title: Behavioural interventions for the prevention of sexually transmitted infections in young people aged 13-19 years: a systematic review.
abstract: We systematically reviewed school-based skills building behavioural interventions for the prevention of sexually transmitted infections. References were sought from 15 electronic resources, bibliographies of systematic reviews/included studies and experts. Two authors independently extracted data and quality-assessed studies. Fifteen randomized controlled trials (RCTs), conducted in the United States, Africa or Europe, met the inclusion criteria. They were heterogeneous in terms of intervention length, content, intensity and providers. Data from 12 RCTs passed quality assessment criteria and provided evidence of positive changes in non-behavioural outcomes (e.g. knowledge and self-efficacy). Intervention effects on behavioural outcomes, such as condom use, were generally limited and did not demonstrate a negative impact (e.g. earlier sexual initiation). Beneficial effect on at least one, but never all behavioural outcomes assessed was reported by about half the studies, but this was sometimes limited to a participant subgroup. Sexual health education for young people is important as it increases knowledge upon which to make decisions about sexual behaviour. However, a number of factors may limit intervention impact on behavioural outcomes. Further research could draw on one of the more effective studies reviewed and could explore the effectiveness of 'booster' sessions as young people move from adolescence to young adulthood.
authors.affiliation: Southampton Health Technology Assessments Centre, University of Southampton, First Floor, Epsilon House, Enterprise Road, University of Southampton Science Park, Southampton, SO16 7NS, UK. j.picot@soton.ac.uk
authors.forename: Joanna
authors.initials: J
authors.lastname: Picot
authors.forename: Jonathan
authors.initials: J
authors.lastname: Shepherd
authors.forename: Josephine
authors.initials: J
authors.lastname: Kavanagh
authors.forename: Keith
authors.initials: K
authors.lastname: Cooper
authors.forename: Angela
authors.initials: A
authors.lastname: Harden
authors.forename: Elaine
authors.initials: E
authors.lastname: Barnett-Page
authors.forename: Jeremy
authors.initials: J
authors.lastname: Jones
authors.forename: Andrew
authors.initials: A
authors.lastname: Clegg
authors.forename: Debbie
authors.initials: D
authors.lastname: Hartwell
authors.forename: Geoff K
authors.initials: GK
authors.lastname: Frampton
mesh_terms: D000293:Adolescent; D005260:Female; D006801:Humans; D008297:Male; D016032:Randomized Controlled Trials as Topic; D012736:Sex Education; D012749:Sexually Transmitted Diseases / Q000517:prevention & control*; D016896:Treatment Outcome; D055815:Young Adult