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Mixed Results For Study Assesing Effectiveness Of Peer-Led Sex Education

July 21, 2004

Results of a study in this week's issue of THE LANCET suggest a modest benefit for the use of peers (older pupils) to deliver sex-education classes rather than teachers. However the study does not show any effect of such peer-led sex education in reducing the incidence of unprotected first intercourse by age 16 years.

The UK has the highest under-18 pregnancy rate in western Europe; as a result, the UK Government has set a strategic target of halving the number of such pregnancies-currently 90,000 a year-by the end of the decade. Judith Stephenson (University College London, UK) and colleagues at the Institute of Education, UK, did a randomised trial involving 8000 pupils from 27 schools in England. The study investigated whether sex education given to year 9 pupils (aged 13-14 years) was more effective if given by peers (16-17 year-old pupils) than conventional sex education given by teachers. Peer-led education consisted of three one-hour sessions encompassing issues such as contraception, information about sexually transmitted infections, and discussions about relationships. Role play and teaching in small groups was a feature of peer-led sex education less commonly used in conventional teacher-led classes.

Fewer girls reported intercourse before age 16 if they had been given sex education by peers (35% compared with 41% for girls who had received teacher-led sex education); there was no difference among boys. The type of sex education received had no effect on the proportion of pupils reporting unprotected first intercourse: around 8% for girls and around 6% for boys. Fewer girls in the peer-led group reported pregnancies (2% versus 3% for the teacher-led group) but the numbers were too small to draw firm conclusions at this stage. Further evaluation of the effect on teenage pregnancy is in progress. Peer-led classes were popular, although more than half of girls and around a third of boys would have preferred single-sex classes.

Dr Stephenson comments: "Peer-led sex education was effective in some ways, but broader strategies are needed to improve young people's sexual health. The role of single-sex sessions should be investigated further. The longer-term follow-up results of this study assessing sexual behaviour and pregnancy up to age 20 years should give a fuller evaluation into the effect of peer-led sex education in schools.

In an accompanying commentary (p 307), Roger Short (University of Melbourne, Australia) concludes: "In planning better educational strategies for English schools in the future, the team would profit from studying the way the Chinese have tackled peer-group sex education for young people, with considerable success. To quote Tony Blair: "As a country, we can't afford to continue to ignore this shameful record." But to succeed, it is going to require a concerted effort on the part of all concerned-Government, schools, parents, teachers, and pupils. Wake up, England!"

Contact: Dawn Duncan, Medical Research Council Press Office; T) +44 (0)20 7637 6011; press.office@headoffice.mrc.ac.uk

Professor Roger V Short, Department of Obstetrics & Gynaecology, The University of Melbourne, Australia; T) +61 3 9344 2635; r.short@unimelb.edu.au

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