Original scientific paper
Systematic Review of Interventions to Prevent the Spread of Sexually Transmitted Infections, Including HIV, Among Young People in Europe
Jeffrey V. Lazarus
; Copenhagen School of Global Health, Copenhagen University, Copenhagen, Denmark
Henna Sihvonen-Riemenschneider
; Department of Public Health, Faculty of Medicine, Dresden University of Technology, Dresden, Germany
Ulrich Laukamm-Josten
; World Health Organization Regional Office for Europe, Copenhagen, Denmark
Fiona Wong
; Matrix Public Health Consultants Inc, New Haven, Conn, USA
Jerker Liljestrand
; University Research Cooperation, Better Health Service, Phnom Penh, Cambodia
Abstract
Aim To examine the effectiveness of interventions seeking
to prevent the spread of sexually transmitted infections
(STIs), including HIV, among young people in the European
Union.
Methods For this systematic review, we examined interventions
that aimed at STI risk reduction and health promotion
conducted in schools, clinics, and in the community
for reported effectiveness (in changing sexual behavior
and/or knowledge) between 1995 and 2005. We also reviewed
study design and intervention methodology to discover
how these factors affected the results, and we compiled
a list of characteristics associated with successful and
unsuccessful programs. Studies were eligible if they employed
a randomized control design or intervention-only
design that examined change over time and measured behavioral,
biologic, or certain psychosocial outcomes.
Results Of the 19 studies that satisfied our review criteria,
11 reported improvements in the sexual health knowledge
and/or attitudes of young people. Ten of the 19 studies
aimed to change sexual risk behavior and 3 studies reported
a significant reduction in a specific aspect of sexual risk
behavior. Two of the interventions that led to behavioral
change were peer-led and the other was teacher-led. Only
1 of the 8 randomized controlled trials reported any statistically
significant change in sexual behavior, and then only
for young females.
Conclusion The young people studied were more accepting
of peer-led than teacher-led interventions. Peerled
interventions were also more successful in improving
sexual knowledge, though there was no clear difference
in their effectiveness in changing behavior. The improvement
in sexual health knowledge does not necessarily
lead to behavioral change. While knowledge may help improve
health-seeking behavior, additional interventions
are needed to reduce STIs among young people
Keywords
reproductive health; sexually transmitted infections; HIV/AIDS; young people; Europe
Hrčak ID:
53509
URI
Publication date:
15.2.2010.
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