What educational programs prevent sexually-transmitted diseases in adolescents? A meta-analysis

Abstract

Background. Educational programs for preventing sexually transmitted diseases (STDs) have often been implemented in different settings and populations. However, it is not clear to what extent interventions are effective and what are the program characteristics contributing to this effect. Method. We reviewed published and unpublished reports (1989-2012) on methodologically sound programs aiming to reduce sexual risk behaviors in US adolescents. Findings. Eighteen studies met the selection criteria and provided data on STD incidence (N=15,579). On average interventions reduced incidence roughly from 7 to 6 out of 100 people (17% relative risk reduction (RRR)). Interventions focused on abstinence had no effect, while comprehensive education programs aiming to improve skills and promote safe sexual practices reduced risk by 4 percentage points (23% RRR). In particular, interventions teaching condom use skills or communication and negotiation skills reduced incidence of STDs by 3 to 4 percentage points (30% RRR). Discussion. Interventions should offer STD knowledge and solid communication and condom use skills to adolescents. Properly designed interventions with the above-mentioned characteristics can achieve a 30% reduction of STD incidence.