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Statewide, there were 47.8 births per 1,000 females ages 15 to 19 in 2011, the fifth highest rate in the country, Burk said. In Oklahoma County the birthrate was 56.2.

"I think that brought about a more inclusive awareness," Johnson Staples said. "More parents got involved in the process and started asking questions, calling or coming to school."

"We are very open and honest with them about the things they are going through," she said. "But when they ask me questions about sexuality I tell them, 'that's a conversation you should have with mom or dad.'"

The AIDS scare changed the way parents, educators and lawmakers looked at sex education and in 1987, legislation was passed requiring public schools to teach AIDS prevention.

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"Based on the STD rate that we're seeing in adolescents, it's obvious that there's an educational need regarding sexual health," said Kristen Eberly, who manages the Health Department's HIV and STD programs. continue to decline, Oklahoma still has one of the highest teen birthrates in the country, said Thad Burk, who studies diseases and analyzes trends for the Health Department.

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"They're not required to report it to us, so we don't have a way to count it," said Tricia Pemberton, a spokeswoman for the state Department of Education.

Dearth of sex education in Oklahoma City schools raises questions

"We still will have those parents who truly believe that this is a subject matter that needs to be addressed at home and not in a school setting," Johnson Staples said.

And that has Johnson Staples and others concerned, including those who track births and sexually transmitted diseases among teenagers.

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The state's largest school district no longer offers sex education courses, choosing instead to teach related content that applies to core subjects like physiology and elective courses such as adult and family living.

In the early 1990s, the district stopped teaching students about contraception in favor of abstinence.

The Oklahoma City district provides permission slips for parents to sign only if they do not want their child to be exposed to such content.

"I would say our overriding goal is that we want to teach kids that participating in sexual activity is a choice and that it can lead to things and that abstinence is probably the safest way to avoid anything," Johnson Staples said.

Under state law, parents have the right to inspect all curriculum and material used in connection with a sex education class or program designed to discuss sexual behavior or attitudes.

The number of teen births and sexually transmitted diseases (STDs) has prompted concern among administrators with state and local health departments.

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"Those were the kinds of things that were discussed, but they were discussed in a very structured, sequential and age appropriate manner."

Debbie Johnson oversees about three dozen nurses for the Oklahoma City district as health services administrator. Those nurses teach human growth and development to fourth and fifth graders.

"I just don't think people sit down and have the conversations they need to have with their kids, and I don't think the kids sit down and have the conversations they need to have with their parents," she said. "They listen to their peers and older siblings."

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Statewide, 21,307 cases of sexually transmitted diseases, including Nike Air Max 2016 For Boys

20 cases of HIV, were reported among those ages 15 to 19 in 2012, according to the state Health Department.

By law, public schools in Oklahoma are not required to teach sex education but must provide AIDS prevention education.

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Students who choose to disregard the district's message of abstinence are encouraged to talk to their parents and their doctors, Johnson Staples said.

It is unclear how many of Oklahoma's more than 500 school districts teach sex education.

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"We had a longer length of time to talk about relationships, to talk about intimacy, to talk about refusal skills, to talk about the use of contraception," recalled Johnson Staples, now the district's director of college and career readiness and guidance services.

Oklahoma is one of the states that does not mandate school districts to provide comprehensive health education, which includes sex education.

if you look at simply the birthrates, you can say that yes, there is a need for more comprehensive sexuality education," said Linsey Garlington, teen pregnancy prevention program supervisor for the Oklahoma City County Health Department. "We believe that parents are the Nike Air Max 2016 Grey Running Shoes first and most important educators of their children. We hope that they're getting information from a trusted adult."

"I believe that given everything that is happening in society today it would be helpful to offer good quality programs," Johnson Staples said. "In the absence of healthy, accurate information, kids are going to find their own answers. Kids are really misinformed in a lot of areas when it comes to those things."

gets lost in translation, said Johnson, a former elementary school nurse.

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