Sexual Behavior

Sexuality is a central part of being human, and individuals express their sexuality in a variety of ways.

Sexual Behavior Live Behaviors:

Having applied the sexual behavior subconcepts at the appropriate age, the learner will be able to:

  • Enjoy and express one’s sexuality throughout life.
  • Express one’s sexuality in ways that are congruent with one’s values.
  • Enjoy sexual feelings without necessarily acting on them.
  • Discriminate between life-enhancing sexual behaviors and those that are harmful to self and/or others.
  • Express one’s sexuality while respecting the rights of others.
  • Seek new information to enhance one’s sexuality.
  • Engage in sexual relationships that are consensual, non-exploitative, honest, pleasurable, and protected.

ABSTINENCE ONLY UNTIL MARRIAGE PROGRAMS

Abstinence-only-until-marriage programs have gained popularity in recent years in large part because the federal government continues to sink over $170 million each year into such programs.  These programs have never been proven effective and often rely on fear, shame, and misinformation.  In addition, virginity pledges, a cornerstone of many of these programs, have been shown to be ineffective at best and possibly harmful.


ANALYZING DEFINITIONS AND CURRICULA

As abstinence-only-until-marriage programs have gained popularity many new curricula and resources have been created.  A number of researchers and organizations have reviewed these materials and found that they rely on fear and shame, include medical inaccuracies, and are inconsistent in their definitions of abstinence.  In addition to the resources listed in this section, see  SIECUS’ reviews of some of the more popular abstinence-only-until-marriage curricula at http://www.communityactionkit.org/curricula_reviews.html

 

Defining Abstinence: Views of Directors, Instructors, and Participants in Abstinence-Only-Until-Marriage Programs in Texas

Source:  Patricia Goodson, et. al., “Defining abstinence: views of directors, instructors, and participants in abstinence-only-until-marriage programs in Texas,” Journal of School Health 73(3)(2005): 91-96.

Description:  The researchers evaluated how program directors, instructors, and teens in eight Texas abstinence-only-until-marriage education programs define the term “abstinence.”

Key Findings:

  • There was “substantial variability” in how the term “abstinence” was defined.
  • Researchers concluded that “…many of the programs awarded federal funding for abstinence education are not sex education programs.”

 

The Waxman Report

Source:Prepared for Rep. Henry A. Waxman, The Content of Federally Funded Abstinence-Only Education Programs(Washington, DC: United States House of Representatives, Committee on Government Reform, Minority Staff, Special Investigations Division, 2004).

Description: This Congressional report prepared for Representative Henry Waxman (D-California) found that widely used federally funded abstinence-only curricula distort information, misrepresent the facts, and promote gender stereotypes.

Key Findings:

  • More than 80 percent of the abstinence-only curricula reviewed contain false, misleading, or distorted information about reproductive health.
  • The curricula reviewed misrepresent the effectiveness of contraceptives in preventing STDs and unintended pregnancy.
  • The curricula reviewed contain false information about the risks of abortion, blur religion and science, promote gender stereotypes, and contain basic scientific errors.

 

To View this Resource:  http://oversight.house.gov/investigations.asp

Prevalence of Unprotected Anal Sex among Teens Requires New Education Strategies

Prevalence of Unprotected Anal Sex among Teens Requires New Education Strategies

Description: 

Although anal intercourse is known to be a risky behavior when it comes to transmission of HIV and other STDs, most messages given to teens about STDs and condom use focus on vaginal intercourse. This study examined the prevalence of anal intercourse and associated condom use rates in an effort to determine if different education strategies are necessary. The data was acquired as part of a greater longitudinal study of adolescent STD acquisition and cervical ectopy.

The participants were 350 adolescent females ages 12–18 from an urban environment; 96% were African American. All of them had engaged in sexual activity, were healthy, and were neither pregnant nor had been pregnant in the previous three months. Participants were asked about sexual activity with two different types of partners: a “main partner” and a “casual partner.”

The participants were given the following definition about the partner types: “A main partner is someone that you have vaginal sex with and that you are serious about. A casual partner is someone you have vaginal sex with but do not consider to be a main partner.” The casual partner could be someone the participant had had sex with once, or many times—as long as she did not consider him to be a main partner.

Participants were asked about their sexual activity with each type of partner in the last three months.  Specifically, researchers asked about the: (a) occurrence and frequency of vaginal sex, (b) frequency of condom use in vaginal sex, (c) occurrence and frequency of anal sex, (d) frequency of condom use in anal sex, and (e) method of contraception use with partner (condom, withdrawal, anal sex, spermicide, etc.).

Source:

Avril Melissa Houston, M.D., M.P.H, et al., “More Than Just Vaginal Intercourse: Anal Intercourse and Condom Use Patterns in the Context of ‘Main’ and ‘Casual’ Sexual Relationships among Urban Minority Adolescent Females,” Journal of Pediatric Adolescent Gynecology 20 (2007): 299-304

Key Findings:

Participants were more sexually active with main partners. While the frequency of either anal or vaginal sex was lower with casual partners, participants were much more likely to use contraception/condoms with casual partners during both anal and vaginal sex.

Furthermore, the rates of condom use during anal sex were significantly lower than during vaginal sex. This was reflected both in the median frequency for condom use and the lower percentage of participants who always used a condom for anal sex.

Type of Partner

  • 302 (86.5%) participants had engaged in any sexual activity with a main partner.
  • 142 (40.7%) participants had engaged in any sexual activity with a casual partner.

Frequency of Sex

  • Of the participants who reported having had sex with a main partner, 272 (90.1%) had had vaginal intercourse and 47 (15.6%) had had anal intercourse. The median frequency of sex for each type of intercourse was once per week.
  • Of the participants who reported having had sex with a casual partner, 118 (83.1%) had had vaginal intercourse and 17 (12%) had had anal intercourse. The median frequency of sex for each type of intercourse was few times per month.

Frequency of Condom Use

  • With a main partner, the median frequency of condom use during vaginal sex was sometimes, while the median frequency of condom use during anal sex was few times in the last 3 months.
  • With a casual partner, the median frequency of condom use during vaginal sex was always, while the median frequency of condom use during anal sex was few times in the last 3 months.
  • With a main partner, 32.4% of participants always used a condom during vaginal sex, while only 21.3% of participants always used a condom during anal sex.
  • With a casual partner, 61% of participants always used a condom during vaginal sex, while only 47.1% of participants always used a condom during anal sex.

Contraception Use during Last Vaginal Intercourse

  • With a main partner, 48.2% used a condom, 18.4% used withdrawal, 6.6% used spermicide, and 15.1% used any other methods.
  • With a casual partner, 70.3% used a condom, 29.7% used withdrawal, 13.6% used spermicide, and 38.1% used any other methods.

Anal Sex as Contraception

  • 41.2% of the participants had used anal sex as a method of contraception with a casual partner, while only 8.5% had used anal sex for contraception with a main partner

SIECUS Analysis: This study has a number of very disturbing findings.  First, that participants are not using condoms consistently for vaginal sex and second, that they are even less likely to use condoms when engaging in anal sex.  These results show that the standard discussion of STDs and pregnancy in a vaginal sex paradigm is obviously insufficient in meeting the needs of today’s teens. Education about condoms must improve and take into account the reality of young people’s relationships and behaviors.

While the frequency of condom use was too low regardless of partner, it is interesting to note that young people were even less likely to use a condom with a main partner.  It is unclear if the subjects were motivated by the belief that they are less likely to contract an STD or become pregnant with a main partner, by a greater desire for intimacy with that partner, or by some other factor.  While further research on young people’s motivations could be useful, these findings suggest that young people need a better forum for learning about condom use and, perhaps, additional help in communicating about condom use with partners.

Another worrisome finding is the prevalence of unprotected anal sex. Anal sex is as risky in terms of STD transmission as vaginal sex, yet participants were more likely to forgo condoms.  This raises questions about both their level of knowledge of STD risks and their reasons for using condoms.  In particular it suggests (as previous studies have) that young people are more concerned with pregnancy than STDs.  This seems to be confirmed by the number of participants who acknowledged using anal sex as a method of contraception. The idea that anal sex is somehow “safer” than vaginal sex (and therefore can be performed unprotected) is a dangerous misconception.

Young people need comprehensive sexuality education that discusses not only vaginal sex, condoms, and contraception, but also extends that discussion to other sexual practices, like anal sex.

Contraception Lesson Plans

Birth Control Basics, Grade 7 and 8, Lesson #14
Source: Family Life and Sexual Health (F.L.A.S.H.) curriculum, Public Health – Seattle & King County

Target Audience: Level III (early adolescence, ages 12 through 15; middle school/junior high school; grades 7-8)

Duration of Lesson: 50 minutes

Date Published: 2009

Summary: In this lesson, learners will 1) List at least four birth control methods, including abstinence, with no prompt; 2) Name seven methods, given a description of each; 3) Explain that any method is more effective than not using a method and is safer than pregnancy and childbirth; and 4) List at least two good reasons to communicate with parents and loved ones about birth control.

To view this lesson click here:
http://www.kingcounty.gov/healthservices/health/personal/famplan/educators/~/media/health/publichealth/documents/famplan/Grades78Lesson14.ashx

To view all F.L.A.S.H. lessons, click here:
www.kingcounty.gov/healthservices/health/personal/famplan/educators/FLASH.aspx

HIV and AIDS: Rights & Responsibilities, Grade 8, Lesson #24

Source: Family Life and Sexual Health (F.L.A.S.H.) curriculum, Public Health – Seattle & King County

Target Audience: Level III (early adolescence, ages 12 through 15; middle school/junior high school; grades 7-8)

Duration of Lesson: One class period (approx. 50 minutes)

Date Published: 2009

Summary: The lesson gives students the opportunity to apply knowledge, solve problems, and identify feelings around the issue of HIV by responding to hypothetical situations. Students also learn about correct condom use. An optional family homework assignment is included.

To view this lesson click here:
www.kingcounty.gov/healthservices/health/personal/famplan/educators/~/media/health/publichealth/documents/famplan/G78_L24.ashx

To view all F.L.A.S.H. lessons, click here:
www.kingcounty.gov/healthservices/health/personal/famplan/educators/FLASH.aspx

Preventing Pregnancy: Birth Control Methods, Grade 9-12, Lesson #10
Source: Family Life and Sexual Health (F.L.A.S.H.) curriculum, Public Health – Seattle & King County

Target Audience: Level IV (adolescence, ages 15 through 18; high school; grades 9-12)

Duration of Lesson: 50 minutes

Date Published: 2011

Summary: In this lesson, birth control is framed positively, with intention. Multiple teen pregnancy prevention studies demonstrate that having “more positive attitudes towards contraception, including condoms” and “perceiving more benefits of using contraception” are important protective factors against teen pregnancy. Hence, in this lesson, students develop commercials to emphasize the positive aspects of birth control using medically accurate information.

To view this lesson click here:
http://www.kingcounty.gov/healthservices/health/personal/famplan/educators/~/media/health/publichealth/documents/flash/HS10BirthControl.ashx

To view all F.L.A.S.H. lessons, click here:
www.kingcounty.gov/healthservices/health/personal/famplan/educators/FLASH.aspx

Talking with Partners about Prevention, Grades 9-12, Lesson #13
Source: Family Life and Sexual Health (F.L.A.S.H.) curriculum, Public Health – Seattle & King County

Target Audience: Level IV (adolescence, ages 15 through 18; high school; grades 9-12)

Duration of Lesson: one class period

Date Published: 2011

Summary: In this lesson, learners will demonstrate assertive communication with a partner about abstinence, STD testing, condoms, and other contraception. A family homework assignment is included.

To view this lesson click here:
http://www.kingcounty.gov/healthservices/health/personal/famplan/educators/~/media/health/publichealth/documents/flash/HS13TalkingWithPartners.ashx

To view all F.L.A.S.H. lessons, click here:
www.kingcounty.gov/healthservices/health/personal/famplan/educators/FLASH.aspx

Contraceptive Options
Source: ETR RECAPP Website

Target Audience: Level IV (adolescence, ages 15-18; high school)

Duration of Lesson: 1 hour 20 minutes (Part I, 30 minutes; Part II, 50 minutes)

Date Published: 2002

Summary: This learning activity is designed to help youth understand the risks of unprotected sex and learn about contraceptive options. In Part I of the lesson, participants read and discuss a scenario about a sexually active couple; in Part II they learn about methods of birth control.

To view this lesson click here:
http://recapp.etr.org/recapp/index.cfm?fuseaction=pages.LearningActivitiesDetail&PageID=132

Contraceptive Commercials
Source: Advocates for Youth

Target Audience: Level IV (adolescence, ages 15-18; high school)

Duration of Lesson: 40 to 50 minutes

Date Published: 2007

Summary: In this interactive lesson, students form teams to create commercials for various methods of nonprescription contraceptive methods.

To view this lesson click here:
http://www.advocatesforyouth.org/index.php?option=com_content&task=view&id=203Itemid=129

Facts about Emergency Contraception – True or False
Source: Advocates for Youth

Target Audience: Level IV (adolescence, ages 15-18; high school)

Duration of Lesson: 50 minutes

Date Published: Undated

Summary: The purpose of this lesson is to educate youth about the existence, safety, and effectiveness of emergency contraception and help them increase awareness of and access to emergency contraception in their community.

To view this lesson click here:
http://www.advocatesforyouth.org/index.php?option=com_content&task=view&id=209Itemid=129

Emergency Contraception: Good Reasons to Use it for Emergencies Only

Source: ETR ReCAPP Website

Target Audience: Level IV (adolescence, ages 15-18; high school)

Duration of Lesson: 20 minutes
Date Published: 2000, with subsequent updates

Summary: In this lesson facilitators provide youth with information on emergency contraception (EC) and why using a method of birth control is preferred over relying on emergency contraception alone.

To view this lesson click here:
http://recapp.etr.org/recapp/index.cfm?fuseaction=pages.LearningActivitiesDetail&PageID=14

The Board Meeting

Source: ETR ReCAPP Website

Target Audience: Level IV (adolescence, ages 15 through 18, high school)

Duration of Lesson: 60 to 75 minutes (can be broken up into 2 sessions)

Date Published: 2001

Summary: In this lesson, students are asked to role play a mock Board of Directors meeting where they debate about whether or not an organization’s education program should provide information on contraceptives to 15-18 year old students.

To view this lesson click here:
http://recapp.etr.org/recapp/index.cfm?fuseaction=pages.LearningActivitiesDetail&PageID=163

Condom Wise

Source: ETR ReCAPP Website

Target Audience: Level III (early adolescence, ages 12 through 15; middle school/junior high school) and IV (adolescence, ages 15 through 18; high school)

Duration of Lesson: 35 to 40 minutes

Date Published: 2001

Summary: Participants engage in a variety of activities including discussing whether a case study couple should or should not use condoms and a forced-choice activity and large group discussion to address condom use and STD and HIV/AIDS prevention.

To view this lesson click here:
http://recapp.etr.org/recapp/index.cfm?fuseaction=pages.LearningActivitiesDetail&PageID=166

How Do I Rate? -A Personalization Activity

Source: ETR ReCAPP Website

Target Audience: Level IV (adolescence, ages 15-18; high school)

Duration of Lesson: 5 to 10 minutes

Date Published: 1999

Summary: This short activity is designed to help students privately identify their pregnancy risk-taking behaviors, reflect on their comfort level with their risks of pregnancy, and identify what they can do to reduce their risk-taking behavior using a self-assessment inventory.

To view this lesson click here:
http://recapp.etr.org/recapp/index.cfm?fuseaction=pages.LearningActivitiesDetail&PageID=178

Scavenger Hunt: What’s New in Contraception and Reproductive Health

Source: ETR ReCAPP Website

Target Audience: Level IV (adolescence, ages 15-18; high school)

Duration of Lesson: Total Class time is 75 minutes (Part 1: 15 minutes in class, Part 2: 60 to 120 minutes out of class, Part 3: 60 minutes in class)

Date Published: 2001

Summary: This three-part lesson is designed to help participants identify resources for current reproductive health information. Students are assigned a contraceptive or reproductive health topic to research and then identify three types of information resources: community-based organizations, toll-free numbers, and websites. A list of suggested topics is provided and can be easily adapted.

To view this lesson click here:
http://recapp.etr.org/recapp/index.cfm?fuseaction=pages.LearningActivitiesDetail&PageID=162

From An Objective Point of View (video and lesson plan)
Source: Scenarios USA

Target Audience: Level IV (adolescence, ages 15 through 18; high school)

Duration of Lesson: 45 minutes including video

Date Published: 2002
Summary: Two best friends make a pact not to have sex without consulting the other. With their agreement on the verge of being broken, the result is an honest look at teenage desire. This video deals with decision-making, prevention, abstinence, and issues of gender.Scenarios USA videos are professionally-produced films written by teens for teens. This film was written by 16-year old Janet Aponte of Forest Hills High School in Queens, New York City, and directed by Jim McKay (Law & Order: Special Victims Unit) and Hannah Weyer (La Boda).

To view this lesson click here:
http://www.scenariosusa.org/films/film/from-an-objective-point-of-view/

To view all Scenarios USA Films, Curriculum and Lesson Plans click here:
http://www.scenariosusa.org/films/
He Said, She Said (video and lesson plan)
Source: Scenarios USA

Target Audience: Level IV (adolescence, ages 15 through 18; high school)

Duration of Lesson: 45 minutes including video

Date Published: 2000

Summary: Tonight is the night… or is it? The story of a guy and his girlfriend dealing with the awkwardness of and embarrassment about safe sex. This video deals with the prevention, communication, and decision-making. Scenarios USA videos are professionally-produced films written by teens for teens. This film was written by four 17-year old New York City residents of Harlem and Washington Heights. It was co-directed by the lead teen writer, Ravi Lambert (Manhattan Village Academy) and director Doug Liman (Swingers, Go, The Bourne Identity). It stars Rosario Dawson (The 25th Hour, Men in Black II).

To view this lesson click here:
http://www.scenariosusa.org/films/film/he-said-she-said/

To view all Scenarios USA Films, Curriculum and Lesson Plans to click here:
http://www.scenariosusa.org/films/

Sex Education Series : Condoms and Pregnancy Prevention

Workshop Summary: Scientific Evidence on Condom Effectiveness for Sexually Transmitted Disease (STD) Prevention

Source: Department of Health and Human Services, National Institutes of Health (NIH), National Institute of Allergy and Infectious Diseases

Description: Published in 2001, this report presents the findings of a workshop to evaluate the effectiveness of latex male condoms. The effort was led by the National Institutes of Health (NIH), in association with the Centers for Disease Control and Prevention (CDC), the Food and Drug Administration (FDA), and the United States Agency for International Development (USAID).

Key Statistics:

  • In a recent well-controlled randomized clinical trial of monogamous couples using latex male condoms for contraception over six months, the pregnancy rate during “typical use” was reported at 6.3%, with a 1.1% pregnancy rate during “consistent use.”
  • As condom experience and facility in use of condoms increases in couples using condoms as their primary method of birth control, unintended pregnancies decrease.
  • The combined method failure rate (slippage plus breakage) of condoms is estimated at 1.6%–3.6%.

To View this Resource: http://www3.niaid.nih.gov/about/organization/dmid/PDF/condomReport.pdf


Male Condoms

Source: R. A. Hatcher, et al., Contraceptive Technology, 17th revised Edition (New York: Ardent Media, Inc., 1998).

Description: This article contains all of the basic information about male condoms as a method of contraception that health care practitioners, educators, and users will need

Key Statistics:

  • To fully understand research on condom effectiveness, one must understand the difference between method failure and user failure. Method failure is failure that results from a defect in the product. User failure refers to failure that results from incorrect or inconsistent use.
  • The first-year effectiveness rate in preventing pregnancy among typical condom users on average is 86%. This includes pregnancies resulting from errors in condom use.
  • Method failure of male condoms (failure that is a direct result of a flaw in the condom) is uncommon. In fact, it is estimated to occur among only 3% of couples using condoms consistently and correctly during the first year of use. To help individuals understand this estimate, Contraceptive Technology explains that “only three of 100 couples who use condoms perfectly for one year will experience an unintended pregnancy.”
  • If each of these 100 couples had intercourse at the average coital frequency of 83 acts per year, then 100 couples would have intercourse a combined 8,300 times a year. Three pregnancies resulting from 8,300 acts of condom use is a remarkably low pregnancy rate (.04 %) when calculated on a per-condom basis.
  • Among couples using condoms as their primary method of contraception, approximately 14% experience an unintended pregnancy each year. It is important to remember that they may not have been using a condom correctly or at all when they became pregnant.
  • In comparison, 85% of women using no birth control will become pregnancy in the first year, as will 25% of women using periodic abstinence.

To View this Resource: This book may be obtained online for a fee. For more information:

See the Contraceptive Technology online at: www.amazon.com/Contraceptive-Techonology-Robert-Hatcher/dp/0966490215, or Contact your local librarian.

If you have difficulty finding this book, you may contact SIECUS


Contraceptive Failure in the United States: An Update

Source: J. Trussel, et al., “Contraceptive Failure in the United States: An Update,” Studies in Family Planning 21.1 (January/February 1990).

Description: Studies in Family Planning is a peer-reviewed journal published on behalf of the Population Council. This article contains the results of research on contraceptive effectiveness.

Key Statistics:

  • Condoms are 98% effective in preventing pregnancy when used consistently and correctly.

To View this Resource: The full text of this article may be obtained online for a fee. For more information:

See the Studies in Family Planning online at: www.blackwellpublishing.com/subs.asp?ref=0039-3665, or Contact your local librarian.

If you have difficulty finding this article, you may contact SIECUS at www.siecus.org/feedback.html.


l Pregnancy Rates for Birth Control Methods

Source: The Food and Drug Administration (FDA), “Consumer-Friendly Birth Control Information,” Consumer Magazine (April 1997).

Description: This table compares the effectiveness of different birth control methods in preventing pregnancy. The methods studied include male and female sterilization, implants (Norplant), hormone shots (Depo-Provera), oral contraceptives, intrauterine devices (IUDs), male and female condoms, vaginal sponges, cervical caps, diaphragms, spermicides, withdrawal, and natural family planning methods (calendar, temperature, cervical mucus).

Key Statistics:

  • With consistent and correct use, male condoms have a 3% failure rate, the diaphragm has a 6% failure rate, the pill (estrogen/progestin) has a 0.1% failure rate, and withdrawal has a 4% failure rate.
  • With “typical use”—which the FDA defines as not always using the method correctly, not using the method during every act of sexual intercourse, sometimes forgetting to take the birth control pill, or using the method correctly but having it fail— the failure rate for condoms is 14%, the failure rate for the diaphragm is 20%, the failure rate for the pill is 5%, and the failure rate for withdrawal is 19%.

To View this Resource:
http://www.fda.gov/fdac/features/1997/conceptbl.html

Comprehensive Education about Sexuality

Numerous studies and evaluations published in peer-reviewed literature have looked at sexuality education programs. Studies have shown that comprehensive education about sexuality, programs that teach teens about both abstinence and contraception/ disease prevention, are an effective strategy to help young people delay their initiation of sexual intercourse, reduce the number of sexual partners they have, and increase condom or contraceptive use when they do become pregnant.

EVALUATIONS
The studies listed in this section are reviews of evaluations of interventions designed to prevent HIV, other STDs, and teen pregnancy.

Sex and HIV Education Programs for Youth: Their Impact and Important Characteristics
Source: Doug Kirby, et. al., Sex and HIV Education Programs for Youth: Their Impact and Important Characteristics (Scotts Valley, CA: ETR Associates, 2006).

Description: The researchers gathered information on 83 different studies of effective education programs that showed an ability to reduce risks for HIV, other STDs, or unintended pregnancy. Of the 83 studies reviewed, 56 were based in the United States. Programs targeted young people ages 9–24.

Key Findings:

Of the 52 studies that measured impact on the initiation of sex, 22 (42 %) found that the programs significantly delayed the initiation of sex among one or more groups for at least six months, 29 (55%) found no significant impact, and one (in the United States) found the program hastened the initiation of sex.
Of the 54 studies measuring program impact on condom use, almost half (48%) showed increased condom use; none found decreased condom use.
Of the 13 studies that measured pregnancy rates, three found significant positive effects, nine found insignificant effects, and one (in the United States) found significant negative effects.
Of the 10 studies that measured impact on STI rates, two found a positive impact, six found no significant impact, and two found a negative impact.
Based on these finding the researchers identified 17 characteristics of effective programs.

To View this Resource: www.etr.org/recapp/documents/programs/SexHIVedProgs.pdf

Emerging Answers: Research Findings on Programs to Reduce Teen Pregnancy
Source: Doug Kirby, Emerging Answers: Research Findings on Programs to Reduce Teen Pregnancy (Washington, DC: National Campaign to Prevent Teen Pregnancy, 2001).

Description: The National Campaign to Prevent Teen Pregnancy commissioned a review of programs considered effective at reducing teen pregnancy and/or STD rates among young people. Kirby gathered information on over 250 studies to identify the elements that made the programs effective.

Key Findings:

Research clearly shows that comprehensive education about sexuality does not hasten the onset of sex, increase the frequency of sex, or increase the number of sexual partners teens have.
Research shows that some sexuality and HIV education programs can delay the onset of sex, reduce the frequency of sex, or reduce the number of sexual partners.
Research on abstinence-only-until-marriage programs, however, remains inconclusive. This report identified several programs that had proven ability to delay sex or increase condom or other contraceptive use, thereby decreasing unprotected sex. Among these were:

Reducing the Risk
Safer Choices
Becoming a Responsible Teen
Making a Difference: An Abstinence Approach to STD, Teen Pregnancy, and HIV/AIDS Prevention
Making a Difference: A Safer Sex Approach to STD, Teen Pregnancy, and HIV/AIDS Prevention

To View this Resource: www.teenpregnancy.org/resources/data/pdf/emeranswsum.pdf

Science and Success: Sex Education and Other Programs That Work to Prevent Teen Pregnancy, HIV & Sexually Transmitted Infections
Source: S. Alford, et al., Science and Success: Sex Education and Other Programs That Work to Prevent Teen Pregnancy, HIV & Sexually Transmitted Infections, (Washington, DC: Advocates for Youth, 2003)

Description: This paper compiles descriptions of the rigorously evaluated programs that have demonstrated effectiveness at reducing adolescents’ risk for pregnancy and STDs, including HIV.

Key Findings:

12 of the 19 programs included in this review showed a delay in the initiation of sex.
17 of the 19 programs included in this review had beneficial effects on sexual behaviors among sexually experienced youth.
Eight of the 19 programs included in this review programs had a positive impact on incidence of STDs or on the number or rate of adolescent pregnancies.

To View this Resource: www.advocatesforyouth.org/programsthatwork/index.htm

Best-Evidence Interventions: Findings From a Systematic Review of HIV Behavioral Interventions for US Populations at High Risk, 2000–2004
Source: C.M. Lyles, et. al., “Best-evidence interventions: Findings from a systematic review of HIV behavioral interventions for U.S. populations at high risk, 2000–2004,” American Journal of Public Health 97(1) (2006): 133-143.

Description: Researchers from the Centers for Disease Control and Prevention reviewed U.S.-based HIV-prevention research literature from 2000 through 2004 to identify interventions demonstrating best evidence of efficacy for reducing HIV risk. They found eighteen interventions that met the criteria for “best evidence.”

Key Findings:

Results of these interventions included increased condom use and reductions in unprotected sexual intercourse, number of sexual partners, injection drug use or needle sharing, and newly acquired sexually transmitted infections.
None of the “best evidence” programs were based on abstinence-only-until-marriage.

To View this Resource: This article may be obtained online for a fee. For more information:

See the American Journal of Public Health online at www.ajph.org, or
Contact your local librarian.
If you have difficulty finding this article, you may contact SIECUS at
www.siecus.org/feedback.html.

A Decade in Review: Building on the Experiences of Past Adolescent STI/HIV Interventions to Optimize Future Prevention Efforts
Source: J.M. Sales, et. al., “A decade in review: Building on the experiences of past adolescent STI/HIV interventions to optimize future prevention efforts,” Sexually Transmitted Infections 82 (2006): 431-436.

Description: Researchers reviewed findings from selected adolescent STD/HIV interventions in the United States between 1994 and 2004. They examined the most current STD risk reduction programs in a wide range of settings: communities, schools, clinics, detention homes, and drug treatment facilities. They then identified the features that were associated with effective programs.

Key Findings:

The risk behavior most susceptible to change was condom use during vaginal sex.
Researchers concluded that to be most effective at reducing risk, programs should educate teens on correct condom use and other behaviors that have been proven most likely to change.

To View this Resource: This article may be obtained online for a fee. For more information:

If you have difficulty finding this article, you may contact SIECUS at siecus@siecus.org.

SOURCES OF EFFECTIVE PROGRAMS

ReCAPP (ETR Associates): Evidence-Based Programs

This web resource provides practical tools and information to effectively reduce sexual risk-taking behaviors. Health educators will find up-to-date, evaluated programming materials to help with their work with teens. A section on Evidence-Based Programs identifies curricula that have shown evidence of changing adolescent sexual risk-taking behavior.

To View this Resource: See ETR’s Resource Center for Adolescent Pregnancy Prevention (ReCAPP) at: www.etr.org/recapp

DEBIs: Diffusion of Effective Behavioral Interventions

This project was designed to help community-based service providers, as well as state and local health departments, provide effective, science-based, HIV-prevention initiatives. The website contains detailed information on interventions including Healthy Relationships, Holistic Health Recovery, empowerment, Safety Counts, Street Smart, and many others.

To View this Resource: www.effectiveinterventions.org

PASHA: Program Archive on Sexuality, Health and Adolescence

This archive created by Sociometrics provides a collection of promising teen pregnancy and STD/HIV/AIDS prevention programs that have demonstrated effectiveness. Educators can obtain a package containing all of the materials needed for program implementation. In addition, it provides three evaluation resources that give program developers a starting point for re-evaluating the promising program.

To View this Resource: www.socio.com/pasha.htm

Compendium of HIV Prevention Interventions with Evidence of Effectiveness

This compendium was compiled by the Centers for Disease Control and Prevention (CDC) to help educators locate effective HIV-prevention interventions for drug users, heterosexual adults, men who have sex with men, and youth. The CDC determined rigorous evaluation requirements to ensure that only effective interventions would be included. This document contains summaries of those interventions that met these criteria.

To View this Resource: www.cdc.gov/hiv/resources/reports/hiv_compendium