A Literature Review on the State of High School Sex Education Implemented by School Nurses

Abstract

Objective: In recent years, increases in sexually transmitted infections, cervical cancer caused by HPV, and abortions due to unwanted pregnancy among those in their 20s have become serious issues that threaten fertility. This study aims to identify issues in need of attention and the difficulties experienced by school nurses in teaching sex education in high schools preemptively before these students become sexually active in order to promote responsible sexual behaviors for the prevention of STIs. Method: ICHUSHI Web Ver. 5 and CiNii were queried for literature published between 2000 and May 2022. Search terms were “yōgokyōyu” [school nurses], “seikyōiku” [sex education], “seikansenshō” [sexually transmitted infections/diseases], and “kōkōsei” [high school students]. In addition, we limited the search to Japanese literature only, due to differences in cultural background and the roles of school nurses. Results & Observations: Sex education is taught by multiple faculty members and implemented into multiple subjects such as health & physical education and home economics. There are differences in the content taught by school nurses and other faculty. As specialists in health and hygienics, school nurses demonstrate high awareness and positive attitudes toward sex education. Additionally, while they play a central role in sex education, they face difficulties due to having no position in school health plans, differences in awareness among faculty, busy schedules, difficulty securing time, and failure to coordinate with other faculty. It is necessary to consider school-wide policies that systematize sex education as a continuous subject. Furthermore, while they have many opportunities to undertake consulting duties on sexuality, there is uncertainty among school nurses on their ability to meet student needs. Therefore, the development of teaching materials and opportunities for school nurses to improve their teaching skills is absolutely essential.