The percentage of students who learned about HIV and AIDS in school dropped to a two-decade low in Hawaii in 2015, according to a statewide health survey slated for release later this spring.

The Hawaii Youth Risk Behavior Survey, which is filled out anonymously in class every two years by middle and high school students, is one of the few steady indicators that policy-makers can use to monitor health risks and trends in behavior that adolescents might be reluctant to discuss openly.

Roughly 44 percent of middle school students in 2015 said they were taught about the diseases at public school — down from 85.7 percent in 1999. In high school, the percentage dropped from 90.6 in 1999 to 75.6 last year.

Those figures are expected to change substantially when the 2017 survey is passed out, after the Board of Education made significant policy changes last year to mandate that schools teach comprehensive and medically-accurate sex education.

But as the first academic year under the new policy draws near an end, it’s unclear just how many schools are offering comprehensive sex education or what challenges they may have to overcome to do so. 

Talking About Sex

Changing sex education in Hawaii was a tough sell last year, in the wake of public controversies over the University of Hawaii’s Pono Choices sex ed curriculum pilot.

Perhaps an even broader problem the Board of Education faced in addressing sex education last year though was the widespread confusion over what policies, laws, and curriculum requirements were already in place.

Board of Education members, legislators, and Department of Education officials all expressed differing opinions on what schools were required to teach. The result was an uneven mishmash of offerings from school to school.

There was also no accounting of which schools offered sex education, what curriculum they used, or how many students were enrolled in the classes.

The new BOE policy tried to resolve much of the confusion by making a clear mandate that schools provide “age-appropriate,” comprehensive and medically accurate sex education.

Sexual Health Education Policy 103.5 expanded what information students need to be provided, included an additional reference to HIV, and changed the name of the BOE policy from “Abstinence-based Education Policy.” The revised policy still calls for instruction to include education on abstinence, in addition to contraception, and methods of disease prevention.

It also made the Department of Education switch back to an “opt-out” system instead of asking parents to sign their children up for sex education — a policy the DOE put into place after the outcry over Pono Choices.

The shift in education policy was heralded last year by advocates of comprehensive sex education as a “big step” for Hawaii, while opponents like conservative state Rep. Bob McDermott called the decision a “travesty.”

One big unknown at the end of last year was what might be needed to help schools meet challenges like training additional teachers, purchasing new curriculum, and keeping parents informed about what kids would be learning.

“We have the policy in place. Now we have to get to the logistics of how to make that happen in every school,” Judith Clark, executive director of Hawaii Youth Services Network, told Civil Beat after the policy passed.

What’s Happening Now?

Department of Education officials say there haven’t been any issues with implementing the policy changes so far.

The DOE conducted trainings for staff in all eight district areas in the fall on implementation of the policy, instructional strategies, and ways to increase health literacy, DOE Spokeswoman Donalyn Dela Cruz said in an email.

According to Dela Cruz, most middle and high schools are teaching sexual health education this year. Any that are not are “actively working on including sexual health curriculum in the upcoming school year,” Dela Cruz wrote.

But there’s no way to concretely quantify how far along the state is with offering mandated sex education because the DOE doesn’t track which schools are teaching the subject or what curriculum they are using.

Policy implementation at the school level is up to the principals, who are expected as professional school officials to apply board policy in their schools consistently, Assistant Superintendent Suzanne Mulcahy said.

Schools have been availing themselves of training offered by the state DOE office and have also been purchasing new curriculum, Mulcahy said, both signs that schools are starting to implement the policy.

The lack of data or a system to monitor “the quality and fidelity of program implementation” is one of several challenges that the state might face in successfully implementing the new sexual health policy, according to a research article published last month in the Hawaii Journal of Medicine and Public Health.

Putting a data management system into place could help with tracking outcomes and comparing curriculum choices, Kathleen Johnson wrote in “The Current State of Sexual Health Education in Hawaii Public Schools.”

One way that the BOE tried to alleviate parental concerns about teaching the sensitive subject was to mandate that schools give parents access to a description of the school’s chosen sex ed curriculum and also post that description on the school website prior to the start of instruction.

Civil Beat checked the websites of 31 middle schools and high schools on Oahu and found references to sexual health education curriculum posted on eight of the 31.

Regardless of how many schools have changed their offerings, enrollment in sex education this year should likely increase simply by the switch back to an “opt-out” system.

For comparison, participation in the Youth Behavior Risk Survey increased substantially after the state stopped relying on teens to bring back a permission slip to allow them to participate and sent them home with an optional opt-out form for parents to fill out instead.

Clark, of the Hawaii Youth Services Network, said it would be unrealistic to expect all public schools to be offering sex education this year. But she points to a lack of any push for funding by the DOE as a possible sign that the department isn’t working as actively as it might to implement the policy.

Mulcahy contends that schools already have many of the resources they need, including access to professional development, online curriculum, and the expertise of health teachers already in place.

Full results from the YRBS Survey — along with national comparisons — will be posted in June. The next survey will be administered in 2017.