Issue: June 2020
Disclosures: The authors report no relevant financial disclosures.
April 29, 2020
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Sexual health interventions improve sexual well-being among black adolescents

Issue: June 2020
Disclosures: The authors report no relevant financial disclosures.
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A systematic review and meta-analysis of 29 studies published over the course of 30 years showed that sexual health interventions among black adolescents were significantly associated with improvements in abstinence, condom use and sexual health knowledge.

Reina Evans

The studies included a total of 11,918 black adolescents in the United States. In their analysis, Reina Evans, BS, a social and community psychology graduate student at North Carolina State University, and colleagues looked to assess for the first time the impact these interventions have on the sexual behavior of black adolescents, who are at an increased risk for contracting HIV and other STIs, they noted.

“Parents and clinicians often play a unique and invaluable role in adolescent sex education,” Evans told Healio. “Many of the successful sexual health interventions in this study had components aimed at increasing parent-child communication about sex and clinic-based sexual health counseling. Parents and clinicians should look for opportunities to get involved in adolescents’ sex education and to talk to adolescents about sex.”

Evans and colleagues used the standardized mean difference, Cohen d, to indicate effect sizes of small (0.2), medium (0.5) or large (0.8).

Study effect sizes for abstinence ranged from –0.48 (95% CI, –1.77 to 0.81) to 0.71 (95% CI, –0.02 to 1.44), with a weighted mean effect size across all studies of 0.14 (95% CI, 0.05-0.24).

Study effect sizes for condom use ranged from –0.27 (95% CI, –1.04 to 0.51) to 0.82 (95% CI, 0.29-1.35), with a weighted mean effect size across all studies of 0.25 (95% CI, 0.11-0.39).

“It was surprising to find that sexual health interventions actually delayed sexual activity among adolescents,” Evans said. “Some communities express concern that if their teens learn about sex, they will have sex. However, this meta-analysis shows that the exact opposite may be true. When black adolescents participate in sexual health interventions — when they learn about reproduction, condoms, and contraception — they are actually less likely to have sex than teens who do not participate in the interventions.”

Sexual health interventions also were associated with improvements in three psychological outcomes: sexual health intentions (0.17; 95% CI, 0.05-0.3), sexual health knowledge (0.46; 95% CI, 0.30-0.63) and sexual health self-efficacy (0.19; 95% CI, 0.09-0.28). The researchers did not observe an association between these interventions and number of sex partners, pregnancy or STI contraction.

“School-based sexual health interventions (eg, sex education classes) delay sexual activity and increase condom use among black adolescents,” Evans said. “Parents and clinicians should encourage schools to provide evidence-based sex education.”