Limits of teacher delivered sex education: interim behavioural outcomes from randomised trial

Daniel Wight, senior researcher, a Gillian M Raab, professor, b Marion Henderson, senior researcher, a Charles Abraham, professor, c Katie Buston, senior researcher, a Graham Hart, professor, a Sue Scott, professor. d
a Medical Research Council Social and Public Health Sciences Unit, Glasgow G12 8RZ, b Applied Statistics Group, School of Mathematics and Statistics, Napier University, Edinburgh EH11 4BN, c School of Social Sciences, University of Sussex, Arts Building E, Falmer, Brighton BN1 9SN, d Department of Sociology and Social Policy, University of Durham, Durham DH1 3JT
Correspondence to: D Wight danny@msoc.mrc.gla.ac.uk
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Objective: To determine whether a theoretically based sex education programme for adolescents (SHARE) delivered by teachers reduced unsafe sexual intercourse compared with current practice. Design: Cluster randomised trial with follow up two years after baseline (six months after intervention). A process evaluation investigated the delivery of sex education and broader features of each school. Setting: Twenty five secondary schools in east Scotland. Participants: 8430 pupils aged 13-15 years; 7616 completed the baseline questionnaire and 5854 completed the two year follow up questionnaire. Intervention: SHARE programme (intervention group) versus existing sex education (control programme). Main outcome measures: Self reported exposure to sexually transmitted disease, use of condoms and contraceptives at first and most recent sexual intercourse, and unwanted pregnancies. Results: When the intervention group was compared with the conventional sex education group in an intention to treat analysis there were no differences in sexual activity or sexual risk taking by the age of 16 years. However, those in the intervention group reported less regret of first sexual intercourse with most recent partner (young men 9.9% difference, 95% confidence interval 18.7 to 1.0; young women 7.7% difference, 16.6 to 1.2). Pupils evaluated the intervention programme more positively, and their knowledge of sexual health improved. Lack of behavioural effect could not be linked to differential quality of delivery of intervention. Conclusions: Compared with conventional sex education this specially designed intervention did not reduce sexual risk taking in adolescents.
What is already known on this topic Despite the widespread assumption that sex education delivered by teachers can reduce sexual risk taking in young people, there have been few randomised trials large enough to show this and none in the United Kingdom
Several quasi-experimental studies have concluded that sex education is effective, but most randomised trials suggest it is not
What this study adds Improvements in teacher delivered whole class sex education have some beneficial effect on the quality of young people's sexual relationships but do not influence sexual behaviour