Introduction: Human Immunodeficiency Virus (HIV) continues to threaten public health, despite a 40-year history of risk and prevention mitigation efforts. Advances in science and medicine have increased knowledge on how the virus is spread and how to treat it. This has driven clinical practices and policy initiatives. Policy has the capacity to drive primary prevention. Some policy, however, can pose barriers and impede primary prevention initiatives. This study investigates of the potential effect of sex education policy on primary prevention among young adults ages 13-24. Methods: Sex education policy in 8 states in the western and southern United States was collected and assessed for the impact these policies had on HIV incidence rates on young adults ages 13-24 using legal epidemiology methods. This cross-sectional study used data relevant to 2020-2022. Qualitative analysis state sex education and HIV education laws were coded for and analyzed in MonQcle. Statutes were assessed for inclusion of primary prevention education and resources within mandated curriculum. States were also assessed for type of content included in mandated curriculum and who mandated the curriculum (the state or local jurisdiction). An odds ratio was calculated at the end to assess the association between sex education of policy and HIV incidence. Findings: Young adults that live in states with opt-out parental consent sex education policy have higher odds of having a new diagnosis of HIV than young adults living in states with opt-in parental consent policy. A weak association of statistical significance was found during analysis, the OR was found to be 0.76, 95% CI [0.68, 0.86]. This association reflects that there is a weak association between sex education laws with opt-in parental permission and HIV incidence in young people ages 13-24, however, there are many policy elements and confounding factors that may affect the odds ratio for HIV surveillance data collected between 2020-2022. Conclusion: This study analyzed the association between opt-in parental consent policy and HIV incidence in young adults ages 13-24. Young adults have lower odds of having newly diagnosed HIV in states where active or opt-in consent is mandated for student participation in education programs. There are no strong associations between who sets the curriculum and HIV incidence in young adults, however, there is an opportunity to analyze the health impacts of mandated within each state and which of these sex education trends may not be keeping up with changing societal needs.