Sexuality education is a lifelong process that begins at birth. Parents, family, peers, partners, schools, religion, and the media influence the messages people receive about sexuality at all stages of life (Reis, 1981; Ansuini, 1996; Walker, 2006). Therefore, in today’s world, comprehensive school-based sexuality education that is appropriate to students` age, developmental level, and cultural background should be an important part of the education program at every grade. A comprehensive sexuality education program will respect the diversity of values and beliefs represented in the community and will complement and augment the sexuality education children receive from their families, religious and community groups, and health care professionals (Milton, 2000). Thus, the main goal of sexuality education is the promotion of sexual health by providing learners with the opportunities to develop a positive and factual view of sexuality and indeed sexual health (Action Health Incorporated, 2009). Borawski et al. (2015) identified the effectiveness of school-based health education offered by both classroom teachers and nurses. However, educational programs at schools for preventing STIs have often been implemented in many different ways (Mason-Jones, Sinclair, Mathews, Kagee, Hillman, and Lombard et al., 2016). In Japan, sexual health and relationships education (SHRE) was adapted in 1948 as a part of health and physical education. Young people in the period of secondary or high schools will need adequate and appropriate information and assurance about their physical and mental changes since young people are exposed to information related to sexuality from mass media which have much stronger influence (Ministry of Health, Labour and Welfare, 2017; Japanese Foundation for Sexual Health Medicine, 2017). In Akita Prefecture in Japan, for example, the effectiveness of school-based SHRE is reported in the context of teenage abortions (asuka_someyaChildren Publishers, 2015). However, the current school-based SHRE in many places in Japan has been unsuccessful in the context ofgiven the steady high cases in of teenage abortions and STIs among young people. According to the Ministry of Health, Labour and Welfare, STDs have remained relatively steady in the past 10 years from 2007 to 2016 in Japan (Figure 1). The most common are chlamydia, gonorrhea, herpes, and condyloma acuminata., and tThe prevalence by age for genital chlamydia is the third highest for women aged 15–19 indicating that the infection rate in the teens is relatively high (Ministry of Health, Labour and Welfare, 2017). Japanese Foundation for Sexual Health Medicine reported that a the number of young people who have had their first sexual experience in their teens had been decreasing since 2005 (Japanese Foundation for Sexual Health Medicine, 2017). However, the abortion rate (the number of abortions per 100 pregnancies) is the highest for women younger than 20 years of age. Some 60% of teenage pregnancies end in abortion in Japan (Ishiwata, 2011).
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