24445180

PMC4634364

Purpose

An earlier randomized controlled trial found that two middle school sexual education programsda risk avoidance (RA) program and a risk reduction (RR) programddelayed initiation of sexual intercourse (oral, vaginal, or anal sex) and reduced other sexual risk behaviors in ninth grade. We examined whether these effects extended into 10th grade.

Methods

Fifteen middle schools were randomly assigned to RA, RR, or control conditions. Follow-up surveys were conducted with participating students in 10th grade (n = 1,187; 29.2% attrition).

Results

Participants were 60% female, 50% Hispanic, and 39% black; seventh grade mean age was 12.6 years. In 10th grade, compared with the control condition, both programs significantly delayed anal sex initiation in the total sample (RA: adjusted odds ratio [AOR], .64, 95% confidence interval [CI], .42–.99; RR: AOR, .65, 95% CI, .50–.84) and among Hispanics (RA: AOR, .53, 95% CI, .31–.91; RR: AOR, .82, 95% CI, .74–.93). Risk avoidance students were less likely to report unprotected vaginal sex, either by using a condom or by abstaining from sex (AOR: .61, 95% CI, .45–.85); RR students were less likely to report recent unprotected anal sex (AOR: .34, 95% CI, .20–.56). Both programs sustained positive impact on some psychosocial outcomes.

Conclusions

Although both programs delayed anal sex initiation into 10th grade, effects on the delayed initiation of oral and vaginal sex were not sustained. Additional high school sexual education may help to further delay sexual initiation and reduce other sexual risk behaviors in later high school years.

CDC Public Access

5U48DP000057/DP/NCCDPHP CDC HHS/United States
90XF0036/PHS HHS/United States
CC999999/Intramural CDC HHS/United States