A near peer approach to sexual health education: Findings from a North Carolina high school theater-based intervention

North Carolina youth initiate sex at earlier ages, have more sexual partners, and are less likely to report using condoms during last sexual intercourse compared to the national average. School-based comprehensive sexual education (sex-ed) is an effective strategy to address these outcomes, yet “abstinence-only” approaches are prevalent, suggesting the need for innovative ways to introduce comprehensive sex-ed. AMP! (Arts-based, Multiple intervention, Peer-education) is an interactive, theater-based, sexual health education intervention delivered by near peers in high schools. Near peers are undergraduate students with similar sociodemographics as intervention participants, who share their struggles and successes in making protective sexual health decisions using drama and health education techniques. During AMP! high school students interact with near peers through performances and demonstrations to learn: sexual health, how to challenge sexual stigma, and skills to navigate adolescent sexuality. We used a pretest-posttest, control group, mixed-measures study design; data were collected from near peers, high school students, teachers and school district administrators. Quantitative analyses showed statistically significant (p<0.05) changes in high school students’ HIV knowledge and attitudes. Qualitative analyses revealed facilitators and barriers to using near peers. Facilitators included the perception of near peers as opinion leaders and their performances as a fun and open way to discuss sexual health. Barriers included near peers’ limited experience with comprehensive sex-ed and perception of some near peer performances contradicting school culture. Findings indicate the effectiveness of using near peers and the importance of identifying and testing innovative approaches to introduce comprehensive sex-ed in less progressive school settings.