Making the grade: Preliminary psychosocial results from two sexual health education curricula for middle school youth

Background: Effective approaches for sexual education are urgently needed. "All About Youth" is a randomized controlled trial to evaluate two multi-media, middle school curricula, one risk avoidance (RA), one risk reduction (RR), comparable in duration, delivery, and theory, to examine common elements of effective programs.

Methods: 7th graders in 15 Texas middle schools were randomly assigned to RA, RR, or control conditions. The RA curriculum follows Title V, A-H criteria for abstinence education; the RR curriculum emphasizes abstinence but includes condom/contraceptive skills-training. Both curricula address peer norms, attitudes, refusal and communication skills related to healthy relationships, dating, and sex. Youth completed ACASI surveys in fall of 7th grade (n=1742), spring of 7th grade (n=1,547) (89%) and spring of 8th grade (n=1421) (82%). Ninth grade surveys are underway.

Results: Baseline sample characteristics were 59% female, 49% Latino, 39% Black, mean age 13.1 years; 13.1% had experienced vaginal sex, 9% oral sex, 7% anal sex. In 8th grade, psychosocial outcomes indicate positive impact for both RA and RR curricula relative to controls regarding: abstinence beliefs, HIV/STI knowledge, perceived friends' sexual beliefs, global character, and healthy dating relationships (p<.05). RA youth also reported signficantly less exposure to risky situations, reduced vaginal sex intentions, increased abstinence intentions (through high school and until marriage), and less permissive parental sexual beliefs. RR youth reported increased condom use knowledge and self-efficacy.

Conclusions: Both curricula indicate promising short-term psychosocial results increasing the likelihood of positive behavioral outcomes (delayed sexual initiation and reduced sexual risk behavior) in 9th grade.