Comprehensive sexuality education in Italian schools: preliminary results of a national project

Abstract Background WHO recommends comprehensive sexuality education (CSE) as a key tool to prevent negative sexual health outcomes, gender-based violence, and empower young people in sexual decision-making. School-based CSE is the most effective and equal way to promote healthier behaviours. In Italy, however, CSE is absent from school curricula. This study, funded by the Ministry of Health, investigates information uptake and attitudes toward sexuality among adolescents involved in a CSE intervention across seven Italian regions (Dec 2023-June 2025). Methods A 10-hour intervention conducted by trained professionals in health and education was implemented in a convenient sample of 49 lower and upper secondary schools (LSS/USS). The curriculum covered two main domains: Domain 1 (puberty, relationships, consent, sexual identities) and Domain 2 (STIs, contraception, health services). Students completed pre/post-tests assessing knowledge, attitudes, and satisfaction, using a Solomon 4-group design to compare intervention groups 1 and 3 with the other control groups. Group 1 and 2 compiled pre-tests. Results During first year, in LSS (n = 488), post-test Domain 1 improved only in Group 1 (p < 0.05), indicating limited knowledge gain and pre-test sensitisation. For Domain 2, significant gains were observed in both Group 1 and 3, with stronger effects in pre-tested Group 1. Among USS students (n = 540), the intervention significantly improved knowledge in both Domains (p < 0.05), regardless of pre-testing. Over 90% of students considered school the ideal setting for CSE and highly appreciated the project. Conclusions Results suggest that the CSE intervention has improved knowledge and positive attitudes towards sexuality, especially in the field of sexual health, although contextual adaptation is needed. Further evidence from qualitative and follow-up data will assess long-term impact and will be used to improve advocacy at policy level for the introduction of CSE in Italian schools. Key messages • School-based CSE represents a strategic tool to promote healthier sexual behaviours among young people and its implementation should be included in all school curricula. • Italian secondary school students highly appreciate CSE as it supports and enhance their knowledge and attitudes towards sexuality and allows them to freely discuss relevant topics of interest.