Sex education delivered by teenagers for teenagers

Researchers carrying out a major new Medical Research Council study said today (23 July 2004), that sex education delivered by teenagers for teenagers could be a promising way forward if we are to tackle some of the major sexual health problems facing the UK today.

The MRC study known as RIPPLE (A Randomised Intervention trial of Pupil-led sex Education in England) was designed to assess the effectiveness of sex and relationship education delivered by pupils (peer-led) versus sessions given by teachers. Although overall changes in behaviour were modest in both groups, pupils taught by their peers were more satisfied with their sex education and importantly, fewer girls in the pupil-led group reported sex by age 16.

Improving sex education is a key part of the UK government’s strategy to reduce teenage pregnancy rates. RIPPLE provides the most rigorous evaluation to date of peer-led sex education as an approach. The main assessment was the number of teenagers reporting first sex without a condom by age sixteen. It also took into account which approach was more popular, knowledge gained on key sexual health issues and effect on behaviour. Some of the key findings were:

• Peer-led education was no better and no worse than traditional sex education in improving contraceptive use which was already high in both groups, with eight out of ten boys and girls reporting use of contraception.
• Overall peer-led sex and relationship education was more popular with boys and girls than traditional teacher-led lessons, although some would like to explore single-sex sessions.
• Boys and girls who received peer-led sessions had better knowledge about how to protect themselves against sexually transmitted infections.
• Significantly, by age sixteen only 35% of girls in the peer-led group reported sex, compared with 41% of the teacher-led group. Overall however, there were only minor differences in behaviour between the groups.
• Fewer girls in the peer-led group reported unintended pregnancies but the numbers were too small to draw firm conclusions at this stage. Follow-up work is ongoing to see if this initial finding can be confirmed.
• There was no difference in the percentage of boys and girls in either group who expressed regret about their first sexual intercourse.

The research involved 8000 pupils aged 13-14 from 27 schools in England that were randomly assigned to receive sex education sessions with pupils aged 16-17, or to continue with their usual programme with teachers. The peer educators underwent extensive training with experts to deliver the programme.

The work was carried out by the Centre for Sexual Health & HIV Research, University College London and the Social Science Research Unit, Institute of Education. The research team was led by Dr Judith Stephenson, University College London and the findings will contribute towards developing more effective sex and relationship education.

Dr Stephenson said: “We are facing a major problem in the UK in relation to teenage pregnancies and the number of young people with sexually transmitted infection.

“Based on our findings, getting older teenagers to teach the younger ones about sexual health and relationships could be a step in the right direction. Further follow-up to age 20 will provide a fuller evaluation of the effects of sex education on sexual behaviour and pregnancy.

“We now have a good idea about the elements that pupils themselves think make a good school sex education programme. However, we should also continue to look at other ways of educating and supporting young people outside of school.

“As with all areas of social and medical research it’s important to make a scientific evaluation of pros, cons and effectiveness of various approaches to determine the most beneficial intervention.”

Results of trial are published today (Friday 23 July 20004) in the Lancet