HIV Prevention Begins with Comprehensive Sex Ed

By Melissa Pintor Carnagey, LBSW

What was your sex education like growing up?

Was it inclusive of LGBTQ+ identities and experiences?

Did it leave you better prepared to navigate sexual decision-making?

Chances are, if you were living in Texas (and many other parts of the United States), your sexuality education was lacking, especially if you attended a public school.

Texas is currently in the process of updating their sexuality education standards, which has not been revised since 1998. Without accurate knowledge and skills, young people are more likely to stumble through sexual risks without the tools that keep them safer and better prepared. Texas’ high rates of HIV and STIs among young people, as well as high birth rates among teens, all speak to the need for improvements in sex education.

To illuminate the issue, Texas Freedom Network, an advocacy organization working to improve sex ed in Texas schools, has started a campaign sharing sex ed stories such as these:

“I did not receive a sex ed class in high school. My only sex ed experience came from a discussion with a coach in the boys’ locker room with all the other boys in my 6th grade class. After the discussion, we received a stick of deodorant and proceeded with our warm up routine.”

Another Texas adult shared:

“My main concern as a young queer Mexican American girl was that same-sex relationships were never mentioned. If it was mentioned, it was taboo and discouraged. It made me feel invisible. I didn’t know any of the risk in girl-girl relationships. I didn’t know what birth control was or that it even existed.”

Experiences like these have left many adults without the information and support needed to navigate their sexual health in safer, satisfying ways, let alone have the ability to confidently educate the next generation. It’s no wonder that Texas ranks third in the US for HIV diagnoses. Though HIV is a preventable infection, new diagnoses remain steady each year. The best pathway to prevention is through education.

Currently, Texas is one of 39 states that mandate sexuality and HIV education in public schools. This may sound positive, but a closer look reveals that when sex ed is taught, Texas requires it stress abstinence, with an emphasis on sex that is only within the construct of marriage. Texas’ sex education legislation also does not require the teachings to be medically accurate, culturally competent, inclusive of LGBTQ+ identities or to include consent education. The facts remain that in Texas, young people are not receiving the necessary knowledge and skills to thrive in their sexual health and sexual decision-making. 

How can we do better? By providing comprehensive sexuality education that is medically accurate, gender affirming, LGBTQ+ inclusive, consent-conscious and not fear-based. Furthermore, the education must be early and ongoing within a young person’s development. This means it cannot be limited to what may or may not be taught in schools. Parents and caregivers play an active role in being the primary sexual health influencers and educators.

There are local and national resources that can help families and educators tackle the talks. Organizations such as Amaze and Scarleteen provide trusted education online that is medically accurate, inclusive and youth-focused. For parents looking to increase their knowledge and confidence, Sex Positive Families and the Six Minute Sex Ed Podcast provide tools that strengthen sexual health conversations at every age and stage. For educators seeking sexuality education resources, curricula such as Unhushed, Advocates for Youth and Our Whole Lives offer comprehensive K-12 options.

Improving sexual health is a community effort not limited to HIV service organizations and health clinics. It’s about more than reducing the rate of HIV and STI transmission. Young people deserve to know their bodies; feel confident exploring their identities; learn the skills for navigating consent and safety; and, be clear about the risks and pleasures associated with relationships and sex. The work of sexual health promotion is not limited to HIV service organizations and health clinics. The answer begins early via comprehensive sexuality education for our young people.


Melissa Carnagey is a sexuality educator and social worker with over 10 years’ experience in the field of sexual health. Melissa began their career in HIV case management working for organizations such as The Wright House Wellness Center and AIDS Services of Austin before transitioning to macro-level work for the Texas Department of State Health Services in HIV/STI surveillance and public health follow-up. In 2017, Melissa transitioned to sexuality education with a desire to impact the sexual health of youth and families. Since then she has taught sex ed to hundreds of middle and high school students, bringing a dynamic energy, passion and commitment to inclusive, medically accurate, shame-free education and support for youth. She currently serves as the Training and Education Coordinator for EngenderHealth. Melissa is also the founder of Sex Positive Families, an organization that provides education and support to help parents and caring adults raise sexually healthy children. Through this platform, she facilitates workshops, speaking events, and leads engaged online communities, offering content and virtual learning spaces that strengthen sexual health talks within families. Their work has been featured in HuffPost, Parents Magazine, Mashable and Mother Magazine. Melissa graduated from St. Edward’s University with a Bachelor of Arts in Social Work and lives in Austin with her partner, Ryan, raising their three sex positive children ages 6-20.

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