School-based sex education among adolescents worldwide: Interventions for the prevention of STIs and unintended pregnancies

Abstract

Background: Adolescents are at high risk of exposure to sexually transmitted infections (STIs) and unintended pregnancies, and school is the appropriate environment for interventions to promote sexual and reproductive health. Aim: The evaluation of the results of sex education interventions aimed at preventing STIs and unintended pregnancies, performed on adolescents in school settings worldwide. Methods: The search of studies was conducted independently in three databases from 15/3/2021 to 30/04/2021. The inclusion criteria required the studies to be randomised control trials including school-based interventions that aim to prevent STIs and unintended pregnancies, among adolescent students aged 10–19 years old. Findings: A total of 2 952 articles were found, of which 24 were included in the final systematic review through the PRISMA method. A total of 59 055 students participated in these 24 controlled randomised trials conducted in 13 countries. The grading of the strength of evidence estimated that 45.83% of the studies were level I, while 54.17% were level II. Conclusions: Our findings show positive results regarding the improvement of adolescents' knowledge and attitudes towards Sexual and Reproductive Health, following school-based interventions on STIs and unintended pregnancy prevention.