Abstract

PIP: Sex education and venereal disease of sexually transmitted disease (STD) education has been around for some time. A review of major approaches implemented in the past 20 years and their evaluations is provided and discussed in terms of successful programs and the theoretical basis of 3 program types which have demonstrated effectiveness in changing adolescent behavior. Effective programs recognize that there are no "magic solutions." Some programs are effective in delaying the beginning of intercourse, or increasing protection against pregnancy or STDs, or reducing the number of sexual partners. Abstinence and condoms prevent pregnancy and STD including AIDS/HIV infection. Programs should integrate AIDS, STD, and pregnancy reduction into a single more comprehensive unit. Group norm development and social skill development in responding to peer pressure need to be developed in very practical ways; i.e., what to say to your partner when contraception is unavailable and desire is strong. Programs need to encourage both delay and refraining from intercourse and also to encourage contraceptive usage which is appropriate to the age. Programs should be comprehensive and should include schoolwide peer programs, group discussions, individual counseling, media or theater events, and lends with community reproductive health services. Sexuality education curriculums fall into three broad groups: knowledge-based which stress risks and consequences of pregnancy; a continuation of factual knowledge which includes values and skills development in decision-making and communication; and reactionary abstinence-only programs. New approaches are based on a health belief model and use elements of social learning theory. Through discussions and role playing teenagers awareness of the probability of becoming pregnant, and of the personal benefits of delayed sexual activity and consistent effective contraceptive use is enhanced. The Schenke and Gilchrist curriculum based on social learning theory is reviewed in detail because its use led to evidence of behavioral change.