旨在减少美国青少年怀孕和性传播感染的全面性教育：系统回顾和荟萃分析

Comprehensive Sexuality Education to Reduce Pregnancy and STIs in Adolescents in the United States: A Systematic Review and Meta-Analysis

原载《美国性教育杂志》2023年第18卷第1期

<American Journal of Sexuality Education>2023, 18 (1)

【摘要】美国青少年怀孕率高于其他发达国家，30%的美国女孩在20岁之前怀孕。各国关于性教育纳入和内容的法律各不相同，各州之间怀孕率和性传播感染 (STI) 率存在差异。本系统评价旨在确定全面性教育（CSE）在减少青少年怀孕方面是否比仅禁欲或不进行性教育更有效，次要目标包括分析全面性教育对性传播感染发病率、性活动、安全性行为和社会不适的影响。我们检索了多个数据库，查找1990年至2021年发表的研究。有29项研究符合我们的纳入标准。七项将怀孕作为结果，其中三项符合我们的荟萃分析标准。与对照组相比，CSE干预参与者的妊娠率有所下降（n = 3，风险比=0.89，95% CI 0.79–1.00，I2=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著影响。该系统评价可以作为美国实施全面性教育的证据。

【关键词】禁欲；青少年；全面的性教育；怀孕；性传播感染

[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.

[Key words] Abstinence; adolescent; comprehensive sexuality education; pregnancy; sexually transmitted infections.

论文原文：Amy L. Bordogna,manda C. Coyle,upa Nallamothu,lina L. Manko &enata W. Yen (2023). Comprehensive Sexuality Education to Reduce Pregnancy and STIs in Adolescents in the United States: A Systematic Review and Meta-Analysis. American Journal of Sexuality Education. Volume 18, Issue 1, Pages 39-83. https://doi.org/10.1080/15546128.2022.2080140

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