Review of evaluated programs shows well-designed programs work, but implementation issues remain challenging. Recent research has confirmed and expanded earlier findings concerning the positive impacts of reproductive health (RH) and HIV education programs. More guidance regarding developing and adapting curricula for diverse settings has also emerged based on sharing of field implementation experiences. Even so, implementing this guidance at the country level remains challenging, given inadequate teacher training, varying availability of funds, and cultural sensitivities about discussing sexuality. Communities should implement well-designed curriculum-based RH and HIV education programs in their schools, clinics, and youth-serving agencies.