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Sex education beyond school: Implications for practice and research



The negative consequences of teenage sexual behaviour are issues of concern in Britain and many other western countries. Over one-quarter of British young people are reported to become sexually active prior to the age of 16 and the rate of teenage pregnancy remains one of the highest in Western Europe. Current UK Government policy on sex education highlights the provision of skills for ‘safe sex’ at school to reduce teenage pregnancy rates. This paper argues that school cannot alone provide sufficient guidance to change teenage sexual behaviour, as school, family, religion, peers and media all have their part to play. Cooperation between schools, young people, their families and communities is crucial to enhance the effectiveness of sex education and to promote positive sexual health.
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Yu J (2010) Sex education beyond school: Implications for practice and research. Sex
Education: Sexuality, Society and Learning, 10(2), 187-199.
Dr Juping Yu, Faculty of Life Sciences and Education, University of South Wales,
Glyntaf, Pontypridd, UK
Sex Education beyond School: Implications for Research and Practice
The negative consequences of teenage sexual behaviour are issues of concern in Britain and
many other western countries. Over one-quarter of British young people are reported to
become sexually active prior to the age of 16 and the rate of teenage pregnancy remains one
of the highest in Western Europe. Current UK government policy on sex education
highlights the provision of skills for ‘safe sex’ at school to reduce teenage pregnancy rates.
This paper argues that school cannot alone provide sufficient guidance to change teenage
sexual behaviour, as school, family, religion, peers and media all have their part to play.
Cooperation between schools, young people, their families and communities is crucial to
enhance the effectiveness of sex education and to promote positive sexual health.
Keywords: teenagers; sex education; family; peers; religion; media; sexual behaviour
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J Yu (2010)
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Recent news about a boy who became a father at 13 has provoked a fierce political
debate over high rate of teenage pregnancies in the UK, politicians stating that the case
raised ‘huge worrying’ questions about sex education and the sexualisation of modern
British society (Bingham 2009). Based on UK national surveys, over one-quarter of young
people become sexually active prior to the age of 16 (Currie et al. 2008; Wellings et al.
2001). The adverse consequences of early sexual initiation, such as increased lifetime sexual
partners, unwanted teenage pregnancies and sexually transmitted infections (STIs), are issues
of concern in Britain and many other countries. The UK teenage pregnancy rate remains one
of the highest in Western Europe (Darroch, Sigh and Frost 2001). Moreover, the number of
new episodes of STIs in young people is still on the increase (Heath Protection Agency
Current government policy has argued for the provision of skills for ‘safe sex’ at school
(Social Executive Unit 1999). However, a range of factors have been reported to be relevant
to teenage sexual behaviour, including biological determinants such as age, hormone levels
and puberty developments (Edgardh 2002; He et al. 2004), individual variables such as
attitudes, self-esteem and school performance (Bonell 2005), and social factors such as
family and peers (Sieving et al. 2006; Yu 2008). Biological variables are unlikely to be
modified, while personal factors are often regulated by socio-cultural norms (Wellings et al.
1994). This paper, therefore, focuses on the social environment in which young people shape
their sexual behaviour.
The aim of this paper is to review the current literature on school sex education and the
role social factors played in teenage sexual behaviour.
The CINAHL, MEDLINE, ASSIA and PsycINFO databases were searched, using the
terms ‘sexual attitude/value’, ‘sexual behaviour’, ‘sex education’ and
‘teenager/adolescent/young people’ in combination. The inclusion criteria were:
Publication dates: between 2000 and 2009
Population: 13-19 year olds
Language: English
Type of study: quantitative research, qualitative research and literature reviews.
The review excluded studies that examined homosexual behaviour due to the complexity and
limited studies in this area or studies that explored personal and biological variables on
teenage sexual behaviour because of the focus of this review.
A total of 1458 references were retrieved. The titles and abstracts were scanned and full
manuscripts of relevant papers obtained. References within these papers were also examined.
A meta-analysis was not feasible due to the heterogeneity of the studies in terms of the
samples, settings and designs. Therefore, the findings were organised into themes using a
narrative approach.
The majority of the studies reviewed involved young people themselves only and some
also involved parents and friends. Five key themes were identified: sex education at school,
family environment, religion, interactions with peers, and media.
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Sex education at school
Sources of sex education for adolescents were examined in three UK national surveys
(Currie et al. 2008; Macdowall et al. 2006; Wellings et al. 2001). School-based sex education
was reported as the main source of information about sex, others including parents, peers and
media. Similar findings were found in a survey of 682 youth in China (Zhang, Li and Shah
Its effects on sexual knowledge and skills were explored. In England, Stephenson et al.
(2004) conducted a school-based randomised trial of over 8000 pupils aged 13 to14 years to
evaluate the long-term effect of pupil-led sex education. The programme showed some
positive impact on self-reported knowledge of methods to prevent STIs and skills in using
condoms at age 16 years (p=0.02, p<0.0001, respectively). In Scotland, the SHARE
programme (Sexual Health and Relationships: Safe, Happy and Responsible) was developed
for 13-15 year olds. Respondents (n=2689) in the intervention group scored significantly
higher on knowledge about sexual health than those (n=2812) in the control group (p=0.003-
0.0006) (Wight et al. 2002). Healthy Respect’ was part of the SHARE project as
implemented in 10 schools in Lothian. Tucker et al. (2007) reported that among 2796 pupils
in the intervention groups, there was a significant increase in confidence about getting and
using condoms, and in believing that condom use reduces the chance of contracting a STI
(Adjusted odds ratio (ORadj)=0.90-1.22, ORadj=1.09-1.47, ORadj=0.88-1.14, respectively),
but there were no significant differences in the remaining eight items about knowledge,
attitudes or intentions related to condom use.
Examinations of its impact on attitudes and behaviour revealed different results. Using
data from a US national survey, Kohler, Manhart and Lafferty (2008) compared the sexual
health risks of 1719 respondents who received abstinence-only or comprehensive sex
education to those who received no formal sex education. Neither type of intervention
significantly reduced the incidence of STIs. Compared with no sex education at all,
comprehensive sex education significantly correlated with fewer pregnancies and was
marginally associated with a lower likelihood of having had sex (ORadj=0.4, p=0.001;
ORadj=0,7, p=0.06 respectively); however, abstinence-only education was associated with
neither outcomes. Sather and Zinn (2002) confirmed that an intervention of abstinence-only
education did not significantly change 132 students' attitudes and intention to premarital sex.
Although its sample size was small, it supported the view that abstinence-only sex education
was an ineffective method.
Some positive outcomes were found by others. Somers and Surmann (2005) examined
multiple sources (peers, media, school and other adults) and timing of sex education among
672 pupils. Earlier learning from most sources and greater input from schools on various
sexual topics significantly reduced the frequency of both oral sex and sexual intercourse.
Analysing data from the US National Survey of Family Growth (n=2019), Mueller, Gavin
and Kukkarni (2008) reported that receiving sex education at schools, churches or
community organisations was associated with more likelihood of postponing sexual
intercourse until age 15 (OR=0.41, 95% confidence interval (CI)=0.21-0.77 for males;
OR=0.29, 95%CI=0.17-0.48 for females), being virgins (OR=0.42, 95%CI=0.25-0.69), and
using contraception at first sexual intercourse among males (OR=2.77, 95%CI=1.13-6.81). A
large Hong Kong survey also confirmed these findings (Wong et al. 2006). Respondents
receiving school AIDS education were significantly less likely to have had sex (OR=0.5,
p=0.024) and twice as likely to discuss emotional (p=0.001) or puberty issues (p=0.032).
Even so this intervention did not result in fewer pregnancies or increased condom use
In a US study of 158 adolescents, Somers and Eaves (2002) found that learning about
sex at school earlier was not associated with the loss of virginity earlier. In Scotland, the
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SHARE intervention showed no effects on self-reported sexual initiation, contraceptive
behaviour and unwanted pregnancy (Wight et al. 2002). A later evaluation using NHS data
confirmed that participants in the SHARE group did not differ significantly in rates of
terminations and conception by age 20, compared with those in the control group (p=0.18-
0.40) (Henderson et al. 2007). A systematic review of 26 randomized control trials also
suggested that school interventions did not delay sexual intercourse, improve the use of
contraceptives or reduce pregnancies (DiCenso et al. 2002). Another review on sex and HIV
education programmes worldwide, however, indicated that these programmes did not hasten
or increase sexual behaviour, but some did show positive effects on sexual behaviour (Kirby,
Laris and Rolleri 2007).
It may be difficult to draw conclusions from these studies, as interventions with diverse
aims were utilised in dissimilar groups. School was seen as important at least in the
provision of sexual information. Even so it was not the sole influential factor to teenage
sexual behaviour.
Family environment
The family, as a primary means of the socialisation of children, can have some influence
on adolescents. Interactions with parents, family disruption and socio-economic
disadvantages were all found to be important.
Interactions with parents
Sex was reported as a topic too embarrassing to discuss at home in many cultures
(Jaccard, Dittus and Gordon 2000; Robert et al. 2005; Yu 2007a), but parents were identified
as the preferred source of sex education when compared with peers, school, media and heath
professionals, as reported in a US study of 672 pupils (Somers and Surmann (2004). Of 4206
parents surveyed in Canada, 95% agreed or strongly agreed that sex education should be the
shared responsibility of school and home, but most respondents did not discuss sex-related
topics in detail with their children (Weaver et al. 2002). These findings were echoed in
qualitative studies of Chinese-British families in Scotland (Yu 2007a) and of young people
in Mongolia (Roberts et al. 2005). Reported barriers to such communication included the
limited sexual knowledge of parents, lack of communication skills, language obstacles,
divergent intergenerational sexual values, lack of available time to speak to children, and
parents not receiving sex education from their own parents (Mbugua 2007; Walker 2001; Yu
2007a, b).
Although reported family discussion about sex was limited, its impact on teenagers was
widely investigated. A US survey by Vesely et al. (2004) involved 1253 teenagers and their
parents, showing that greater family communication correlated with a teenager being a virgin
(OR=1.29, p<0.05). A community-based study of 1083 youth by Aspy et al. (2007)
confirmed these findings. Sexually active respondents were also found to be more likely to
use birth control if taught at home about delaying sexual activity and contraception (p<0.01).
Similarly, a study of 894 pupils in Ghana showed that family communication about
HIV/AIDS was significantly associated with condom use (OR=2.21, p<0.05), although it did
not result in sexual abstinence (Adu-Mireku 2003). Positive effect on contraceptive use and
even decreased negative peer influences on sexual risky behaviour was reported in two US
studies, one of 544 African American females (DiClemente et al. 2001) and the other of 355
African American and Hispanic adolescent-mother dyads (Whitaker and Miller 2000).
However, McNeely et al. (2002) studied a sample of 2006 adolescent-mother dyads in the
US and did not find an association between family discussion about sex and the timing of
sexual initiation. This longitudinal study raised some methodological issues. Some
respondents who reported being non-virgins at the first interview gave contradictory answers
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to this question at the subsequent interview. This may be due to recall difficulties, but
challenges the reliability of longitudinal studies on teenage sexual behaviour. Using data
from 9530 children-mother dyads, Fingerson (2005) reported that the greater the dialogue
about sex within the dyad, the greater the likelihood of teenage sexual activity. The impact
of family communication appeared to depend on what parents talked about. A longitudinal
study by Romo et al. (2002) documented matters of talking about dating and sex among 55
Latino mothers and their children. Dialogue about values and beliefs was found to have a
positive impact on attitudes to premarital sex and sexual initiation; however, talking about
everyday activities had no effect. The generalisibility of this study is limited due to its small,
non-randomised sample, yet it did show the importance of parental values and support
findings reported by others (McNeely et al. 2002; Somers and Gleason 2001; Somers and
Paulson 2000).
Some evidence supported the positive influence of parental disapproval of teenage sex on
teenagers (Dittus and Jaccard 2000; He et al. 2004). On the other hand, parents with
permissive attitudes to sex tended to raise children who held similar views, who lost
virginity at a young age, and who had more sexual partners (Fingerson 2005). The quality of
parent-child relationships could be influential (Jaccard, Dittus and Gordon 2000). After
controlling for age and peer variables among a sample of 568 African American females,
Maguen and Armistead (2006) found that both restrictive parental sexual attitudes and better
quality of parent-child relationships were positively related to respondents being virgins
(OR=1.17, p<0.01; OR=0.90, p<0.05, respectively). Knafo and Schwartz 2003 suggested
that a positive parent-child relationship provided the context, within which parents passed on
their values more effectively and children were more willing to accept their values. Young
people, especially girls, living in this environment were more likely to hold values similar to
their parents and delay sexual initiation (Fingerson 2005).
Family disruption and socio-economic disadvantages
A large survey of 14,287 adolescents in nine European countries showed that intact
family was a key protective factor for early sexual engagement (OR=1.7-3.0, p<0.05), while
close parent-adolescent relationships and high levels of parental monitoring were less
protective (Lenciauskiene and Zaborskis 2008). Studied conducted in various countries
confirmed these findings. In England, Bonell et al. (2006) followed 8766 pupils for 2.5
years, reporting that respondents from lone parent families were more likely to report having
had sex in the subsequent 2.5 years (ORadj=1.39 for females; ORadj=1.323 for males). In the
US, analysing a subset of sample from a longitudinal survey (n=497), Upchurch et al. (2001)
found that Hispanic adolescents who lived with one sole parent or non-biological parents
held more permissive sexual attitudes and lost virginity at a younger age (p<0.001). A
longitudinal study of 567 Swedish girls revealed a similar pattern (Magnusson 2001). In
addition, Moore and Chase-Lansdale (2001) found that living in any type of married family
protected African American females from getting pregnant (n=289, p≤0.05).
The influence of family disruption may be explained by other factors. For example,
family socio-economic status was found to be associated with parental marital status
(Upchurch et al. 2001). Young people from lower social class families or deprived
backgrounds tended to lose virginity or become pregnant at a younger age (Aten et al. 2002;
McNeely et al. 2002). Bonell et al. (2006) found that teenagers whose mothers gave birth to
them as teenagers were more likely to report being non-virgins. Family disruption might be
related to a general loss of parental control and some studies showed a positive impact of
parental monitoring and family rules on teenage sexual behaviour (McNeely et al. 2002;
Wight, Williamson and Henderson 2006).
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The positive impact of religious commitment and participation of religious activities were
also reported. In a New Zealand longitudinal study of a cohort of 1020 participants, Paul et
al. (2000) found that religious beliefs/practices were an important factor enabling them to
sustain in sexual abstinence to age 21. A study of 1153 adolescents in Nigeria by
Odimegwu’s (2005) revealed its positive effect on both sexual attitudes and initiation
(p<0.05). In addition, its positive impact on condom use was reported in a US study of 230
first year students at a Catholic university (p<0.01) (Zaleski and Schiaffino 2000).
Yu (2007b) in a qualitative study of Chinese-British teenagers and parents in Scotland
reported that religious practice reinforced the quantity and quality of parent-child
interactions and may have made the young people more willing to share parental values.
Religious practices also offered the teenagers more opportunities to make friends who hold
similar sexual values. Christian parents highlighted the value of providing sex education
within a moral and religious context by teaching young people the option of sexual
abstinence (Yu 2007a).
Interactions with peers
Peers were considered as increasingly important as young people grew up and
overwhelmed the influence of parents in guiding sexual behaviour, as reported by He et al.
(2004) in a US survey of 1487 pupils. Adolescents were found to share more details of a
sexual nature and felt more comfortable discussing sexual issues with friends than parents
(Amoran, Onadeko and Adeniyi 2004; Currie et al. 2008; Macdowall et al. 2006; Shoveller
et al. 2004; Wellings et al. 2001). Friends were also seen as the major source of information
about sex and relationships (Chung et al. 2005; Currie et al. 2008; Yu 2008).
The effect of dialogue about sex with friends appeared to depend on the content of such
communication. In a small US study of 157 school teenagers, Somers and Gleason (2001)
found that gaining more information about sexual intercourse from friends was related to
more liberal sexual attitudes in respondents. A US survey by Lefkowitz and Espinosa-
Hernandez (2007) explored sex-related communication with mothers and close friends
among 182 first-year college students aged 17-19 years. More frequent discussion about
behaviours and feelings and more open and comfortable communication with friends
correlated with respondents being non-virgins (OR=2.14, p<0.05; OR=5.57, p<0.001
respectively). Similarly, Amoran, Onadeko and Adeniyi (2004) in a community-based study
(n=274) in Nigeria found that significantly more respondents who sought sexual information
from peers had had sex compared to those who sought information from parents, teachers
and other sources (43.2%, 25.2%, 14.4%, 17.1%, respectively, p<0.001). In contrast, greater
dialogue about abstinence with friends correlated with less likelihood of sexual initiation
(OR=0.46, p<0.001). The direction of this correlation was unclear. It could be that the
respondents with more open attitudes intended to initiate sexual intercourse and therefore
looked for relevant information from their peers. Despite the small sample size of these
studies, they did indicate some negative influences of peers.
Similarity in sexual behaviour between young people and their peers was also reported.
On the one hand, perceived peer norms about refraining from sex were a strong and
consistent protector of sexual initiation, as revealed in US studies by Santelli et al. (2004) of
3161 pupils (p≤0.001) and by Maguen and Armistead (2006) of 568 female African
American youth (OR=0.81, p<0.05). On the other hand, Potard, Courtois and Rusch (2008)
in a French study found that respondents (n=1000) who perceived a high prevalence of
sexual initiations of peers tended to have greater intentions to have sex. Such perception was
also related to earlier sexual debut, as reported by Babalola (2004) in a survey of 1327 youth
in Rwanda, Africa (OR=1.88, p≤0.05 for males; OR=1.73, p≤0.1 for males). Analysing data
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from 2436 respondents who were virgins at baseline in the US National Longitudinal Study
of Adolescent Health, Sieving et al. (2006) found that the greater the proportion of friends
who were non-virgins at baseline, the higher the odds of sexual debut of respondents at
follow up (OR=1.01, p≤0.001). Similarly, a US longitudinal study by Nahom et al. (2001)
revealed that school youth (n=1173) who were sexually experienced were more likely than
virgins to divulge that their friends had had sex. These findings were echoed in another US
study (OR=3.03, p<0.01) (Maguen and Armistead 2006).
It was uncertain whether this similarity was due to young people selecting friends of
similar behaviour or due to the actual influence of friends. Drawing data from 1350
participants in the US National Longitudinal Study of Adolescent Health, Henry et al. (2007)
found that respondents tended to socialise with friends who had similar sexual attitudes and
behaviour, but they tended to select friends based on similar values rather than similar
behaviour. Similar findings were reported by Yu (2008) in a qualitative study of Chinese-
British teenagers.
Role of the media
Parents in some UK qualitative studies were found to use the media such as television,
books and magazines to open a channel for discussions about sex-related topics (Walker
2001; Yu 2007b). A qualitative study by Ngo, Ross and Ratliff (2008) in Vietnam showed
that 15-19-year olds used the Internet to obtain sexual information that was not available in
the family or school on topics such as emotions and loving relationships, as well as to
publicly discuss such information. A study of 682 Chinese youth also confirmed that
knowledge of more taboo topics (sexuality, STIs/HIV/AIDS) was gained from mass media
(Zhang, Li and Shah 2007). Similarly, a qualitative study of young Cypriots showed that
television and magazines were the main sources of information on sex, abortion and
relationships (Lesta, Lazarus and Essen 2008).
Lou et al. (2006) evaluated the feasibility and effectiveness of sex education conducted
through the Internet in China. At post test, participants (n=624) in the intervention group
scored significantly higher on the overall sexual knowledge than those (n=713) in the control
group (p<0.001). In the UK, Bragg (2006) received positive responses from teachers and
pupils in a pilot study developing a teaching pack about media images of sex and
relationships. ‘Saving Sex for Later’, a US intervention using three audio-CDs, was
developed to help parent-child communication about values, expectations, household rules,
emotions and physical development (O’Donnell et al. 2007). Thirty-eight focus groups with
youth and parents were conducted to help develop this resource. These studies showed the
potential of using media to facilitate sex education.
Concerns about sexual content on television were raised by some US studies. In a
national longitudinal survey of 1792 adolescents aged 12-17 years, respondents who were
found to view more sexual content on television at baseline tended to lose virginity during
the subsequent year (p<0.05) (Collins et al. 2004). Somers and Tynan (2006) studied a
sample of 473 pupils, indicating that viewing sexual content and sexually suggestive
dialogue on television was a positive predictor for the frequency of sexual intercourse and
the number of sexual partners in White respondents (p<0.05), whereas this relationship was
not found in Black and Hispanic respondents. These findings were supported by a recent
national longitudinal survey, where 12-17-year olds (n=2003) who exposed to high levels of
sexual content on television were twice as likely to become pregnant in the subsequent three
years, compared with those with lower levels of exposure (p<0.05) (Chandra et al. 2008).
Collins et al. (2003) studied a national sample of 506 adolescents aged 12-17 years who
had been regular viewers of Friends the previous year, suggesting that parents appeared to
be able to mediate the adverse consequences of media exposure. Respondents who talked
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about condom-effectiveness with parents or an adult as a result of watching Friends were
found to be more than twice likely to report that they learned something new about condoms
(38% vs 15%, p<0.05).
This paper has reviewed the current literature on sex education at school and the role
social factors played in teenage sexual behaviour. School, family, religion, peers and media
have all been shown to be influential.
The role of school sex education appears to be controversial. Opponents are worried that
early and comprehensive sex education programmes may encourage pupils to become
sexually active. It seems that there is not enough evidence to support this view. School has
been seen as an important source to gain factual knowledge about sex, contraception, and
sexually transmitted diseases, although its effectiveness in delaying sexual initiation and
reducing teenage pregnancy rates still remains debatable. In Britain, although some general
guidance is established (Department of Education and Employment 2000), the
implementation of sex education varies from school to school and even from teacher to
teacher within a single school (Buston, Wight and Scott 2001). Inadequate training for
teachers and their lack of interest in providing the course have influenced the outcome of this
education (Buston, Wight and Scott 2001). Programmes led by older peers or combinations
of medical staff and peers may be more interesting and acceptable to young people
(Stephenson et al. 2004), but sufficient training and support is essential for both adult-led
and peer-led sex education (Mellanby et al. 2001).
Sex education at school is necessary, but it is not the only way, nor sufficient to change
teenage sexual behaviour. The family provides an environment in which young people often
shape their sexual values consciously or unconsciously (Coleman and Hendry 1999). The
literature has indicated that teenagers may not receive as much sex education from their
parents as they do from schools, friends and media (Currie et al. 2008; Macdowall et al.
2006), but positive impacts of parent-child communication has been suggested, especially
relating to sexual values consistent with the cultural and religious beliefs. Factual
information about sex may be difficult for parents to talk about due to specific knowledge
and skills required. A parent role could involve communicating about values, providing a
positive family environment and monitoring their children’s behaviour. Programmes such as
the Parent-Adolescent Relationship Education(Lederman and Mian 2003) and ‘Safe Sex
for Later’ (O’Donnell et al. 2007) in the US would be useful to enhance family
communication about sex and perhaps to contribute to delaying sexual initiation and
reducing teenage pregnancy rates, HIV and other STIs.
There is some evidence to support the influence of peers on teenage sexual behaviour.
Friendship can provides a common ground for teenagers to share sexual information,
intimate feelings and seeking support, something, which they are often less likely to get from
their parents or schools (Yu 2008). Increased interactions with friends, shared sexual values,
and support from friends suggest that sex education could work more effectively if such
influence is considered.
The media has been increasingly used for sex education. However, what sexual content
portray and how young people apply media content are crucial. Negative impacts may be
reduced through parental monitoring and dialogue about family rules and parents’ own
sexual values.
Implications for research and practice
There are three key implications. First, the perspectives of young people should be heard.
Without listening to their views, it is unlikely that sex education programmes would meet
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their needs. Existing research tends to rely on quantitative methods, while there are
difficulties inherent in conducting such research. For example, inconsistent reports have
been found in longitudinal studies (McNeely et al. 2002). Upchurch et al. (2002) reported
that only 22.2% of respondents provided the same date of sexual initiation. Qualitative
design can complement quantitative approaches and provide an understanding of adolescent
sexual behaviour from their own perspectives.
Second, consideration to the crucial role of parents, their involvement could make sex
education work more effectively. UK government guidelines for sex and relationship
education have stressed the importance of co-operation between schools and parents
(Department of Education and Employment 2000). The positive effect of involving parents
has also been reported (Black et al. 2001; Lederman and Mian 2003).
Third, sex education interventions should be culturally appropriate to the need of young
people from diverse cultural and religious backgrounds. Cultural and ethnic differences in
teenage sexual behaviour have been reported. In the UK, South Asian and Chinese people
tends to be more likely to hold traditional sexual attitudes and become sexual active at a later
age; whereas black teenagers are more likely to have had sex before the age of 16 years
(Wellings et al. 1994; Yu 2008). Young people from diverse ethnic groups have reported
divergent preferences towards sex education and sexual information (Coleman and Testa
2007). A better understanding of their views would be helpful.
Developing effective sex education programmes is challenging due to the complexity of
teenage sexual behaviour and difficulties inherent in conducting research to evaluate their
effectiveness. However, consideration of this education within social contexts in which
teenagers shape their sexual behaviour would be potentially significant to the development
of sex education policy and sexual health services for young people, including those from
minority ethnic groups.
Sex education needs to engage more with young people with respect to their needs and
consideration of the potential influences on their values and behaviour. Family, friends,
religious teaching and media can compliment sex education provided at school. Cooperation
between these is crucial to enhance the effectiveness of sex education and promote positive
sexual health.
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... The lack of efficacy in school-based sexual education efforts and adolescents' tendencies to gain inaccurate information from the internet underscore the importance of parental and familial involvement. There is empirical support for how to more adequately educate adolescents on sexual health by having family members supplement school-based programs to yield helpful outcomes (Aspy et al., 2007;Yu, 2010). Aspy et al. found that youth whose parents taught them how to refuse sexual advances, set clearer boundaries with partners, and discussed a balanced view about delaying sexual activity, were much less likely to have initiated sexual intercourse. ...
... Moreover, youth were also significantly more likely to use birth control if their parents reported talking with youth about birth control and sexually transmitted infections (STI) prevention. Additionally, Yu (2010) emphasized the importance of family by arguing how school cannot alone provide sufficient guidance to change the sexual behavior of a teenager. This is because family, religion, peers, and media all have their part to play. ...
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Previous literature has emphasized the role of mothers in sexual health communication with their adolescents. However, the extant literature lacks exploration of the importance of parental communication in association to specific risk-reduction behaviors, such as access to contraceptives. Therefore, the purpose of the current study was to explore the roles of parental attachment, the mother–daughter relationship, and communication about sexual content during adolescence in relation to women’s recalled access to contraceptives during their teen years. Cisgender female participants aged between 18 and 35 (N = 582) were retrospectively assessed on maternal and paternal attachment, the mother–daughter relationship, mother–daughter communication about sexual content, and their own access to contraceptives during their teen years. After controlling for socioeconomic status, participant race, and history of pregnancy, only maternal communication about sexual content significantly related to access to contraceptives and ease of access to contraceptives. These results demonstrated that specific communication about sexual content was associated with greater access and ease of access to contraceptives, whereas more general relationship factors and communication did not.
... 4). In order to limit negative outcomes such as depression, anxiety, unplanned pregnancy, potential abuse/trauma, poor hygiene, and others associated with human sexuality (Alexander et al., 2014;Domar, Broome, Zuttermeister, Seibel, & Friedman, 1992;Kirby, 2008;Mueller, Gavin, & Kulkarni, 2008;Yu, 2010), counselors must be prepared to address issues of human sexuality. The concepts of understanding clients' needs, concerns, and cultural impacts are reinforced through the ACA Code of Ethics in Standard E.5.c. which requires that "counselors recognize historical and social prejudices in the misdiagnosis and pathologizing of certain individuals and groups and the role of mental health professionals in perpetuating these prejudices through diagnosis and treatment" (ACA, 2014, p. 11). ...
... For more than three decades, considerable attention is given to a full range of research on sexual health and education (Goldfarb et al., 2020). School cannot alone provide sufficient guidance to change teenage sexual behavior, school, family, religion, peers, and media all have their part to play (Yu, 2010). Cooperation between schools, young people, their families, and communities is crucial to enhance the effectiveness of sex education and to promote positive sexual health (Chaiwongroj, 2014). ...
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Teachers hold one of the strong pillars in promoting reproductive health and the well-being of students in the contentious movement on comprehensive sex education. Cognizant of the struggles and controversies of this curricular development, this study explored the perceptions and experiences of teachers on the integration of sex education in their lessons through the Heideggerian phenomenological approach. Thematic analysis revealed that teachers have idealistic perceptions of sex education. It is a holistic perspective, it is necessary and beneficial for adolescents, and it requires maturity and mastery of content. Consequently, they experienced drawbacks in integrating the concepts into their repertoire of instruction due to the following reasons. Fearful that the curiosity of students leads to sexual activity; inconsistencies in the scope and manner of instructional delivery; and sociocultural elements act as strong oppositions are themes under barriers of sex education integration. Teachers' subject matter knowledge and contexts of teaching might influence their perceptions and practices.
... Generally viewed as a protective factor for sexual health behaviours, sexuality education is associated with a range of sexual health benefits including delayed sexual initiation, reduced number of sexual partners, fewer adolescent pregnancies and lower incidences of human immunodeficiency virus HIV and sexually transmitted infections (STIs) (UNESCO, 2016). These protective effects are seen as long term and associated with reduced adverse sexual health outcomes in adulthood (Kirby, 2007;Yu, 2010;Bourke et al., 2015;Haberland and Rogow, 2015;Ingham, 2016). Research shows, however, that in contravention of their developmental rights, children and young people are not being provided with the foundation of sexual health information and skills which they need to lead healthy lives (Bay-Cheng, 2013; Sexuality Information and Education Council of the United States SIECUS, 2018). ...
... Schools and other organizations could consider providing safe physical or digital spaces for adolescents to seek advice on sexting-related coercion and unwanted sexting (Van Ouytsel et al., 2019a). Age-appropriate parent-child communication about media use and e-safety could also play an important role in reducing sexting-related risks, as research on offline sexual behaviors has shown that parental communication plays a vital role in reducing sexual risk behavior (Moreno, 2018;Yu, 2010). The bottom line is that providing younger adolescents with education about sexting may reduce the long-term effects manifested in later developmental stages (Mori et al., 2019). ...
Sexting in young adolescents may be an online form of early sexual debut. We assess the link between potentially problematic sexting (i.e., pressured and receiving unwanted sexts) with known risky behaviors (i.e., substance use and early sexual behavior) among middle school students aged 12 and under. The ethnically diverse sample consisted of 1131 youth (53% female) enrolled in the 7th grade in one of 24 schools in southeast Texas. Participants self-identified as 31% Hispanic, 9% White, 24% Black, 19% Asian, 11% other, and 6% unknown. Participants self-reported pressured sexting, receiving unwanted sexts, history of sexual activity, and substance use. Two-point-one percent of adolescents reported sending a sext under pressure and 13.7% reported having received an unwanted sexting image. Participants with a history of sexual intercourse, relative to their non-sexually experienced counterparts, reported higher rates of being pressured into sexting and receiving unwanted sexts. Further, a portion of youth who experienced pressured or unwanted sexting also reported the use of various substances, relative to their non-sexting counterparts. Our study underscores the need for comprehensive sex education to begin at an early age and include age-appropriate information on sexting, digital citizenship, relationships, and substance use.
... This is true for several reasons. First, the media often casts sexual activity as spontaneous and unplanned (Yu, 2010), which is not consistent with seeking information. Also, as young, healthy adults, people this age do not usually consider themselves at risk. ...
YouTube is a social media venue with great potential as a health education-informing channel. Health educators and the Centers for Disease Control and Prevention (CDC) (2011) recognize that YouTube enjoys a high level of engagement and comfort among young users. This enhances its educational value for this vulnerable population, who already account for half of the new sexually transmitted diseases (STDs) diagnosed annually. It is imperative to reach these users with information about safe sex and sexual risk prevention. In this work, 18-24 year old undergraduates were pre-tested, and half of the participants viewed an entertaining YouTube safe sex education video while the other half viewed a factual YouTube safe sex education video. Post-tests on both groups confirmed YouTube's significant value as a health education-informing channel that fosters knowledge acquisition and provokes healthy future behavior change. This study clarifies user preferences for health education messaging on YouTube, and confirms You-Tube's substantial educational utility, while guiding health educators' effective use of this health education-informing channel.
... Indeed, focus-group data reported by Koren (2019) found that 85% of the teens wanted parents to be a primary source of information. In line with our results of relatively lower reports of learning via social media, and despite the growth in social media use, research continues to report social media as a relatively lower source of information on sex education compared to schools, parents, and peers (Bleakley, Khurana, Hennessy, & Ellithorpe, 2018;Yu, 2010). For example, Bleakley et al. (2018) reported that 61% had learned "some" or "a lot" about sex in general from their parents, while 54% reported learning from peers and 54% from media (see also : Rothman et al., 2021). ...
Theory and research suggest the importance of establishing paternity, co-parenting, and child support for positive child and youth development. However, youth’s relative knowledge of these topics is not well understood. Thus we examine these in the context of other parenting issues and how this information varied by parents, school/teachers, friends, and social media. We also sought to provide preliminary data on parenting programming to determine if the programming was associated with perceived increases in knowledge about these and other parenting topics. Data from 1,713 students in middle and high schools who attended one or more Parenting: It’s a Life modules in their school were available for analysis. Youth reported existing knowledge on establishing paternity, co-parenting, and child support relatively low compared to other topics such as peer pressure and healthy relationships. Among the four sources of information surveyed, youth received the most information from parents and caregivers and the least amount of information from social media. Youth reported significant increases in knowledge regarding parenting topics following exposure to Parenting: It’s a Life curriculum. The information youth receive on content such as establishing paternity, co-parenting, and child support is relatively low. School-based parenting programs focused on these topics may help educate youth about these important parenting topics before parenthood.
... Bahaya seks bebas menjadi perhatian, tidak hanya di Indonesia, namun juga di negara maju. Salah satu kebijakan pemerintah Inggris mengenai pendidikan seks menyebutkan bahwa pemberian edukasi keterampilan tentang 'seks yang aman' di sekolah dapat menurunkan angka kehamilan remaja (Yu, 2010). Namun, edukasi ini bukan hanya menjadi tanggung jawab sekolah untuk mengubah perilaku seksual yang negatif pada remaja, melainkan juga kerjasama yang menuntut pelibatan semua pihak terkait seperti keluarga, agama, teman sebaya, dan media. ...
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p class="p0">Adolescence is a stage of development that is vulnerable to various things. Adolescents who do not have a strong character are at risk of free sex. Data shows that free sex has been common among adolescents. This activity aimes to provide health information to increase the awareness of students of SMAN 6, Depok (public senior high school) towards the culture and dangers of free sex among adolescents. Health promotion activities were carried out with the method of lecture, discussion and short movie-watching. The lecture was conducted in two stages. First, students were explained about the basic concepts of culture and the dangers of free sex. Next, students were given a more in-depth explanation of one of the effects of free sex, infection of HIV/AIDS. Between the break time of the topic of lecture, students were also given the opportunity to ask questions in the discussion session. At the end of the activity, students were asked to fill in the post-test questionnaire regarding the topic given. The evaluation resulted showed that the level of studen's understanding of the topic given was very high with the average value of the questionnaire obtanined above 90%. In addition, evaluation for this activity was carried out by using an assessment for the lecturer related to the presentation of interesting material, delivery that can be well received by participants, easy-to-understand language style, extension media that facilitates participans understanding, and involvement of participants during lectures (Interactive). Assessment using Likert scale consisted of score 1-5, with the categories are: strongly disagree (score 1), disagree (score 2), neutral (score 3), agree (score 4), and strongly agree (score 5). The results showed that the majority of participants were satisfied (66,67%-77.78%) by delivery method of the education provided. Based on this, it can be concluded that these activities have been going fine. It is expected that adolescents, especially students of SMAN 6 Depok, can apply the information that has been received in their everyday life. Bahasa Indonesia Abstrak: Remaja adalah tahap perkembangan yang rentan terhadap berbagai hal. Remaja yang tidak memiliki karakter yang kuat berisiko terhadap perilaku seks bebas. Data menunjukkan bahwa perilaku seks bebas sudah banyak terjadi di kalangan remaja. Kegiatan ini bertujuan untuk memberikan informasi kesehatan guna meningkatkan kesadaran siswa SMAN 6 Depok terhadap budaya dan bahaya seks bebas di kalangan remaja. Kegiatan promosi kesehatan dilaksanakan dengan metode ceramah, diskusi, pemutaran film singkat, dan story telling. Ceramah dilaksanakan dalam dua tahap. Pertama, siswa dijelaskan mengenai konsep dasar budaya dan bahaya seks bebas. Berikutnya, siswa diberikan penjelasan lebih mendalam mengenai salah satu dampak seks bebas, yaitu infeksi HIV/AIDS. Diantara jeda topik ceramah, siswa diberikan kegiatan ice breaking dan fun game. Kegiatan dilanjutkan dengan pemutaran film singkat mengenai salah satu bahaya seks bebas, yaitu infeksi HIV/AIDS dan kegiatan story telling. Siswa juga diberikan kesempatan untuk bertanya pada sesi diskusi. Pada bagian akhir kegiatan, siswa diminta untuk mengisi kuesioner postest mengenai topik yang telah diberikan. Hasil evaluasi menunjukkan bahwa tingkat pemahaman siswa terhadap topik yang diberikan sangat tinggi dengan rerata perolehan nilai benar pada kuesioner mencapai di atas 90%. Selain itu, evaluasi proses dilaksanakan dengan memberikan penilaian terhadap pemberi penyuluhan terkait pembawaan materi yang menarik, penyampaian yang dapat diterima baik oleh peserta, gaya bahasa yang mudah dipahami, media penyuluhan yang memudahakan pemahaman peserta, dan pelibatan peserta saat ceramah (interaktif). Penilaian menggunakan skala likert bernilai 1-5, dengan kategori sangat tidak setuju (skor 1), tidak setuju (skor 2), netral (skor 3), setuju (skor 4), dan sangat setuju (skor 5). Hasil menunjukkan bahwa mayoritas peserta puas (66,67%-77,78%) dengan cara penyampaian edukasi yang diberikan. Berdasarkan hal tersebut, dapat disimpulkan bahwa kegiatan penyuluhan ini sudah berjalan dengan baik. Diharapkan agar para remaja, khususnya siswa SMAN 6 Depok, dapat menerapkan informasi yang sudah didapat ke dalam kehidupan sehari-hari. </p
... First, they can play a role in educating parents about this issue. Parents and caregivers could potentially play an important part in preventing problematic sexting behavior, as research suggests that parent-child communication about sexual topics could reduce sexual risk behaviors (Yu, 2010). Parents are also encouraged to regularly check in with their children from an early age with questions about their media use, and to ask what they have heard or experienced with regard to sexting, using examples appropriate for the child's age. ...
Adolescent sexting remains an important public health issue because of the potential for psychosocial and legal consequences. This article briefly reviews the current state of the science of adolescent sexting research. It serves as an up-to-date and data-driven resource to school nurses and school staff to help augment understanding and facilitate discussion regarding teen sexting. The review is structured along popular myths about sexting.
Sexual coercion among adolescents has been studied as a public health issue in developed and developing countries; however, little is known about the role of family in sexual coercion in Chinese context. A representative school-based survey of 2243 boys and 1664 girls aged 12–17 years in secondary schools was conducted by the Family Planning Association of Hong Kong. The results indicated that severe sexual coercion is not common among Chinese adolescents in Hong Kong. No gender differences in three dimensions of sexual coercion (including sexual assault, being pressured into sex and condom use request) are observed. An unhappy family life is associated with a greater likelihood of being pressured into sex and condom use requests being ignored or refused. Poor communication about sex with one's mother is positively associated with condom use requests being ignored or refused. In addition, sexual coercion exerts a negative impact on mental health problems including self-harm, suicidal ideation and planning, and substance use such as frequent smoking and alcohol consumption.
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Aim: This paper aims to report views on school sex education among British-Chinese families. Methods: Using a qualitative, ethnographic approach and snowball sampling, in-depth interviews were conducted with 20 British-born Chinese teenagers and 20 Chinese parents of teenage children in Scotland. Results: Teenagers and parents presented a range of views on school sex education, which raises a number of questions about current policy and practice. There were differences in the cultural approach to the issue between the 2 generations — teenagers saw sex education as a means of obtaining information about the risks of having sex and the methods of contraception while parents felt the purpose of sex education should be to promote sexual abstinence. Conclusions: Exploring the divergent perspectives of teenagers and parents is particularly important for the development of sex education policy and nursing practice. Sex education and associated services need to be relevant to both cultural diversity and family values.
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Context: Adolescent pregnancy, birth, abortion and sexually transmitted disease (STD) rates are much higher in the United States than in most other developed countries. Methods: Government statistics or nationally representative survey data were supplemented with data collected by private organizations or for regional or local populations to conduct studies of adolescent births, abortions, sexual activity and contraceptive use in Canada, the United States, Sweden, France and Great Britain. Results: Adolescent childbearing is more common in the United States (22% of women reported having had a child before age 20) than in Great Britain (15%), Canada (11%), France (6%) and Sweden (4%); differences are even greater for births to younger teenagers. A lower proportion of teenage pregnancies are resolved through abortion in the United States than in the other countries; however, because of their high pregnancy rate, U.S. teenagers have the highest abortion rate. The age of sexual debut varies little across countries, yet American teenagers are the most likely to have multiple partners. A greater proportion of U.S. women reported no contraceptive use at either first or recent intercourse (25% and 20%, respectively) than reported nonuse in France (11% and 12%, respectively), Great Britain (21% and 4%, respectively) and Sweden (22% and 7%, respectively). Conclusions: Data on contraceptive use are more important than data on sexual activity in explaining variation in levels of adolescent pregnancy and childbearing among the five developed countries; however, the higher level of multiple sexual partnership among American teenagers may help explain their higher STD rates.
This study examined the attitudes and experiences of New Brunswick parents regarding sexual health education (SHE) at school and at home. Over 4200 parents with children in grades K-8 in 30 New Brunswick schools completed surveys. Ninety-four percent of parents agreed that SHE should be provided in school and 95% felt that it should be a shared responsibility between school and home. Almost all parents felt that SHE should begin in elementary (65%) or middle school (32%), although there was not consensus on what grade level various topics should be introduced. The majority of parents supported the inclusion of a broad range of sexual health topics at some point in the curriculum, including topics often considered controversial such as homosexuality and masturbation. Although parents indicated that they wish to be involved in their child's SHE, most of them had not discussed any of a range of SHE topics ill a lot of detail with their child. Parents also indicated that they want more information from schools about the SHE curriculum, about sexuality in general, and about communication strategies to assist them in providing education at home.
There are, and have been, many school-based sex education projects in this country which have used peer leaders (students delivering an educational programme who are of similar, or slightly older, age than the students receiving the programme). Rigorous evaluation of the methodology remains scant. This paper describes a comparative investigation of peerled and adult-led sex education in National Curriculum Year 9 (aged 13/14 years). The results from this study suggest that peer leaders appear to be more effective in establishing conservative norms and attitudes related to sexual behaviour than the adults. Peer leaders were less effective than adults in imparting factual information and getting students involved in classroom activities. These findings suggest that both adult-led and peer-led methods may have a place in effective sex education— the challenge being to determine which areas are best dealt with by whom.
Objective: To review the effectiveness of primary prevention strategies aimed at delaying sexual intercourse, improving use of birth control, and reducing incidence of unintended pregnancy in adolescents. Data sources: 12 electronic bibliographic databases, 10 key journals, citations of relevant articles, and contact with authors. Study selection: 26 trials described in 22 published and unpublished reports that randomised adolescents to an intervention or a control group (alternate intervention or nothing). Data extraction: Two independent reviewers assessed methodological quality and abstracted data. Data synthesis: The interventions did not delay initiation of sexual intercourse in young women (pooled odds ratio 1.12; 95% confidence interval 0.96 to 1.30) or young men (0.99; 0.84 to 1.16); did not improve use of birth control by young women at every intercourse (0.95; 0.69 to 1.30) or at last intercourse (1.05; 0.50 to 2.19) or by young men at every intercourse (0.90; 0.70 to 1.16) or at last intercourse (1.25; 0.99 to 1.59); and did not reduce pregnancy rates in young women (1.04; 0.78 to 1.40). Four abstinence programmes and one school based sex education programme were associated with an increase in number of pregnancies among partners of young male participants (1.54; 1.03 to 2.29). There were significantly fewer pregnancies in young women who received a multifaceted programme (0.41; 0.20 to 0.83), though baseline differences in this study favoured the intervention. Conclusions: Primary prevention strategies evaluated to date do not delay the initiation of sexual intercourse, improve use of birth control among young men and women, or reduce the number of pregnancies in young women.
The purpose of this study was to explore the relation between the timing of sex education and adolescents' sexual behaviours. The specific research questions were (1) 'Is timing of sex education related to frequency of sexual behaviour?' (2) 'Is timing of sex education related to age of onset of experimentation with sexual intercourse?' The subjects in the study were 158 American adolescents (sixty-three boys and ninety-five girls) in the ninth through twelfth grades. The questionnaires included a demographics section, questions about sex education experience, sexual behaviours, and age of first sexual intercourse. The results showed two main findings: (1) earlier learning about some individual topics was correlated with more frequent occurrence of certain sexual behaviours, which are presented in detail; (2) however, earlier learning about a variety of sexual topics was not correlated with earlier onset of sexual intercourse, indicating that earlier school sex education can be beneficial. This suggests that schools should not only concentrate on the timing of sexual education but also on what is taught in such classes. The implications for the interpretation of the research and consideration of future research are discussed.