Eda Algur1, Elin Wang2, Howard S Friedman3, Bidia Deperthes2. 1. Department of Economics, Harvard University, Cambridge, Massachusetts. Electronic address: ealgur@hsph.harvard.edu. 2. Department of Global Health, Yale University, New Haven, Connecticut. 3. United Nations Population Fund, New York, New York.
Abstract
PURPOSE: High levels of HIV, sexually transmitted infections (STIs), and pregnancy among adolescents has motivated some countries to consider the implementation of condom availability programs (CAPs) in high schools. In this present study, we analyzed the impact of CAP on students' sexual behaviors and health outcomes. METHODS: We conducted a systematic literature review of peer-reviewed articles published between 1990 and 2017. RESULTS: Twenty-nine articles from seven countries were included in this review. We found that CAP does not increase sexual activity nor lead to a greater number of sexual partners. It also does not lower the age of sexual initiation. A majority of the studies reported an increase in condom uptake and use at last sex among students with CAP. All the studies that examined STI found a decrease of STI symptoms and rates for students with CAP compared with the control group. The data on HIV rates was inconclusive. There was no difference in pregnancy rates associated with participation in CAP programs. CONCLUSION: This global literature review showed that the fears surrounding CAP and promiscuity are unfounded. Once CAP is in place, students utilize it, and condom use increases, which translates to improved sexual health outcomes.
PURPOSE: High levels of HIV, sexually transmitted infections (STIs), and pregnancy among adolescents has motivated some countries to consider the implementation of condom availability programs (CAPs) in high schools. In this present study, we analyzed the impact of CAP on students' sexual behaviors and health outcomes. METHODS: We conducted a systematic literature review of peer-reviewed articles published between 1990 and 2017. RESULTS: Twenty-nine articles from seven countries were included in this review. We found that CAP does not increase sexual activity nor lead to a greater number of sexual partners. It also does not lower the age of sexual initiation. A majority of the studies reported an increase in condom uptake and use at last sex among students with CAP. All the studies that examined STI found a decrease of STI symptoms and rates for students with CAP compared with the control group. The data on HIV rates was inconclusive. There was no difference in pregnancy rates associated with participation in CAP programs. CONCLUSION: This global literature review showed that the fears surrounding CAP and promiscuity are unfounded. Once CAP is in place, students utilize it, and condom use increases, which translates to improved sexual health outcomes.