Abstract
BackgroundAn emerging model for sexuality education is the rights-based approach, which unifies discussions of sexuality, gender norms, and sexual rights to promote the healthy sexual development of adolescents. A rigorous evaluation of a rights-based intervention for a broad population of adolescents in the U.S. has not previously been published. This paper evaluates the immediate effects of the Sexuality Education Initiative (SEI) on hypothesized psychosocial determinants of sexual behavior.MethodsA cluster-randomized trial was conducted with ninth-grade students at 10 high schools in Los Angeles. Classrooms at each school were randomized to receive either a rights-based curriculum or basic sex education (control) curriculum. Surveys were completed by 1,750 students (N = 934 intervention, N = 816 control) at pretest and immediate posttest. Multilevel regression models examined the short-term effects of the intervention on nine psychosocial outcomes, which were hypothesized to be mediators of students’ sexual behaviors.ResultsCompared with students who received the control curriculum, students receiving the rights-based curriculum demonstrated significantly greater knowledge about sexual health and sexual health services, more positive attitudes about sexual relationship rights, greater communication about sex and relationships with parents, and greater self-efficacy to manage risky situations at immediate posttest. There were no significant differences between the two groups for two outcomes, communication with sexual partners and intentions to use condoms.ConclusionsParticipation in the rights-based classroom curriculum resulted in positive, statistically significant effects on seven of nine psychosocial outcomes, relative to a basic sex education curriculum. Longer-term effects on students’ sexual behaviors will be tested in subsequent analyses.Trial registrationClinicalTrials.gov NCT02009046 [http://www.advocatesforyouth.org/the-3rs].
Highlights
Overview of program goals; introduction to gender stereotypes; availability of clinical sexual health services2
Attrition Comparisons between students lost to attrition and students who were retained were made on seven key background characteristics assessed at pretest
Results indicated that students in the Sexuality Education Initiative (SEI) curriculum group showed larger increases in scores from pretest to posttest than students in the control curriculum group, and that this SEI curriculum group effect was statistically significant for seven of the nine outcome measures
Summary
Overview of program goals; introduction to gender stereotypes; availability of clinical sexual health services2. An emerging model for sexuality education is the rights-based approach, which unifies discussions of sexuality, gender norms, and sexual rights to promote the healthy sexual development of adolescents. The rights-based approach is guided by a recognition of adolescents’ fundamental rights to sexual health information and services, selfdetermination, and non-discrimination, which are core to frameworks of reproductive rights [17,18] and reproductive justice [19] It expands the goals of sexuality education beyond disease and pregnancy prevention to include positive sexuality, empowerment, and even civic engagement, and incorporates curriculum content related to the larger contextual issues that affect adolescents’ sexual lives, including gender and cultural norms, relationship power, and sexual orientation
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