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.
