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The percentage of male students who reported using condoms each time they had vaginal intercourse had increased by one-third--from 37% to 50%--in the year following the start of a condom availability program in their California high school (grades 9-12). The percentage of young men who reported using a condom when they had intercourse for the first time increased by about one-quarter--from 65% to 80%--according to a new program evaluation "Impact of a High School Condom Availability Program on Sexual Attitudes and Behaviors," by Mark Schuster, MD, PhD, and colleagues with RAND, Santa Monica, California.The findings generally countered fears that a school-based condom availability program might encourage students to engage in sexual activity that they might otherwise refrain from, or encourage those who are having sex to do so more often or with more partners: During the study period, there was no increase in either the percentage of students who had ever had vaginal intercourse or in the percentage of sexually active students who had had three or more partners thus far in their lives. Moreover, the results of the analysis were broadly consistent with those of a recent evaluation of New York City's condom availability program, which found no evidence of program effects on sexual behavior but showed an effect on frequency of condom use at last intercourse.
The evaluation also revealed that among male and female students who were virgins, there was a dramatic increase in the proportion of students who reported that they planned to use a condom the first time they have intercourse--from 62% to 90% among young men and --more--from 73% to 94% among young women. Both before the program started and one year later, 10-13% of students said that they definitely would not have vaginal intercourse during the following year.
The study, published in the March/April 1998 issue of The Alan Guttmacher Institute"s peer-reviewed professional journal, Family Planning Perspectives, provides the results of the pretest-posttest evaluation of a condom availability program in an urban high school that serves a racially and socioeconomically diverse Los Angeles county community.
The program, which began in April 1992, provided unrestricted access to packets containing two male condoms and an instruction sheet left in baskets placed in four classrooms and outside the nurse"s office. The packets also contained a card warning:
"Condoms are not 100% effective in preventing AIDS/HIV, sexually transmitted diseases or pregnancy during intercourse. Abstinence is! Not all teenagers are sexually active. THINK BEFORE YOU ACT! The consequences may be for a lifetime."No new curricula were added to the school to augment the condom program. However, implementation of the program was publicized within the school, the district had an existing ninth-grade health curriculum covering sexual behavior and risk prevention, and the district observed an AIDS Awareness Week which included assemblies and other educational programs.
The evaluation consisted of an anonymous, self-administered baseline survey of 1,945 ninth-to-twelfth graders conducted during regular class periods in April 1992 before the condom program started, and a follow-up survey of 1,112 students in grades 9-12 one year later. The two surveys obtained information about the students" demographic characteristics; their knowledge, attitudes and beliefs about sexually transmitted diseases, pregnancy and contraception; specific sexual behaviors; and condom use. Parental permission for student participation was obtained through passive consent for the pretest and active consent for the posttest.
The Alan Guttmacher Institute is a non-profit organization for reproductive health research, policy analysis and public education, with offices in New York and Washington, D.C.
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