Abstract

ObjectivesTo describe the comprehensive sex education (CSE) coverage and to evaluate a set of indicators related to knowledge, attitudes, and practices associated with the seven components of the CSE framework among Mexican high-school students.MethodsWe conducted a cross-sectional survey of a nationally representative sample of students in public and private high schools in Mexico. Questions about CSE coverage and about knowledge, attitudes, and practices related to sexual health were included. We present descriptive statistics for demographic characteristics, exposure to CSE, and sexual health outcomes. We fitted a series of multivariate logistic regression models to examine the association between each CSE component exposure and sexual health outcomes, adjusting for age and sex.ResultsThere were significant associations between being exposed to each CSE components and the related sexual health outcomes. The strongest one was for identifying effective contraceptives among those exposed to the Sexual and Reproductive Health component (SRH) (OR 4.10; 95%CI[2.93,5.75]). Also, students exposed to the relationships component had 20% higher odds of affirming they could convince their partner to use condoms (OR 1.20; 95%CI[1.05,1.36]).ConclusionsThis paper provides evidence of the potential beneficial effects of CSE on attitudes, knowledge, and behaviors regarding sexual and reproductive health among adolescents. In addition, it identifies areas that should be strengthened to increase the positive impact of CSE.

Highlights

  • Worldwide, adolescent sexual and reproductive health remains a challenge

  • The strongest one was for identifying effective contraceptives among those exposed to the Sexual and Reproductive Health component (SRH)

  • This paper provides evidence of the potential beneficial effects of comprehensive sex education (CSE) on attitudes, knowledge, and behaviors regarding sexual and reproductive health among adolescents

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Summary

Introduction

Adolescent sexual and reproductive health remains a challenge. 111 million cases of sexually transmitted infections (STI), and 15% of new adult HIV cases, occur among adolescents [2,3,4]. Maternal health issues are a leading cause of death among adolescent women [5]. In 2015 the Adolescent Fertility Rate (AFR) for 15 to 19 years old women was 44 per 1000 births, with much higher rates in low-income counties (97 per 1000) compared to high-income countries (19 per 1000) [5]. A middle-income country (LMIC), has systematically occupied the first place for AFR among Organization for Economic Cooperation and Development (OECD) members, with a birth rate of 64.2 per 1000 births in 15–19 years-old women in 2008, which by 2014 had increased to 77 per 1000 births [6,7]

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