Behavioral and psychosocial effects of two middle school sexual health education programs at tenth-grade follow-up.
OBJECTIVE
An earlier randomized controlled trial found that two middle school sexual education programs-a risk avoidance (RA) program and a risk reduction (RR) program-delayed initiation of sexual intercourse (oral, vaginal, or anal sex) and reduced other sexual risk behaviors in ninth grade. We examined whether these effects extended into 10th grade.


METHODS
Fifteen middle schools were randomly assigned to RA, RR, or control conditions. Follow-up surveys were conducted with participating students in 10th grade (n = 1,187; 29.2% attrition).


RESULTS
Participants were 60% female, 50% Hispanic, and 39% black; seventh grade mean age was 12.6 years. In 10th grade, compared with the control condition, both programs significantly delayed anal sex initiation in the total sample (RA: adjusted odds ratio [AOR], .64, 95% confidence interval [CI], .42-.99; RR: AOR, .65, 95% CI, .50-.84) and among Hispanics (RA: AOR, .53, 95% CI, .31-.91; RR: AOR, .82, 95% CI, .74-.93). Risk avoidance students were less likely to report unprotected vaginal sex, either by using a condom or by abstaining from sex (AOR: .61, 95% CI, .45-.85); RR students were less likely to report recent unprotected anal sex (AOR: .34, 95% CI, .20-.56). Both programs sustained positive impact on some psychosocial outcomes.


CONCLUSIONS
Although both programs delayed anal sex initiation into 10th grade, effects on the delayed initiation of oral and vaginal sex were not sustained. Additional high school sexual education may help to further delay sexual initiation and reduce other sexual risk behaviors in later high school years.
Center for Health Promotion and Prevention Research, University of Texas Health Science Center at Houston, Texas. Electronic address: Christine.Markham@uth.tmc.edu.
Christine M
CM
Markham
Center for Health Promotion and Prevention Research, University of Texas Health Science Center at Houston, Texas.
Melissa F
MF
Peskin
Center for Health Promotion and Prevention Research, University of Texas Health Science Center at Houston, Texas.
Ross
R
Shegog
Center for Health Promotion and Prevention Research, University of Texas Health Science Center at Houston, Texas.
Elizabeth R
ER
Baumler
Center for Health Promotion and Prevention Research, University of Texas Health Science Center at Houston, Texas.
Robert C
RC
Addy
Center for Health Promotion and Prevention Research, University of Texas Health Science Center at Houston, Texas.
Melanie
M
Thiel
Division of Epidemiology, University of Texas MD Anderson Cancer Center, Houston, Texas.
Soledad Liliana
SL
Escobar-Chaves
Division of Adolescent and School Health, Centers for Disease Control and Prevention, Atlanta, Georgia.
Leah
L
Robin
Center for Health Promotion and Prevention Research, University of Texas Health Science Center at Houston, Texas.
Susan R
SR
Tortolero
D000293:Adolescent; D003075:Coitus; D017280:Condoms / Q000706:statistics & numerical data; D003625:Data Collection; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D012736:Sex Education / Q000379:methods; D012746:Sexual Abstinence; D012725:Sexual Behavior / Q000208:ethnology / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D014481:United States
Adolescents; Computer-based; Health education; Intervention studies; Sexual behavior; Urban populations