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) 44-207-637-6011;
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
The Lancet