State Profiles

U.S. Territories: Puerto Rico and other Caribbean Islands Profile

About the U.S. Territories

There are currently two inhabited U.S. territories in the Caribbean Sea: Puerto Rico and the U.S. Virgin Islands. People living in U.S. territories have a unique relationship to the U.S. government. Residents in U.S. territories are either considered “U.S. nationals” or citizens, but cannot vote for the President of the United States, and they do not have full representation in the U.S. Congress. Territorial infrastructure is generally inferior to that of the continental U.S. and Hawaii, and poverty rates are higher in the territories than in the states.

Sex ed in the Caribbean Sea


U.S. Virgin Islands (U.S. Territory)
U.S. Virgin Islands Code, Title XVII Ch.5, § 41, requires sex education, including AIDS prevention education, to be a component of the health curriculum taught to students in grades K–12.

Puerto Rico’s Sex Education Snapshot

Puerto Rico’s ongoing economic crisis, paired with 2017’s catastrophic Hurricane Maria, has drastically reduced access to sexual and reproductive health care services and education for Puerto Rico residents. In addition, the Puerto Rico Department of Education has taken recent restrictive action to limit access to more comprehensive sex education instruction by recently revoking the policy that would have included instruction on gender inequality, interpersonal violence, sexual orientation, and gender identity. The initiative was approved under the previous administration. Despite this restrictive action, advocates note that the Department of Education facilitates a comprehensive approach to sex education along with the Positive Youth Development program. The Positive Youth Development program highlights the voices of young people and encourages active participation in efforts to improve the health of young people. To advance sex education in Puerto Rico, advocates recommend that the Department of Education review and amend current regulations to require comprehensive sex education in health courses.

While schools in Puerto Rico are required to teach sex education, curriculum is largely determined by each school district. Such discretion in sex education curriculum allows for the implementation of policies and curriculum that stigmatize marginalized youth, such as LGBTQ youth, and presents further challenges in ensuring that low income districts have access to resources to implement comprehensive sex education. Educators report teaching primarily abstinence-based lessons from textbooks that are outdated and in poor condition. They note an urgent need for updated curriculum and course materials. Outdated curriculum is one of many barriers to advancing sex education in Puerto Rico. Advocates report that the Department of Education’s removal of the gender perspectives curriculum policy, conservative community and legislative perspectives, and bureaucracy in implementing advanced policies all inhibit young people from accessing advanced sex education.

To address these barriers in education, organizations such as Profamilias, an affiliate of the International Planned Parenthood Federation, provide comprehensive sex education in schools and additional resources for youth. The Maternal Child and Adolescent Health (MCAH) Division in the Puerto Rico Department of Health also offers comprehensive sex education along with a locally developed curriculum for the Youth Health Promoter’s Program. Further, the Youth Advisory Council is currently developing a web page to act as a resource for information on health and wellness, including resources related to reproductive health. Taller Salud, a community based feminist organization in Loíza, also facilitates sexual and reproductive education programming for young people.

Advocates note that the culture of shame and stigma surrounding sexuality in many communities must first be addressed, and individuals seeking to advance sex education can debunk misconceptions concerning sexuality and comprehensive sex education. After contacting their local school board, advocates can determine what topics are missing from sex education instruction, such as trauma informed, medically accurate instruction on consent, sexual orientation and gender identity, and contraceptives. They can then vocalize the important need for advancing sex education requirements in their community.  Further, advocates can contact their representatives to discuss the critical need for the Department of Education to review and amend current regulations to require comprehensive sex education in health courses.

State Sex Education Policies and Requirements at a Glance

  • Schools in Puerto Rico are required to teach sex education.
  • Curriculum is not required to be comprehensive.
  • Puerto Rico has no standard regarding instruction on abstinence. However, the health education standards include discussion on abstinence.
  • Curriculum is not required to include instruction on sexual orientation or gender identity.
  • Curriculum is not required to include instruction on consent.
  • Puerto Rico does not require parental permission for students to participate in sex education, and statute does not entail whether or not parents and guardians can remove their children from sex education courses.
  • Puerto Rico has no standard regarding medically accurate sex education.

Puerto Rico Law

Puerto Rico’s Title 3 Chapter 9A subchapter III § 144c-d requires schools to implement sex education programs for students. These programs shall “emphasize the physiological and emotional aspects of sexual relations, as well as the family responsibilities related thereto, and the risks entailed as a result of these relationships.” Additionally, the law states that schools shall “provide information and orientation to the students on the sexual development of human beings; family relations; problems of adolescence; personal finances; and on any other topics that the school or the Secretary deem are pertinent.” Puerto Rico does not require parental permission for students to participate in sexuality or HIV/AIDS education, nor does it say whether parents or guardians may remove their children from such classes.

Puerto Rico Standards

Puerto Rico’s Programa de Salud Escolar (health education standards) include discussion on abstinence, safer-sex practices, and avoiding sexually transmitted diseases (STDs) and HIV.

Puerto Rico Legislative Activity

State legislative activity related to sex education does not take place in isolation from the broader embroiled political and policy climate. Attacks on the rights of lesbian, gay, bisexual, transgender, queer, or questioning (LGBTQ) individuals, and efforts to limit access to abortion care and other reproductive health care services prevent students from receiving comprehensive sex education and accessing sexual and reproductive health care services. Below are highlights of current legislative activity related to these topics. Puerto Rico’s 2020 legislative session convened January 13, 2020 and the 2019 session adjourned on November 30, 2019.

Youth Sexual Health Data

Young people are more than their health behaviors and outcomes. While data can be a powerful tool to demonstrate the sex education and sexual health care needs of young people, it is important to be mindful that these behaviors and outcomes are impacted by systemic inequities present in our society that affect an individual’s sexual health and well-being. To learn more about Puerto Rico’s Youth Risk Behavior Survey (YRBS) results, click here.

State School Health Profiles Data

In 2019, the Centers for Disease Control and Prevention (CDC) released the School Health Profiles, which measure school health policies and practices and highlight which health topics were taught in schools across the country. Since the data were collected from self-administered questionnaires completed by schools’ principals and lead health education teachers, the CDC notes that one limitation of the School Health Profiles is bias toward the reporting of more positive policies and practices. In the School Health Profiles, the CDC identifies 20 sexual health education topics as critical for ensuring a young person’s sexual health.

Puerto Rico did not participate in the 2018 School Health Profiles. Below are key instruction highlights for secondary schools in Puerto Rico as reported for the 2015–2016 school year. In this edition of the School Health Profiles, the CDC identified 19 sexual health education topics and has since updated the number of topics to 20.

Reported teaching all 19 critical sexual health education topics

  • 37.9% of Puerto Rico secondary schools taught students all 19 critical sexual health education topics in a required course in any of grades 6, 7, or 8.
  • 65% of Puerto Rico secondary schools taught students all 19 critical sexual health education topics in a required course in any of grades 9, 10, 11, or 12.

Reported teaching about the benefits of being sexually abstinent

  • 91.8% of Puerto Rico secondary schools taught students about the benefits of being sexually abstinent in a required course in any of grades 6, 7, or 8.
  • 93.7% of Puerto Rico secondary schools taught students about the benefits of being sexually abstinent in a required course in any of grades 9, 10, 11, or 12.

Reported teaching how to access valid and reliable information, products, and services related to HIV, other STDs, and pregnancy

  • 82.8% of Puerto Rico secondary schools taught students how to access valid and reliable information, products, and services related to HIV, other STDs, and pregnancy in a required course in any of grades 6, 7, or 8.
  • 88.6% of Puerto Rico secondary schools taught students how to access valid and reliable information, products, and services related to HIV, other STDs, and pregnancy in a required course in any of grades 9, 10, 11, or 12.

Reported teaching how to create and sustain healthy and respectful relationships

  • 86.8% of Puerto Rico secondary schools taught students how to create and sustain healthy and respectful relationships in a required course in any of grades 6, 7, or 8.
  • 92.6% of Puerto Rico secondary schools taught students how to create and sustain healthy and respectful relationships in a required course in any of grades 9, 10, 11, or 12.

Reported teaching about preventive care that is necessary to maintain reproductive and sexual health

  • 77.3% of Puerto Rico secondary schools taught students about preventive care that is necessary to maintain reproductive and sexual health in a required course in any of grades 6, 7, or 8.
  • 86.7% of Puerto Rico secondary schools taught students about preventive care that is necessary to maintain reproductive and sexual health in a required course in any of grades 9, 10, 11, or 12.

Reported teaching how to correctly use a condom

  • 51.7% of Puerto Rico secondary schools taught students how to correctly use a condom in a required course in any of grades 6, 7, or 8.
  • 80.5% of Puerto Rico secondary schools taught students how to correctly use a condom in a required course in any of grades 9, 10, 11, or 12.

Reported teaching about methods of contraception other than condoms

  • 71.8% of Puerto Rico secondary schools taught students about methods of contraception other than condoms in a required course in any of grades 6, 7, or 8.
  • 84.4% of Puerto Rico secondary schools taught students about methods of contraception other than condoms in a required course in any of grades 9, 10, 11, or 12.

Reported teaching about sexual orientation

  • 71.8% of Puerto Rico secondary schools taught students about sexual orientation in a required course in any of grades 6, 7, or 8.
  •  83.8% of Puerto Rico secondary schools taught students about sexual orientation in a required course in any of grades 9, 10, 11, or 12.

Reported teaching about gender roles, gender identity, or gender expression

  • 77.4% of Puerto Rico secondary schools taught students about gender roles, gender identity, or gender expression in a required course in any of grades 6, 7, or 8.
  • 86.4% of Puerto Rico secondary schools taught students about gender roles, gender identity, or gender expression in a required course in any of grades 9, 10, 11, or 12.

Reported providing curricula or supplementary materials relevant to lesbian, gay, bisexual, transgender, or questioning (LGBTQ) youth

  • 63.9% of Puerto Rico secondary schools provided students with curricula or supplementary materials that included HIV, STD, or pregnancy prevention information relevant to LGBTQ youth.

(Visit the CDC’s School Health Profiles report for additional information on school health policies and practices.)

***The quality of sex education taught often reflects funding available for sex education programs. To learn more about federal funding streams, click here.