HIV prevention in Mexican schools

Current efforts to combat sexually transmitted infections and unplanned pregnancy in schools do not change sexual risk behaviour, concludes a study in the British Medical Journal.

Most recent efforts to prevent sexually transmitted infections (including HIV) and pregnancy in adolescents have been school based projects that promoted either condoms or abstinence. Studies have produced mixed results, with only some interventions delaying the onset of sexual activity, increasing condom use, or decreasing unplanned pregnancy

Nearly 11,000 students at 40 public high schools in Mexico participated in this study to assess the effects of an HIV prevention programme that promoted condom use and emergency contraception.

Fifteen schools received the HIV prevention course that promoted condom use. Another 15 schools received the same course plus a module on emergency contraception, and ten schools acted as controls and continued with the existing sex education course. Students were surveyed at the start of the study and again at four months and 16 months.

Neither strategy had any affect on reported condom use or sexual behaviour. However, students who received emergency contraception education also reported increased use of emergency contraception.

Knowledge of HIV improved in both intervention groups, and knowledge of emergency contraception improved in students who received the additional module.

"Our study adds to the growing body of evidence that current HIV prevention efforts based in school do not alter sexual risk behaviour, and suggests that current interventions educate effectively but may not change sexual risk behaviour," say the authors.

The study results also suggest that there is no risk in combining condom promotion messages with emergency contraception education.

"New strategies are urgently needed to combat HIV and other sexually transmitted diseases and unplanned pregnancy among adolescents," they conclude.

http://www.bmj.com