A statewide, cross-sectional survey was conducted among Texas secondary school teachers to determine the scope of HIV education provided and training needs. Among 269 participants, 199 (75%) taught HIV education. Investigator developed scales measured instructional emphasis, preparation adequacy, desire for future training, comfort, instructional effectiveness, social support, and instructional barriers. Alpha levels indicated high levels of internal consistency on all scales. Considerable variations were noted in instructional emphasis among 18 content areas related to HIV education. Lessons were predominantly self-developed. Most teachers were self-taught with no formal training, relied primarily on traditional teacher-centered instructional methods, felt uncomfortable and ineffective using peer leaders and role plays, wanted additional training in all subject areas, and perceived others to be supportive. Comparisons between groups indicated middle school teachers spent less instructional time on HIV education, reported more instructional barriers, less support from district personnel, a poorer fit (coordination) of HIV education with other subjects, less adequate preparation, and less responsibility and effectiveness. High school teachers were more prone to want additional training. Differences in responses to individual scale items, major instructional barriers, and recommendations for teacher training are provided.