The controversial Pono Choices sex education program can again be taught in public middle schools, the Department of Education announced Thursday, saying several revisions have been made by the program’s developers at the University of Hawaii at Manoa to improve the curriculum and address public concerns.

Pono Choices, billed as a "culturally responsive" program that aims to help reduce teen pregnancies and prevent sexually transmitted infections, has been under fire since last year’s special legislative session on gay marriage amid criticism that it is medically inaccurate — classifying the anus as genitalia, for example — and includes explicit lessons inappropriate for students as young as 11.

The DOE halted the program for a second time in June, when it asked UH-Manoa’s Center on Disability Studies, which developed and owns Pono Choices, to revise the curriculum using recommendations made by a stakeholder review panel.

The review panel focused on 15 parts of the curriculum that were identified as controversial, including the teaching material’s definition of sex, anus, pono (generally meaning correct, moral or upright in Hawaiian) and abstinence; a condom demonstration; relationship scenarios that included same-sex couples; and images of sexual and reproductive anatomy parts.

The DOE said a total of 10 changes have been made by the university, including no longer grouping anus under the term genitals; new emphasis on the dangers of unprotected anal sex; and elimination of confusing language about condom effectiveness rates.

State Rep. Bob McDermott (R, Ewa Beach-Iroquois Point), a leader in the charge against Pono Choices, has said the program is still flawed.

Changes also have been made to the script and materials for the required parent informational night to tell parents more about the language and scenarios used in the curriculum, the DOE said.

"Children deserve to be educated about life choices that affect their well being and we look forward to continuing our work with the DOE as one of the approved options for sexual health education in Hawaii’s middle schools," Kelly Roberts, principal investigator for Pono Choices, said in an email.

Pono Choices is one of seven DOE-approved programs for sexual health education. The DOE over the summer changed its policies to make sex ed optional and require parents to opt their children in to participate.

"The DOE strengthened the role of parents in this decision by changing its policy from an opt-out to an opt-in. Beginning in the 2014-15 school year, all parents must sign an opt-in form permitting their children to participate in sexual health education," the department said in a statement.

The Center on Disability Studies has been running a television ad, which Roberts calls a public service announcement, featuring Claire Hughes, who has been recognized for her work to improve and raise public awareness of Native Hawaiian health needs.

Roberts said the center produced the ad using funds from the federal Office of Adolescent Health as part of the overall grant for Pono Choices.

"The purpose of the PSA is to edu cate the public about where they can find accurate information about the Pono Choices curriculum, which is ponochoices.com," she said.