Interventions to reduce sexual risk for human immunodeficiency virus in adolescents: a meta-analysis of trials, 1985-2008.

OBJECTIVE: To provide an updated review of the efficacy of behavioral interventions to reduce sexual risk of human immunodeficiency virus (HIV) among adolescents.
DESIGN: We searched electronic databases, leading public health journals, and the document depository held by the Synthesis of HIV/AIDS Risk Reduction Project. Studies that fulfilled the selection criteria and were available as of December 31, 2008, were included.
SETTING: Studies that investigated any behavioral intervention advocating sexual risk reduction for HIV prevention, sampled adolescents (age range, 11-19 years), measured a behavioral outcome relevant to sexual risk, and provided sufficient information to calculate effect sizes.
PARTICIPANTS: Data from 98 interventions (51,240 participants) were derived from 67 studies, dividing for qualitatively different interventions and gender when reports permitted it.
MAIN OUTCOME MEASURES: Condom use, sexual frequency, condom use skills, interpersonal communication skills, condom acquisition, and incident sexually transmitted infections (STIs).
RESULTS: Relative to controls, interventions succeeded at reducing incident STIs, increasing condom use, reducing or delaying penetrative sex, and increasing skills to negotiate safer sex and to acquire prophylactic protection. Initial risk reduction varied depending on sample and intervention characteristics but did not decay over time.
CONCLUSIONS: Comprehensive behavioral interventions reduce risky sexual behavior and prevent transmission of STIs. Interventions are most successful to the extent that they deliver intensive content.

Abstinence education has no effect on US teenagers' sexual activity.

Tanne JH.
BMJ. 2007 Apr 28;334(7599):867.

Although the United States spends about $88m (£44m; 65m) a year teaching teenagers to abstain from sex outside marriage, young people in the programmes are just as likely to have sex as those who don't receive counselling, a new study says.
Teenagers who received abstinence education did not delay sexual activity any longer than those in a control group. When they became sexually active they had the same number of partners and were as likely to use condoms or other contraceptives as those who had not been counselled.
This rigorous, well designed study adds to and confirms previous research findings that abstinence only education programmes are ineffective and a waste of taxpayer dollars. It is called for more comprehensive programmes that not only teach abstinence but also provide information on contraception and safe sex.