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UNESCO HIV and Health Education Clearinghouse

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  1. Rethinking sexual agency: proposing a multicomponent model based on young people’s life stories

    Sexual health policies explicitly aim to encourage young people to take responsibility for their sexuality to prevent adverse outcomes such as unintended pregnancies, STIs and sexual assault. In Europe and North America, ‘choice’ has become a central concept in sexual and reproductive health policy making. However, the concept of choice is not unproblematic, not least because the cultural emphasis on individual responsibility obscures structural limitations and inequalities, and mutual responsibility between partners. …

  2. The effects of school-based condom availability programs (CAPs) on condom acquisition, use and sexual behavior: a systematic review

    We conducted a systematic review to assess the impact of school-based condom availability programs (CAPs) on condom acquisition, use and sexual behavior. We searched PubMed to identify English-language studies evaluating school-based CAPs that reported process (i.e. number of condoms distributed or used) and sexual behavior measures. We identified nine studies that met our inclusion criteria, with the majority conducted in the United States of America. We judged most studies to have medium risk of bias. …

  3. Interventions for preventing unintended, rapid repeat pregnancy among adolescents: A review of the evidence and lessons from high-quality evaluations

    In 2017, of the 22.5 million parenting adolescents (ages 15–19) in 60 countries, approximately 4.1 million gave birth to a second or higher-order child. Adolescent pregnancy in general, and rapid repeat pregnancies specifically, expose young mothers and their children to multiple health and socioeconomic risks. The purpose of this article is to review the impact of interventions designed to prevent unintended, rapid repeat pregnancies among adolescents, including those aimed at changing norms to postpone "intended" closely spaced pregnancies to promote healthy spacing.

  4. Interventions for adolescent substance abuse: an overview of systematic reviews

    Many unhealthy behaviors often begin during adolescence and represent major public health challenges. Substance abuse has a major impact on individuals, families, and communities, as its effects are cumulative, contributing to costly social, physical, and mental health problems. The authors conducted an overview of systematic reviews to evaluate the effectiveness of interventions to prevent substance abuse among adolescents. They report findings from a total of 46 systematic reviews focusing on interventions for smoking/tobacco use, alcohol use, drug use, and combined substance abuse. …

  5. Interventions to prevent child marriage among young people in low- and middle-income countries: a systematic review of the published and gray literature

    Child marriage, defined as marriage before the age of 18 years, is a human rights violation that can have lasting adverse educational and economic impacts. The objective of this review was to identify high-quality interventions and evaluations to decease child marriage in low- and middle-income countries. PubMed, Embase, PsycInfo, CINAHL Plus, Popline, and the Cochrane Databases were searched without language limitations for articles published through November 2015. Gray literature was searched by hand. Reference tracing was used, as well as the unpacking of systematic reviews. …

  6. Interventions to prevent unintended and repeat pregnancy among young people in low- and middle-income countries: a systematic review of the published and gray literature

    Adolescent pregnancy, particularly unintended pregnancy, can have lasting social, economic, and health outcomes. The objective of this review is to identify high-quality interventions and evaluations to decrease unintended and repeat pregnancy among young people in low- and middle-income countries. PubMed, Embase, PsycInfo, Cinahl Plus, Popline, and the Cochrane Databases were searched for all languages for articles published through November 2015. Gray literature was searched by hand. Reference tracing was utilized, as well as unpacking systematic reviews. …

  7. Interventions to prevent sexually transmitted infections, including HIV, among young people in low- and middle-income countries: a systematic review of the published and gray literature

    Sexually transmitted infections (STIs), including HIV, are prevalent among adolescents and can have lasting adverse health consequences. The objective of this review is to identify high-quality interventions and evaluations to decrease STI transmission and related risky behaviors among young people in low- and middle-income countries. PubMed, Embase, PsycInfo, Cinahl Plus, Popline, and the Cochrane Databases were searched without language limitations for articles published through November 2015. Gray literature was searched by hand. …

  8. School-based interventions for preventing HIV, sexually transmitted infections, and pregnancy in adolescents (Review)

    Background: School-based sexual and reproductive health programmes are widely accepted as an approach to reducing high-risk sexual behaviour among adolescents. Many studies and systematic reviews have concentrated on measuring effects on knowledge or self-reported behaviour rather than biological outcomes, such as pregnancy or prevalence of sexually transmitted infections (STIs). Objectives: To evaluate the effects of school-based sexual and reproductive health programmes on sexually transmitted infections (such as HIV, herpes simplex virus, and syphilis), and pregnancy among adolescents.

  9. Is the sexual behaviour of young people in sub-Saharan Africa influenced by their peers? A systematic review

    Adolescents in sub-Saharan Africa are highly vulnerable to HIV, other sexually transmitted infections (STIs) and unintended pregnancies. Evidence for the effectiveness of individual behaviour change interventions in reducing incidence of HIV and other biological outcomes is limited, and the need to address the social conditions in which young people become sexually active is clear. Adolescents' peers are a key aspect of this social environment and could have important influences on sexual behaviour. There has not yet been a systematic review on the topic in sub-Saharan Africa. …

  10. The effect of school-based health clinics on teenage pregnancy and parenting outcomes: an integrated literature review

    Teenage pregnancy outcomes have become an increasing concern in the United States. Education and support of pregnant teens are critical factors that may determine good or poor pregnancy outcomes. Poor outcomes may include low birth weight, developmental delays, and poor academic performance. Although the number of teenagers experiencing pregnancy and parenting has declined in the U.S., school-based health clinics can be used to provide support and guidance designed to avoid the negative outcomes associated with teenage pregnancy and parenting. …

  11. Factors associated with teenage pregnancy in South Asia: a systematic review

    Background: South Asia has a large proportion of young people in the world and teenage pregnancy has emerged as one of the major public health problem among them. The objective of this study is to systematically review to identify the risk factors associated with teenage pregnancy in South Asian countries. Methods: We systematically searched MEDLINE, EMBASE and CINAHL database (1996 to April 2007) and web-based information. Inclusion criteria were the English-language papers available in the UK and describing teenage pregnancy in South Asia. …

  12. Factors associated with teenage pregnancy in the European Union countries: a systematic review

    Background: As part of the REPROSTAT2 project, this systematic review aimed to identify factors associated with teenage pregnancy in 25 European Union countries.Methods: The search strategy included electronic bibliographic databases (1995 to May 2005), bibliographies of selected articles and requests to all country representatives of the research team for relevant reports and publications. Primary outcome measure was conception. Inclusion criteria were quantitative studies of individual-level factors associated with teenage (13–19 years) pregnancy in EU countries. …

  13. Effective approaches for programming to reduce adolescent vulnerability to HIV infection, HIV risk, and HIV-related morbidity and mortality: A systematic review of systematic reviews

    Background: In 2012, an estimated 2.1 million adolescents were living with HIV. Though there are effective interventions to prevent and treat HIV infection, adolescents face specific barriers in accessing them. As a result, new infections and poor outcomes among HIV-infected adolescents are common. HIV programming for adolescents should focus on interventions of proven effectiveness and address underlying factors driving incidence and lack of effective treatment and care in this age group. …

  14. Can money prevent the spread of HIV? A review of cash payments for HIV prevention

    Cash payments to improve health outcomes have been used for many years; however, their use for HIV prevention is new and the impact not yet well understood. We provide a brief background on the rationale behind using cash to improve health outcomes, review current studies completed or underway using cash for prevention of sexual transmission of HIV, and outline some key considerations on the use of cash payments to prevent HIV infections. We searched the literature for studies that implemented cash transfer programs and measured HIV or HIV-related outcomes. …

  15. Nothing as practical as good theory? The theoretical basis of HIV prevention interventions for young people in sub-Saharan Africa: A systematic review

    This paper assesses the extent to which HIV prevention interventions for young people in sub-Saharan Africa are grounded in theory and if theory-based interventions are more effective. Three databases were searched for evaluation studies of HIV prevention interventions for youth. Additional articles were identified on websites of international organisations and through searching references. 34 interventions were included; 25 mentioned the use of theory. …

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