Exploring How Trauma Is Addressed in Sexual Education Programs for Youth: A Scoping Review

Background and Purpose: Greater exposure to adverse childhood experiences have been linked to higher risk sexual behaviors that increase the likelihood of contracting a sexually transmitted infection and early pregnancy.  While a trauma-focused approach to youth sexuality education has been recommended, there is a paucity of information about how trauma-focused interventions are utilized in sex education.  This study explores how the topic of trauma is addressed in the curriculum of sexuality education programs for youth. 

Methods:  A scoping literature review was selected as the appropriate methodological approach, as it is used in review studies that seek to address gaps in the literature where little to no research has been conducted.  A comprehensive search of PsychINFO, CINAHL Plus with Full Text, MEDLINE, Education Source, and Psychology and Behavioral Sciences Collection was conducted between March 1 – April 30, 2018.  All articles published between 2008-2018 of a non-review nature that were written in English, conducted in the United States, published in peer reviewed journals, and contained a description of a sexual education program geared towards youth were included.  Interventions were classified into two categories based on whether their main curricular focus used a comprehensive or abstinence-oriented approach to sexual education. Articles were analyzed to determine 1) whether the topic of trauma was included at all in the content of an intervention; and 2) if so, how it was addressed, in terms of breadth, depth, and context.

Results: Out of 169 articles, 29 met the inclusion criteria for a full review. Across all studies, the interventions were delivered to 54,698 adolescents and young adults ranging in age from 10-25 years-old.  Overall, 23% (n = 6) interventions addressed the topic trauma in any format, and all of these used a comprehensive approach.  Four interventions had curriculums that included trauma-focused topic areas such as masculinity and the cycle of violence, power imbalances and healthy behaviors in relationships, sexual consent and coercion, sexual harassment and rape, and dating violence.  One provided guidance for facilitators on delivering the intervention to youth affected by a history of sexual and/or gang-related violence in a trauma-informed manner.  Two studies focused on trauma in their outcome measures, which assessed skills for coping with violence and attitudes towards sexual coercion. 

Conclusions and Implications:  Despite the breadth of research that identifies childhood trauma as a risk factor for high risk sexual behavior, only a small portion of sexuality education programs addressed the topic of trauma in their curriculum.  Educators can broaden this reach by developing trauma-focused content that is compatible with existing curriculums.  Ongoing study is recommended to evaluate the impact of trauma-focused content on the sexual knowledge, attitudes, and behaviors of youth.