Review article
Sex and HIV Education Programs: Their Impact on Sexual Behaviors of Young People Throughout the World

https://doi.org/10.1016/j.jadohealth.2006.11.143Get rights and content

Abstract

This paper reviews 83 studies that measure the impact of curriculum-based sex and HIV education programs on sexual behavior and mediating factors among youth under 25 years anywhere in the world. Two thirds of the programs significantly improved one or more sexual behaviors. The evidence is strong that programs do not hasten or increase sexual behavior but, instead, some programs delay or decrease sexual behaviors or increase condom or contraceptive use. Effective curricula commonly incorporated 17 characteristics that describe the curricula development; the goals, objectives, and teaching strategies of the curricula themselves; and their implementation. Programs were effective across a wide variety of countries, cultures, and groups of youth. Replications of studies also indicate that programs remain effective when implemented by others in different communities, provided all the activities are implemented as intended in similar settings.

Section snippets

Identification of evaluation studies

To be included in this review, each study had to meet the following criteria:

The program had to:

  • Be a curriculum- and group-based sex or HIV education program (as opposed to an intervention involving only spontaneous discussion, only one-on-one interaction, or only broad school, community or media awareness activities).

  • Focus on adolescents or young adults ages 9 to 24 years.

The research methods had to:
  • Include a reasonably strong experimental or quasi-experimental design with both intervention

Results

The results are divided into four sections: characteristics of the studies reviewed, impact of programs on sexual risk behaviors and pregnancy and STD rates, impact of programs on mediating factors for sexual risk behaviors, and common characteristics of effective programs.

Conclusions and Recommendations

Many of these studies had significant limitations. For example, few described their respective programs adequately; none studied programs for youth engaging in same-sex behavior; some had problems with implementation; a few had relatively weak quasi-experimental designs; an unknown number had measurement problems; many were statistically underpowered; most did not adjust for multiple tests of significance; few measured impact on either STD or pregnancy rates; and still fewer measured impact on

Acknowledgments

Financial support for this research was provided by the United States Agency for International Development (USAID) through Family Health International (FHI)/YouthNet Project. The views reflected in this article do not necessarily reflect those of USAID, FHI, or ETR Associates.

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