A Systematic Global Review of Condom Availability Programs in High Schools

J Adolesc Health. 2019 Mar;64(3):292-304. doi: 10.1016/j.jadohealth.2018.11.013.

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.

Keywords: Adolescents; Condom availability program; Condom use; HIV; High school students; STIs; Sexual behaviors; Sexuality; Teenage pregnancy.

Publication types

  • Systematic Review

MeSH terms

  • Adolescent
  • Adolescent Behavior / psychology
  • Condoms / supply & distribution*
  • Female
  • Global Health
  • Humans
  • Pregnancy
  • Pregnancy in Adolescence / prevention & control
  • Pregnancy in Adolescence / statistics & numerical data*
  • School Health Services*
  • Sexual Behavior / psychology
  • Sexual Behavior / statistics & numerical data*
  • Sexually Transmitted Diseases / prevention & control
  • Students