Objective: The purpose of this study was to determine if education about human immunodeficiency virus (HIV)/sexually transmitted disease (STD) and pregnancy prevention is dependent on professional preparation and/or class structure. Design: A secondary data analysis of the 2006 School Health Policies and Programmes Study (SHPPS) was conducted. Setting: Data were obtained from the health education classroom level questionnaire of the 2006 SHPPS. Methods: A series of multivariable logistic regression models (N = 34) were computed to determine if instruction of HIV/STD and/or pregnancy prevention content was dependent on professional preparation and/or class structure. Results: Professionally prepared health educators were found to be significantly more likely than their counterparts to teach about teenage age pregnancy risks, teenage pregnancy impacts, finding information/services related to pregnancy, finding information/services related to HIV, and HIV diagnosis/treatment. These topics and three others (methods of contraception, signs/symptoms of HIV and compassion for persons with HIV/AIDS) were significantly more likely to be taught in health-only classes versus combination classes. Conclusion: Findings from the current study support the need for professionally prepared educators and stand-alone class structure in terms of providing the most effective sexual health education.