The American Journal of Public Health recently released a study that analyzed the effect of condom availability programs in public high schools in Massachusetts.

Researchers compared students in schools with condom availability programs to students in schools without condom availability programs. They assessed participants' levels of sexual activity and condom use to determine how condom availability programs affected participants' sexual behavior. Researchers also wanted to know if condom availability programs affected participants' use of other contraceptive methods.

Methods

Researchers used the multistage cluster sampling from the 1995 Massachusetts Youth Risk Behavior Survey to obtain a representative sample of adolescents enrolled in public high schools. They randomly recruited 4,166 students from the 59 schools that participated in the study. Student participation was voluntary and researchers obtained parental consent before proceeding.

Participants completed anonymous surveys that asked them about the range of HIV/AIDS education they received in school and the extent of their sexual behavior, including how many sexual partners they had had and whether they had ever used condoms.

Results

District and School Characteristics

• 15% of participating high schools had condom availability programs. Of these:

  • 62% made condoms available through school nurses

  • 48% made condoms available through other personnel such as physical education teachers or assistant principals

  • 38% made condoms available through school health clinics

  • 10% made condoms available through vending machines

• 21% of participants were enrolled in schools with condom availability programs and 79% of participants were enrolled in schools without condom availability programs

HIV-Related Instruction

• 68% of participants in schools with condom availability programs reported attending a presentation featuring a speaker who had HIV/AIDS compared to 46% of participants in schools without condom availability programs

• 61% of participants in schools with condom availability programs reported having been taught how to use condoms compared to 48% of participants in schools without condom availability programs

Students' Sexual Behavior, Condom Availability, and Condom Use

• 42% of participants in schools with condom availability programs reported ever having had sexual intercourse compared to 49% of participants in schools without condom availability programs

• 72% of sexually active participants in schools with condom availability programs reported using condoms at last intercourse compared to 56% of sexually active participants in schools without condom availability programs

• 85% of sexually active participants in schools with condom availability programs reported using some form of contraception at last intercourse compared to 76% of sexually active participants in schools without condom availability programs

• 30% of sexually active participants in schools with condom availability programs reported having sexual intercourse within the three months preceding the study compared to 35% of sexually active participants in schools without condom availability programs

• 12% of sexually active participants in schools with condom availability programs and 12% of sexually active participants in schools without condom availability programs reported ever having been pregnant or having impregnated someone

The researchers point out that because pre-program and post-program data were not obtained in schools that had condom availability programs, they could not determine whether the existence or lack of condom availability programs affected participants' sexual behavior. Yet, they found that sexually active participants in schools with condom availability programs were more likely to use contraception at last intercourse than sexually active participants in schools without condom availability programs.

Additionally, the researchers determined that participants in schools with condom availability programs received a greater range of HIV/AIDS and condom instruction education than participants in schools without condom availability programs. The data revealed a significant, positive association with condom instruction education and participants who reported using condoms during sexual intercourse.

The researchers believe that skills-based prevention programs enhance the benefits of implementing condom availability programs by encouraging young people to use condoms consistently and correctly. They recommend implementing such complementary programs in order to delay the onset of sexual activity, and reduce the rates of unintended pregnancy and the spread of HIV/AIDS and STDs.

For More Information

Susan M. Blake, Ph.D. et al., "Condom Availability Programs in Massachusetts High Schools: Relationships With Condom Use and Sexual Behavior," American Journal of Public Health, vol. 93, no. 6, pp. 955-961.