Abstract

The United States has a higher rate of teen pregnancy than any other developed country with 30% of American girls becoming pregnant before the age of 20. Laws regarding the inclusion and content of sexuality education vary across the country, which are associated with differences in pregnancy and sexually transmitted infection (STI) rates between states. This systematic review aims to determine whether comprehensive sexuality education (CSE) is more effective than abstinence-only or no sexuality education at reducing teenage pregnancy. Secondary objectives include analyzing the effect of CSE on STI incidence, sexual activity, safe-sex behaviors, and social discomfort. We searched multiple databases for studies published from 1990 to 2021. Twenty-nine studies met our inclusion criteria. Seven included pregnancy as an outcome, with three fitting our meta-analysis criteria. There was a decrease in pregnancy rates for participants in the CSE intervention compared to the control (n = 3, risk ratio = 0.89, 95%CI 0.79–1.00, I² = 0%). We found that CSE is likely to reduce pregnancy rates; however, there was limited data available on this outcome. CSE increased safe-sex behaviors but did not have a notable impact on sexual activity or STIs. This review can serve as evidence for the implementation of CSE in the US.

摘要

美国的青少年怀孕率高于任何其他发达国家，30% 的美国女孩在 20 岁之前怀孕。全国各地关于性教育的内容和内容的法律各不相同，这与怀孕的差异有关和各州之间的性传播感染 (STI) 率。本系统评价旨在确定全面性教育 (CSE) 在减少少女怀孕方面是否比仅禁欲或不进行性教育更有效。次要目标包括分析 CSE 对 STI 发病率、性活动、安全性行为和社会不适的影响。我们在多个数据库中搜索了 1990 年至 2021 年发表的研究。有 29 项研究符合我们的纳入标准。七包括怀孕作为结果，其中三个符合我们的荟萃分析标准。与对照组相比，CSE 干预参与者的怀孕率有所下降（n  = 3，风险比 = 0.89，95%CI 0.79–1.00，I ² = 0%）。我们发现 CSE 可能会降低怀孕率；然而，关于这一结果的可用数据有限。CSE 增加了安全性行为，但对性活动或性传播感染没有显着影响。这篇综述可以作为美国实施 CSE 的证据。