The association of AIDS education and sex education with sexual behavior and condom use among teenage men

Abstract

According to a 1988 nationally representative survey, most 15-19--year-old men in the United States have received formal instruction about AIDS (73%), birth control (79%) and resisting sexual activity (58%). Results of multivariate analyses show the receipt of AIDS education and sex education to be associated with modest but significant decreases in the number of partners and the frequency of intercourse in the year prior to the survey. Having received instruction in these topics was also associated with more consistent condom use. Instruction in some topics was associated with increases in knowledge and attitudes about AIDS, but these increases were not always correlated with safer behavior.

PIP: Multivariate and 1 and 2-limit to bit models were used to analyze data from 1880 noninstitutionalized, never-married men 15-19 years of age included in the US 1988 National Survey of Adolescent Males (NSAM). Cross-sectional data are compared in order to assess the levels of sexual behavior and condom use after AIDS and sex education. Condom consistency rates were calculated. Race, age, urban residence, annual family income, family receipt of welfare within the last 12 months, religious denomination, school attendance, the state incidence of AIDS/100,000 population, and confirmation of mother's teenage pregnancy were used to control for confounding factors. AIDS knowledge and attitudes were also obtained. The 1-limit tobit model was used to analyzed the number of partners and acts of intercourse. Condom use was analyzed with a 2-limit tobit model. The findings were that there has been widespread receipt of AIDS education and sex education in topics on AIDs, birth control biology, and resistance skills, which accounted for 77% of the variance in the 8 topics and were significantly correlated. The receipt of AIDS education was associated with decreases in the number of sexual partners, after controlling for race, age, religion, and other background variables. AIDS education was responsible for 1) a 4% increase in the proportion of students with recent sexual partners (within the past 12 months); 2) a mean reduction of .12 partners among those with recent sex partner; 3) a 7% decrease in the proportion who had never used condoms; recently sex partner; 4) a 9% increase in the proportion using condoms 100% of the time; and a mean increase of 2% among all who ever used a condom. Age, ethnic group, religion, urban residence, and presence of a teenage mother were significant variables in the analysis of AIDS education effects, and the relationship is indicated. In the analysis of other sex education, only AIDS, resistance skills, and birth control were analyzed. Each topic was associated with an increase in condom use (t = 1.91=1.98 at p = .05). In the ordinary least squares analysis, the association between instruction and behavior was not mediated by changes in knowledge or attitudes. No topic affected the perceived risk of infection. Resistance instruction has a strong independent association with fewer sexual partners and acts of intercourse. An integrated and comprehensive approach to HIV education and sex education is suggested. Self-reporting and selection biases are discussed as limitations.