VIP – Very Important Persons use contraception! Evaluation of a sexual education intervention among upper secondary school students in Sweden

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


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.

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