Increases in STD cases in Indiana communities have led to questions about the sexual health of adolescents. School-based sex education can help teenagers adopt healthy attitudes and behaviours. Effective sex education programmes should involve learning from adolescents and young people about their health needs. Student voice, however, is generally absent in curriculum development. This study explored rural young people aged 14-18 years' perceptions of current sex education; opinions about abstinence-only-until-marriage and comprehensive sex education (CSE) curricula; and preferences for future sex education development. Focus groups and surveys were used to elicit high school students' opinions. Constant comparative approach was used for data contextualisation and theme identification. Analysis revealed participants perceive that current sex education content does not relate to them; abstinence-only-until-marriage sex education is impractical either now or later; young people frequently resist abstinence-only-until-marriage education; students want information that helps keep them safe sexually. Taken together, study findings reveal ideal sex education curricula contain relevant, relatable and reliable information. Incorporating these '3Rs' can help students better engage with and apply sex education information.