs, or were infected by previous sexual partners; the same risks apply to polyfidelitous people, who face higher risks depending on how many people are in the polyfidelitous group.
• For those who are not monogamous, reducing the number of one's sexual partners, particularly anonymous sexual partners, may also reduce one's potential exposure to STIs. Similarly, one may restrict one's sexual contact to a community of trusted individuals—this is the approach taken by some pornographic actors and other non-monogamous people.
• When selecting a sexual partner, some characteristics can increase the risks for contracting sexually transmitted diseases. These include an age discordance of more than five years; having an STI in the past year;problems with alcohol; having had sex with other people in the past year.
• Communication with one's sexual partner(s) makes for greater safety. Before initiating sexual activities, partners may discuss what activities they will and will not engage in, and what precautions they will take. This can reduce the chance of risky decisions being made "in the heat of passion".
• If a person is sexually active with a number of partners, regular sexual health check-ups by a doctor, and on noticing unusual symptoms seeking prompt medical advice; HIV and other infectious agents can be either asymptomatic or involve nonspecific symptoms which on their own can be misdiagnosed.

Barrier Protection

 Various protective devices are used to avoid contact with blood, vaginal fluid, semen or other contaminant agents (like skin, hair and shared objects) during sexual activity. Sexual activity using these devices is called protected sex.

Condom machine

• Condoms cover the penis during sexual activity. They are most frequently made of latex, and can also be made out of synthetic materials including polyurethane.
• Female condoms are inserted into the vagina prior to intercourse.
• A dental dam (originally used in dentistry) is a sheet of latex used for protection when engaging in oral sex. It is typically used as a barrier between the mouth and the vulva during cunnilingus or between the mouth and the anus during anal–oral sex.
• Medical gloves made out of latex, vinyl, nitrile, or polyurethane may be used as an makeshift dental dam during oral sex, or to protect the hands during sexual stimulation, such as masturbation. Hands may have invisible cuts on them that may admit pathogens or contaminate the other body part or partner.
• Another way to protect against pathogen transmission is the use of protected or properly cleaned dildos and other sex toys. If a sex toy is to be used in more than one orifice or partner, a condom can be used over it and changed when the toy is moved.

When latex barriers are used, oil-based lubrication can break down the structure of the latex and remove the protection it provides.
Condoms (male or female) are used to protect against STIs, and used with other forms of contraception to improve contraceptive effectiveness. For example, simultaneously using both the male condom and spermicide (applied separately, not pre-lubricated) is believed to reduce perfect-use pregnancy rates to those seen among implant users. However, if two condoms are used simultaneously (male condom on top of male condom, or male condom inside female condom), this increases the chance of condom failure.
Proper use of barriers, such as condoms, depends on the cleanliness of surfaces of the barrier, handling can pass contamination to and from surfaces of the barrier unless care is taken.
Studies of latex condom performance during use reported breakage and slippage rates varying from 1.46% to 18.60%. Condoms must be put on before any bodily fluid could be exchanged, and they must be used also during oral sex.
Female condoms are made of two flexible polyurethane rings and a loose-fitting polyurethane sheath. According to laboratory testing, female condoms are effective in preventing the leakage of body fluids and therefore the transmission of STIs and HIV. Several studies show that between 50% and 73% of women who have used this type of condoms during intercourse find them as or more comfortable than male condoms. On the other hand, acceptability of these condoms among the male population is somewhat less, at approximately 40%. Because the cost of female condoms is higher than male condoms, there have been studies carried out with the aim of detecting whether they can be reused. Research has shown that structural integrity of polyurethane female condoms is not damaged during up to five uses if it is disinfected with water and household bleach. However, regardless of this study, specialists still recommend that female condoms are used only once and then discarded.

Non Penetrative Sex

A range of sex acts, sometimes called "outercourse", can be enjoyed with significantly reduced risks of infection or pregnancy. U.S. President Bill Clinton's surgeon general, Dr. Joycelyn Elders, tried to encourage the use of these practices among young people, but her position encountered opposition from a number of outlets, including the White House itself, and resulted in her being fired by President Clinton in December 1994.
Non-penetrative sex includes practices such as kissing, mutual masturbation, rubbing or stroking and, according to the Health Department of Western Australia, this sexual practice may prevent pregnancy and most STIs. However, non-penetrative sex may not protect against infections that can be transmitted skin-to-skin such as herpes and genital warts.

Avoiding physical contact

Known as autoeroticism, solitary sexual activity is relatively safe. Masturbation, the simple act of stimulating one's own genitalia, is safe so long as contact is not made with other people's bodily fluids. Some activities, such as "phone sex" and "cybersex", that allow for partners to engage in sexual activity without being in the same room, eliminate the risks involved with exchanging bodily fluids.

Terminology

The term safer sex in Canada and the United States has gained greater use by health workers, reflecting that risk of transmission of sexually transmitted infections in various sexual activities is a continuum. The term safe sex is still in common use in the United Kingdom and Australia.

Although "safe sex" is used by individuals to refer to protection against both pregnancy and HIV/AIDS or other STI transmissions, the term was primarily derived in response to the HIV/AIDS epidemic. It is believed that the term of "safe sex" was used in the professional literature in 1984, in the content of a paper on the psychological effect that HIV/AIDS may have on homosexual men. The term was related with the need to develop educational programs for the group considered at risk, homosexual men. A year later, the same term appeared in an article in the New York Times. This article emphasized that most specialists advised their AIDS patients to practice safe sex. The concept included limiting the number of sexual partners, using prophylactics, avoiding bodily fluid exchange, and resisting the use of drugs that reduced inhibitions for high-risk sexual behavior. Moreover, in 1985, the first safe sex guidelines were established by the 'Coalition for Sexual Responsibilities'. According to these guidelines, safe sex was practiced by using condoms also when engaging in anal or oral sex.
Although this term was primarily used in conjunction with the homosexual male population, in 1986 the concept was spread to the general population. Various programs were developed with the aim of promoting safe sex practices among college students. These programs were focused on promoting the use of the condom, a better knowledge about the partner's sexual history and limiting the number of sexual partners. The first book on this subject appeared in the same year. The book was entitled "Safe Sex in the Age of AIDS", it had 88 pages and it described both positive and negative approaches to the sexual life. Sexual behavior could be either safe (kissing, hugging, massage, body-to-body rubbing, mutual masturbation, exhibitionism and voyeurism, telephone sex, sado-masochism without bruising or bleeding, and use of separate sex toys); possibly safe (use of condoms); and unsafe.
In 1997, specialists in this matter promoted the use of condoms as the most accessible safe sex method (besides abstinence) and they called for TV commercials featuring condoms. During the same year, the Catholic Church in the United States issued their own "safer sex" guidelines on which condoms were listed, though two years later the Vatican urged chastity and heterosexual marriage, attacking the American Catholic bishops' guidelines.
A study carried out in 2006 by Californian specialists showed that the most common definitions of safe sex are condom use (68% of the interviewed subjects), abstinence (31.1% of the interviewed subjects), monogamy (28.4% of the interviewed subjects) and safe partner (18.7% of the interviewed subjects).
"Safer sex" is thought to be a more aggressive term which may make it more obvious to individuals that any type of sexual activity carries a certain degree of risk.
The term "safe love" has also been used, notably by the French Sidaction in the promotion of men's underpants incorporating a condom pocket and including the red ribbon symbol in the design, which were sold to support the charity.

Safe Sex

Safe sex is sexual activity engaged in by people who have taken precautions to protect themselves against sexually transmitted diseases (STDs) such as AIDS.It is also referred to as safer sex or protected sex, while unsafe or unprotected sex is sexual activity engaged in without precautions. Some sources prefer the term safer sex to more precisely reflect the fact that these practices reduce, but do not completely eliminate, the risk of disease transmission. In recent years, the term "sexually transmitted infections" (STIs) has been preferred over "STDs", as it has a broader range of meaning; a person may be infected, and may potentially infect others, without showing signs of disease.
Safe sex practices became more prominent in the late 1980s as a result of the AIDS epidemic. Promoting safe sex is now one of the aims of sex education. From the viewpoint of society, safe sex can be regarded as a harm reduction strategy aimed at reducing risks.

The risk reduction of safe sex is not absolute; for example the reduced risk to the receptive partner of acquiring HIV from HIV seropositive partners not wearing condoms to compared to when they wear them is estimated to be about a four- to fivefold.
Although some safe sex practices can be used as contraception, most forms of contraception do not protect against all or any STIs; likewise, some safe sex practices, like partner selection and low risk sex behavior, are not effective forms of contraception.

Modern Sex Manuals

Despite the existence of ancient sex manuals in other cultures, sex manuals were banned in Western culture for many years. What sexual information was available was generally only available in the form of illicit pornography or medical books, which generally discussed either sexual physiology or sexual disorders. The authors of medical works went so far as to write the most sexually explicit parts of their texts in Latin, so as to make them inaccessible to the general public. (See Krafft-Ebing's Psychopathia Sexualis as an example).
A few translations of the ancient works were circulated privately, such as The Perfumed Garden....
In the late 19th Century, Ida Craddock wrote many serious instructional tracts on human sexuality and appropriate, respectful sexual relations between married couples. Among her works were The Wedding Night and Right Marital Living. In 1918 Marie Stopes published Married Love, considered groundbreaking despite its limitations in details used to discuss sex acts.
Theodoor Hendrik van de Velde's book Het volkomen huwelijk (The Perfect Marriage), published in 1926 was well known in Netherlands, Germany, Sweden and Estonia. In Germany Die vollkommene Ehe reached its 42nd printing in 1932 despite its being placed on the list of forbidden books, Index Librorum Prohibitorum by the Roman Catholic Church. In Sweden, Det fulländade äktenskapet was widely known although regarded as pornographic and unsuitable for young readers long into the 1960s. In English, Ideal Marriage: Its Physiology and Technique has 42 printings in its original 1930 edition, and was republished in new editions in 1965 and 2000.
David Reuben, M. D.'s book Everything You Always Wanted to Know About Sex (But Were Afraid to Ask), published in 1969 was one of the first sex manuals that entered mainstream culture in the 1960s. Although it did not feature explicit images of sex acts, its descriptions of sex acts were unprecedentedly detailed, addressing common questions and misunderstandings Reuben had heard from his own patients. Most notably, Reuben dismissed popular medical-psychiatric notions of "vaginal" vs. "clitoral" orgasm, explaining exactly how female physiology works.
The Joy of Sex by Dr. Alex Comfort was the first visually explicit sex manual to be published by a mainstream publisher. Its appearance in public bookstores in the 1970s opened the way to the widespread publication of sex manuals in the West. As a result, hundreds of sex manuals are now available in print.
One of the currently most well known in America is The Guide to Getting it On by Paul Joannides. The Guide to Getting it On, now in its sixth edition, has won several prestigious awards and has been translated into 12 foreign languages since it first appeared in 1996.

Early sex manuals

The oldest sex manuals come from Asia. The oldest sex manual in the world is the Chinese Handbooks of Sex written 5,000 years ago by Emperor Huang-Ti (2697–2598 BCE). It is also believed that the Tao of Love Coupling originated from Huang-ti. A book entitled Su-Nui Ching, became the sexual bible and medical guidebook for many generations.
The Kama Sutra of Vatsyayana, believed to have been written in the 1st to 6th centuries, has a notorious reputation as a sex manual, although only a small part of its text is devoted to sex. It was compiled by the Indian sage Vatsyayana sometime between the second and fourth centuries CE. His work was based on earlier Kamashastras or Rules of Love going back to at least the seventh century BCE, and is a compendium of the social norms and love-customs of patriarchal Northern India around the time he lived. Vatsyayana's Kama Sutra is valuable today for his psychological insights into the interactions and scenarios of love, and for his structured approach to the many diverse situations he describes. He defines different types of men and women, matching what he terms "equal" unions, and gives detailed descriptions of many love-postures.
The Kama Sutra was written for the wealthy male city-dweller. It is not, and was never intended to be, a lover's guide for the masses, nor is it a "Tantric love-manual". About three hundred years after the Kama Sutra became popular, some of the love-making positions described in it were reinterpreted in a Tantric way. Since Tantra is an all-encompassing sensual science, love-making positions are relevant to spiritual practice.
In the Graeco-Roman area, a sex manual was written by Philaenis of Samos, possibly a hetaira (courtesan) of the Hellenistic period (3rd–1st century BCE). Preserved by a series of fragmentary papyruses which attest its popularity, it served as a source of inspiration for Ovid's Ars Amatoria, written around 3 BCE, which is partially a sex manual, and partially a burlesque on the art of love.
Medieval sex manuals include the lost works of Elephantis, by Constantine the African; Ananga Ranga, a 12th century collection of Hindu erotic works; and The Perfumed Garden for the Soul's Recreation, a 16th century Arabic work by Sheikh Nefzaoui. The fifteenth-century Speculum al foderi, or The Mirror of Coitus, is the first western work to discuss sexual positions. Constantine the African also penned a medical treatise on sexuality, known as Liber de coitu.

Sex Education in Virginia

Virginia uses the sex education program called The National Campaign to prevent teen and unplanned pregnancy. The National Campaign was created in 1996. The program focuses on preventing teen and unplanned pregnancies of young adults. The National campaign set a goal to reduce teen pregnancy rate by 1/3 in 10 years. The Virginia Department of Health ranked Virginia 19th in teen pregnancy birth rates in 1996. Virginia was also rated 35.2 teen births per 1000 girls aged 15–19 in 2006. The Healthy people 2010 goal is a teen pregnancy rate at or below 43 pregnancies per 1000 females age 15-17.

Sex Education in United States

Almost all U.S. students receive some form of sex education at least once between grades 7 and 12; many schools begin addressing some topics in grades 5 or 6. However, what students learn varies widely, because curriculum decisions are so decentralized. Many states have laws governing what is taught in sex education classes or allowing parents to opt out. Some state laws leave curriculum decisions to individual school districts.
For example, a 1999 study by the Guttmacher Institute found that most U.S. sex education courses in grades 7 through 12 cover puberty, HIV, STIs, abstinence, implications of teenage pregnancy, and how to resist peer pressure. Other studied topics, such as methods of birth control and infection prevention, sexual orientation, sexual abuse, and factual and ethical information about abortion, varied more widely.
Only two forms of sex education are taught in American schools: "abstinence plus" and abstinence-only. Comprehensive or "abstinence plus" sex education covers abstinence as a positive choice, but also teaches about contraception and avoidance of STIs when sexually active. A 2002 study conducted by the Kaiser Family Foundation found that 58% of secondary school principals describe their sex education curriculum as "abstinence plus".
Abstinence-only sex education tells teenagers that they should be sexually abstinent until marriage and does not provide information about contraception. In the Kaiser study, 34% of high-school principals said their school's main message was abstinence-only.
The difference between these two approaches, and their impact on teen behavior, remains a controversial subject. In the U.S., teenage birth rates had been dropping since 1991, but a 2007 report showed a 3% increase from 2005 to 2006. From 1991 to 2005, the percentage of teens reporting that they had ever had sex or were currently sexually active showed small declines. However, the U.S. still has the highest teen birth rate and one of the highest rates of STIs among teens in the industrialized world. Public opinion polls conducted over the years have found that the vast majority of Americans favor broader sex education programs over those that teach only abstinence, although abstinence educators recently published poll data with the opposite conclusion.
Proponents of comprehensive sex education, which include the American Psychological Association, the American Medical Association, the National Association of School Psychologists, the American Academy of Pediatrics, the American Public Health Association, the Society for Adolescent Medicine and the American College Health Association, argue that sexual behavior after puberty is a given, and it is therefore crucial to provide information about the risks and how they can be minimized; they also claim that denying teens such factual information leads to unwanted pregnancies and STIs.
On the other hand, proponents of abstinence-only sex education object to curricula that fail to teach their standard of moral behavior; they maintain that a morality based on sex only within the bounds of marriage is "healthy and constructive" and that value-free knowledge of the body may lead to immoral, unhealthy, and harmful practices. Within the last decade, the federal government has encouraged abstinence-only education by steering over a billion dollars to such programs. Some 25 states now decline the funding so that they can continue to teach comprehensive sex education. Funding for one of the federal government's two main abstinency-only funding programs, Title V, was extended only until December 31, 2007; Congress is debating whether to continue it past that date.
The impact of the rise in abstinence-only education remains a question. To date, no published studies of abstinence-only programs have found consistent and significant program effects on delaying the onset of intercourse. In 2007, a study ordered by the U.S. Congress found that middle school students who took part in abstinence-only sex education programs were just as likely to have sex (and use contraception) in their teenage years as those who did not. Abstinence-only advocates claimed that the study was flawed because it was too narrow and began when abstinence-only curricula were in their infancy, and that other studies have demonstrated positive effects.
According to a 2007 report, Teen pregnancies in the United States showed 3% increase in the teen birth rate from 2005 to 2006, to nearly 42 births per 1,000.

Virginia

Virginia uses the sex education program called The National Campaign to prevent teen and unplanned pregnancy. The National Campaign was created in 1996. The program focuses on preventing teen and unplanned pregnancies of young adults. The National campaign set a goal to reduce teen pregnancy rate by 1/3 in 10 years. The Virginia Department of Health ranked Virginia 19th in teen pregnancy birth rates in 1996. Virginia was also rated 35.2 teen births per 1000 girls aged 15–19 in 2006. The Healthy people 2010 goal is a teen pregnancy rate at or below 43 pregnancies per 1000 females age 15-17.

Sex Education in Scotland

The main sex education programme in Scotland is Healthy Respect, which focuses not only on the biological aspects of reproduction but also on relationships and emotions. Education about contraception and sexually transmitted diseases are included in the programme as a way of encouraging good sexual health. In response to a refusal by Catholic schools to commit to the programme, however, a separate sex education programme has been developed for use in those schools. Funded by the Scottish Government, the programme Called to Love focuses on encouraging children to delay sex until marriage, and does not cover contraception, and as such is a form of abstinence-only sex education.

Sex Education in England and Wales

In England and Wales, sex education is not compulsory in schools as parents can refuse to let their children take part in the lessons. The curriculum focuses on the reproductive system, fetal development, and the physical and emotional changes of adolescence, while information about contraception and safe sex is discretionary and discussion about relationships is often neglected. Britain has one of the highest teenage pregnancy rates in Europe and sex education is a heated issue in government and media reports. In a 2000 study by the University of Brighton, many 14 to 15 year olds reported disappointment with the content of sex education lessons and felt that lack of confidentiality prevents teenagers from asking teachers about contraception. In a 2008 study conducted by YouGov for Channel 4 it was revealed that almost three in ten teenagers say they need more sex and relationships education.

Sex Education in Slovak Republic

In Slovak republic / Slovakia the content of Sex education varies from school to school, mostly being led by a teacher for a subject which translated to English would be Nature science (The subject covers biology and petrology). The quality of explanation also varies from teacher to teacher and it is not uncommon that the teacher relies on students asking questions. Classes are usually divided into boys/girls, where girls are usually explained the necessary facts about menstruation and pregnancy. Boys are shown a picture of genitalia anatomy with description and may ask questions. Generally is the sex ed level in Slovakia quite poor, though the level actually varies from school to school and reason lies as mentioned above somewhere in the issues of the school or the teacher.

Sex Education in Switzerland

In Switzerland, the content and amount of sex education is decided at the cantonal level. In Geneva, courses have been given at the secondary level since the 1950s. Interventions in primary schools were started more recently, with the objective of making children conscious of what is and isn't allowed, and able to say "No". In secondary schools (age 13-14), condoms are shown to all pupils, and are demonstrated by unfolding over the teacher's fingers. For this, classes are usually separated into girl-only and boy-only subgroups. Condoms are not distributed, however, except among older adolescents engaged in state-run non-compulsory education (age 16-17).

Sex Education in Sweden

In Sweden, sex education has been a mandatory part of school education since 1956. The subject is usually started between ages 7 and 10, and continues up through the grades, incorporated into different subjects such as biology and history.

Sex Education in The Netherlands

Subsidized by the Dutch government, the “Lang leve de liefde” (“Long Live Love”) package, developed in the late 1980s, aims to give teenagers the skills to make their own decisions regarding health and sexuality. Nearly all secondary schools provide sex education as part of biology classes and over half of primary schools discuss sexuality and contraception. The curriculum focuses on biological aspects of reproduction as well as on values, attitudes, communication and negotiation skills. The media has encouraged open dialogue and the health-care system guarantees confidentiality and a non-judgmental approach. The Netherlands has one of the lowest teenage pregnancy rates in the world, and the Dutch approach is often seen as a model for other countries.

Sex Education in Poland

In the Western point of view, sex education in Poland has never actually developed. At the time of the People's Republic of Poland, since 1973, it was one of the school subjects, however, it was relatively poor and did not achieve any actual success. After 1989, it practically vanished from the school life - it is currently an exclusive subject (called wychowanie do życia w rodzinie/family life education rather than edukacja seksualna/sex education) in several schools their parents must give consent to the headmasters so their children may attend. It has much due to the strong objection against sex education of the Catholic Church; the most influential institution in Poland.
It has, however, been changed and since September 2009 sex education will become an obligatory subject in the number of 14 per school year - unless parents do not want their children to be taught. Objecting parents will have to write special disagreements.

Sex Education in Germany

In Germany, sex education has been part of school curricula since 1970. Since 1992 sex education is by law a governmental duty.
It normally covers all subjects concerning the growing-up process, body changes during puberty, emotions, the biological process of reproduction, sexual activity, partnership, homosexuality, unwanted pregnancies and the complications of abortion, the dangers of sexual violence, child abuse, and sex-transmitted diseases, but sometimes also things like sex positions. Most schools offer courses on the correct usage of contraception.
A sex survey by the World Health Organization concerning the habits of European teenagers in 2006 revealed that German teenagers care about contraception. The birth rate among 15- to 19-year-olds was very low - only 11.7 per 1000 population, compared to the UK's 27.8 births per 1,000 population, and—in first place—Bulgaria's 39.0 births per 1,000. but it is considered high by Asian standards.
German Constitutional Court and, in 2011, the European Court of Human Rights rejected complaints from several Baptists against Germany concerning mandatory sex education.

Sex Education in France

In France, sex education has been part of school curricula since 1973. Schools are expected to provide 30 to 40 hours of sex education, and pass out condoms, to students in grades eight and nine. In January 2000, the French government launched an information campaign on contraception with TV and radio spots and the distribution of five million leaflets on contraception to high school students.

Sex Education in Finland

In Finland, sexual education is usually incorporated into various obligatory courses, mainly as part of biology lessons (in lower grades) and later in a course related to general health issues. The Population and Family Welfare Federation provides all 15-year-olds an introductory sexual package that includes an information brochure, a condom and a cartoon love story.

Sex Education in Asia

Asia

The state of sex education programs in Asia is at various stages of development. Indonesia, Mongolia, South Korea have a systematic policy framework for teaching about sex within schools. Malaysia and Thailand have assessed adolescent reproductive health needs with a view to developing adolescent-specific training, messages and materials. India has programs aimed at children aged nine to sixteen years. In India, there is a huge debate on the curriculum of sex education and whether it should be increased. Attempts by state governments to introduce sex education as a compulsory part of the curriculum have often been met with harsh criticism by political parties, who claim that sex education "is against Indian culture" and would mislead children. (Bangladesh, Myanmar, Nepal and Pakistan have no coordinated sex education programs.
In Japan, sex education is mandatory from age 10 or 11, mainly covering biological topics such as menstruation and ejaculation.
In China and Sri Lanka, sex education traditionally consists of reading the reproduction section of biology textbooks. In Sri Lanka they teach the children when they are 17–18 years. However, in 2000 a new five-year project was introduced by the China Family Planning Association to "promote reproductive health education among Chinese teenagers and unmarried youth" in twelve urban districts and three counties. This included discussion about sex within human relationships as well as pregnancy and HIV prevention.
The International Planned Parenthood Federation and the BBC World Service ran a 12-part series known as Sexwise, which discussed sex education, family life education, contraception and parenting. It was first launched in South Asia and then extended worldwide.

Sex Education in Africa

Sex education in Africa has focused on stemming the growing AIDS epidemic. Most governments in the region have established AIDS education programs in partnership with the World Health Organization and international NGOs. These programs were undercut significantly by the Global Gag Rule, an initiative put in place by President Ronald Reagan, suspended by President Bill Clinton, and re-instated by President George W. Bush. The Global Gag Rule "...required nongovernmental organizations to agree as a condition of their receipt of Federal funds that such organizations would neither perform nor actively promote abortion as a method of family planning in other nations...." The Global Gag Rule was again suspended as one of the first official acts by United States President Barack Obama. The incidences of new HIV transmissions in Uganda decreased dramatically when Clinton supported a comprehensive sex education approach (including information about contraception and abortion)^. According to Ugandan AIDS activists, the Global Gag Rule undermined community efforts to reduce HIV prevalence and HIV transmission.
Egypt teaches knowledge about male and female reproductive systems, sexual organs, contraception and STDs in public schools at the second and third years of the middle-preparatory phase (when students are aged 12–14). A coordinated program between UNDP, UNICEF, and the ministries of health and education promotes sexual education at a larger scale in rural areas and spreads awareness of the dangers of female genital cutting.