This study was conducted in 1999 using data from a nationally representative survey of 5th and 6th grader teachers (n=1789) in 5,543 public schools. Analyses were conducted of topics and skills taught relating to sexuality education, grades to which they were taught, teaching approaches, pressures experienced, support received and their needs. Seventy-two percent of the teachers reported that sexuality education is taught in their schools in at least one grade. Over 75% of teachers in these grades discuss puberty, HIV and AIDS and their interaction with alcohol and drugs, and how to stick to a decision. When looking at all schools including those where sexuality education is not provided, these topics are fully covered in a little over half of fifth and sixth grade classrooms. There are gaps between what teachers indicate they are teaching and what they think should be covered in classses, especially relating to sexual abuse, sexual orientation, abortion, contraception and condom use. Fifty-seven percent of teachers cover abstinence - 17% as the sole option for protection and 40% as the best option among others. One of the biggest problems with teaching sexuality education was pressure from the community, parents and school administrators. Another was the need for assistance with materials, information or teaching approaches.