Mississippi responded to high teenage pregnancy rates by enacting a law requiring school districts to choose between an abstinence-only or abstinence-plus program. However, there is limited research on Mississippi’s sex education policies, creating a research gap that inhibits developing successful programs. There is a need to compare the two programs with a focus on rural areas. This study compared programs by examining students’ abstinent sexual attitudes, social norms, self-efficacy, sexual abstinence behaviors, and perceived effectiveness of sexual education and decision making to address whether those variables differed by programs and if there was an interaction between programs and students’ sex. Guided by the health belief model, social cognitive theory, and theory of reasoned action, data was collected from 366 students by way of a demographic survey and the Sexual Risk Behavioral Belief and Self-Efficacy, Sexual Abstinence, and Effectiveness of Sexual Education Scales. Abstinence-plus program students had higher levels of abstinent sexual attitudes, social norms, self-efficacy, and decision-making self-efficacy than abstinence-only program students, with a small effect size for abstinent social norms. Sexual abstinence behavior scores did not differ by programs, and there was no interaction between programs and students’ sex. Results indicate future studies should include a pretest and posttest evaluation.