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However, research on school-based sex education is limited in many developing countries, including Nepal. This study thus had two main objectives: (1) to assess students\u2019 evaluation of school-based sex education, and (2) to examine the associations between students\u2019 evaluations of school-based sex education and their (a) attitudes toward abstinence and (b) intentions for safer sex.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This cross-sectional study was conducted among 634 students from six schools in the Kathmandu Valley during May\u2013June 2010. We used a self-administered questionnaire to assess students\u2019 evaluations of school-based sex education, attitudes toward abstinence, and intentions for safer sex. The data were then analyzed using multiple linear regression models.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Regarding \u201cinformation on HIV and sexual health\u201d, many students perceived that they received the least amount of information on HIV counseling and testing centers (mean 2.29, SD 1.00) through their schools. In terms of \u201csupport and involvement of teachers and parents\u201d in sex education, parents\u2019 participation ranked as the lowest (mean 1.81, SD 1.01). Audiotapes were reported as the least used among the listed \u201cteaching aids for sexual health education\u201d (mean 1.54, SD 0.82). In multivariate analysis, receiving more \u201cinformation on HIV and sexual health\u201d was positively associated with more positive \u201cattitudes toward abstinence\u201d (\u03b2\u2009=\u20090.11, p\u2009=\u2009&lt;0.018) and greater \u201cintentions for safer sex\u201d (\u03b2\u2009=\u20090.17, p\u2009=\u2009&lt;0.001) among students. Similarly, increased \u201csupport and involvement from teachers and parents\u201d was also positively associated with more positive \u201cattitudes toward abstinence\u201d (\u03b2\u2009=\u20090.16, p\u2009=\u2009&lt;0.001) and greater \u201cintentions for safer sex\u201d (\u03b2\u2009=\u20090.15, p\u2009=\u2009&lt;0.002).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our results suggest that students\u2019 needs and expectations regarding HIV and sexual health education are not being met through their schools. Moreover, comprehensive information on HIV and sexual health along with increased support and involvement of teachers and parents in sex education might help to improve adolescents\u2019 attitudes toward abstinence and intentions for safer sex. Adapting future school-based interventions to incorporate such elements may thus be an effective strategy to promote adolescent sexual health.<\/jats:p><\/jats:sec>","DOI":"10.1186\/1471-2458-13-244","type":"journal-article","created":{"date-parts":[[2013,3,20]],"date-time":"2013-03-20T07:14:01Z","timestamp":1363763641000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Better learning in schools to improve attitudes toward abstinence and intentions for safer sex among adolescents in urban Nepal"],"prefix":"10.1186","volume":"13","author":[{"given":"Rachana Manandhar","family":"Shrestha","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keiko","family":"Otsuka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Krishna C","family":"Poudel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junko","family":"Yasuoka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Medin","family":"Lamichhane","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masamine","family":"Jimba","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2013,3,20]]},"reference":[{"key":"5137_CR1","volume-title":"The impact of the HIV\/AIDS epidemic on the education sectors in Sub-Saharan Africa. 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