Logo of pubhealthrepLink to Publisher's site
Public Health Rep. 1994 May-Jun; 109(3): 339–360.
PMCID: PMC1403498

School-based programs to reduce sexual risk behaviors: a review of effectiveness.


This review was undertaken in recognition of the mounting public health and social problems associated with adolescent sexual behavior and the importance of basing school-affiliated programs designed to reduce sexual risk-taking behavior on sound research. The authors were commissioned by the Division of Adolescent and School Health within the Centers for Disease Control and Prevention, Public Health Service, to review carefully the research on these programs and to assess their impact on behavior. The authors identified 23 studies of school-based programs that were published in professional journals and measured program impact on behavior. They then summarized the results of those studies, identifying the distinguishing characteristics of effective programs, and citing important research questions to be addressed in the future. Not all sex and AIDS education programs had significant effects on adolescent sexual risk-taking behavior, but specific programs did delay the initiation of intercourse, reduce the frequency of intercourse, reduce the number of sexual partners, or increase the use of condoms or other contraceptives. These effective programs have the potential to reduce exposure to unintended pregnancy and sexually transmitted disease, including HIV infection. These programs should be replicated widely in U.S. schools. Additional research is needed to improve the effectiveness of programs and to clarify the most important characteristics of effective programs.

Full text

Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (3.8M), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Henshaw SK, Van Vort J. Teenage abortion, birth and pregnancy statistics: an update. Fam Plann Perspect. 1989 Mar-Apr;21(2):85–88. [PubMed]
  • Webster LA, Berman SM, Greenspan JR. Surveillance for gonorrhea and primary and secondary syphilis among adolescents, United States--1981-1991. MMWR CDC Surveill Summ. 1993 Aug 13;42(3):1–11. [PubMed]
  • Nord CW, Moore KA, Morrison DR, Brown B, Myers DE. Consequences of teen-age parenting. J Sch Health. 1992 Sep;62(7):310–318. [PubMed]
  • De Mauro D. Sexuality education 1990. A review of state sexuality and AIDS education curricula. SIECUS Rep. 1990 Jan;18(2):1–9. [PubMed]
  • Forrest JD, Silverman J. What public school teachers teach about preventing pregnancy, AIDS and sexually transmitted diseases. Fam Plann Perspect. 1989 Mar-Apr;21(2):65–72. [PubMed]
  • Iverson DC, Kolbe LJ. Evolution of the national disease prevention and health promotion strategy: establishing a role for the schools. J Sch Health. 1983 May;53(5):294–302. [PubMed]
  • Upchurch DM, Weisman CS, Shepherd M, Brookmeyer R, Fox R, Celentano DD, Colletta L, Hook EW., 3rd Interpartner reliability of reporting of recent sexual behaviors. Am J Epidemiol. 1991 Nov 15;134(10):1159–1166. [PubMed]
  • Ku L, Sonenstein FL, Pleck JH. Factors influencing first intercourse for teenage men. Public Health Rep. 1993 Nov-Dec;108(6):680–694. [PMC free article] [PubMed]
  • Marsiglio W, Mott FL. The impact of sex education on sexual activity, contraceptive use and premarital pregnancy among American teenagers. Fam Plann Perspect. 1986 Jul-Aug;18(4):151–162. [PubMed]
  • Dawson DA. The effects of sex education on adolescent behavior. Fam Plann Perspect. 1986 Jul-Aug;18(4):162–170. [PubMed]
  • Furstenberg FF, Jr, Moore KA, Peterson JL. Sex education and sexual experience among adolescents. Am J Public Health. 1985 Nov;75(11):1331–1332. [PMC free article] [PubMed]
  • Zelnik M, Kim YJ. Sex education and its association with teenage sexual activity, pregnancy and contraceptive use. Fam Plann Perspect. 1982 May-Jun;14(3):117–126. [PubMed]
  • Anderson RM, May RM. Epidemiological parameters of HIV transmission. Nature. 1988 Jun 9;333(6173):514–519. [PubMed]
  • Anderson JE, Kann L, Holtzman D, Arday S, Truman B, Kolbe L. HIV/AIDS knowledge and sexual behavior among high school students. Fam Plann Perspect. 1990 Nov-Dec;22(6):252–255. [PubMed]
  • Ku LC, Sonenstein FL, Pleck JH. The association of AIDS education and sex education with sexual behavior and condom use among teenage men. Fam Plann Perspect. 1992 May-Jun;24(3):100–106. [PubMed]
  • Eisen M, Zellman GL, McAlister AL. Evaluating the impact of a theory-based sexuality and contraceptive education program. Fam Plann Perspect. 1990 Nov-Dec;22(6):261–271. [PubMed]
  • Howard M, McCabe JB. Helping teenagers postpone sexual involvement. Fam Plann Perspect. 1990 Jan-Feb;22(1):21–26. [PubMed]
  • Howard M. Delaying the Start of Intercourse Among Adolescents. Adolesc Med. 1992 Jun;3(2):181–194. [PubMed]
  • Kirby D, Barth RP, Leland N, Fetro JV. Reducing the risk: impact of a new curriculum on sexual risk-taking. Fam Plann Perspect. 1991 Nov-Dec;23(6):253–263. [PubMed]
  • Walter HJ, Vaughan RD. AIDS risk reduction among a multiethnic sample of urban high school students. JAMA. 1993 Aug 11;270(6):725–730. [PubMed]
  • Kirby D, Waszak C, Ziegler J. Six school-based clinics: their reproductive health services and impact on sexual behavior. Fam Plann Perspect. 1991 Jan-Feb;23(1):6–16. [PubMed]
  • Zabin LS, Hirsch MB, Smith EA, Streett R, Hardy JB. Evaluation of a pregnancy prevention program for urban teenagers. Fam Plann Perspect. 1986 May-Jun;18(3):119–126. [PubMed]
  • Zabin LS, Hirsch MB, Streett R, Emerson MR, Smith M, Hardy JB, King TM. The Baltimore pregnancy prevention program for urban teenagers. I. How did it work? Fam Plann Perspect. 1988 Jul-Aug;20(4):182–187. [PubMed]
  • Edwards LE, Steinman ME, Arnold KA, Hakanson EY. Adolescent pregnancy prevention services in high school clinics. Fam Plann Perspect. 1980 Jan-Feb;12(1):6–7,11-4. [PubMed]
  • Kirby D, Resnick MD, Downes B, Kocher T, Gunderson P, Potthoff S, Zelterman D, Blum RW. The effects of school-based health clinics in St. Paul on school-wide birthrates. Fam Plann Perspect. 1993 Jan-Feb;25(1):12–16. [PubMed]
  • Vincent ML, Clearie AF, Schluchter MD. Reducing adolescent pregnancy through school and community-based education. JAMA. 1987 Jun 26;257(24):3382–3386. [PubMed]

Articles from Public Health Reports are provided here courtesy of Association of Schools of Public Health


Related citations in PubMed

See reviews...See all...

Cited by other articles in PMC

See all...


  • Cited in Books
    Cited in Books
    PubMed Central articles cited in books
  • MedGen
    Related information in MedGen
  • PubMed
    PubMed citations for these articles

Recent Activity

Your browsing activity is empty.

Activity recording is turned off.

Turn recording back on

See more...