VIP – Very Important Persons use contraception! Evaluation of a sexual
education intervention among upper secondary school students in Sweden
M. Larsson (1), K. Eurenius (1), R. Westerling (2), T. Tydén (1,2)
Department of Women’s and Children’s Health (1), Department of Public
Health and Caring Sciences (2), Uppsala University, Uppsala, Sweden (2)
Introduction: Swedish upper secondary schools offer theoretical
programs preparing the students for university studies and vocational programs
preparing for various hand-craft professions. Investigations have shown that
students on vocational programs have sexual intercourse at earlier ages and are
less prone to use contraceptives than students on theoretical programs. Abortion
rates and the prevalence of Chlamydia are increasing among Swedish adolescents.
The condom is one of the most frequently used contraceptive methods among
adolescents in Sweden. In case of condom failure, the emergency contraceptive
pill (ECP) can be used as a back-up method. The ECP has been on the Swedish
market since 1994 and in April 2001 a levonorgestrel-only preparation became
available as an over-the-counter product to a cost of 13 Euros.
Aims and methods: To evaluate an intervention aimed at improving
knowledge, attitudes and practices of condoms and emergency contraception (ECP)
among a group of students in upper secondary school, we undertook an
intervention study with quasi-experimental design. A strategic sample of 25
classes from two vocational high school programs was divided into one
intervention group and one comparison group. All students completed
questionnaires before and after the intervention which included sexual education
lessons, free condoms on request and access to telephone counselling.
Results: Of the 461 eligible students, mean age 17 years, 390 (85%)
completed the pre-test and 326 (71%) the post-test. Three out of four (77%) had
experienced sexual intercourse. The majority (76%) had used contraception,
mostly condoms at first intercourse. The students already had good knowledge
about condoms with no change after the intervention, but attitudes improved and
condom use increased. Knowledge and attitudes towards ECP improved but the use
remained stable (29%). The most important source of information about ECP
changed from ‘friends’ to ‘school’ after the intervention. More than one
out of four (28%) had opted for free condoms but only 3% had requested telephone
counselling.
Conclusions: The sexual education intervention reached one important
goal, namely improving knowledge about ECP without increasing ECP use or
jeopardizing condom use. Increased availability of condoms and practice of
condom skills may be ways of reducing barriers for teenage condom use. Senior
students within different health care professions can be a useful resource in
school-based sexual health education programs.
