Jemmott John B, Jemmott Loretta S, Fong Geoffrey T
Department of Psychiatry, Center for Health Behavior and Communication Research, University of Pennsylvania School of Medicine, 3535 Market St, Ste 520, Philadelphia, PA 19104-3309, USA.
Arch Pediatr Adolesc Med. 2010 Feb;164(2):152-9. doi: 10.1001/archpediatrics.2009.267.
To evaluate the efficacy of an abstinence-only intervention in preventing sexual involvement in young adolescents.
Randomized controlled trial.
Urban public schools.
A total of 662 African American students in grades 6 and 7.
An 8-hour abstinence-only intervention targeted reduced sexual intercourse; an 8-hour safer sex-only intervention targeted increased condom use; 8-hour and 12-hour comprehensive interventions targeted sexual intercourse and condom use; and an 8-hour health-promotion control intervention targeted health issues unrelated to sexual behavior. Participants also were randomized to receive or not receive an intervention maintenance program to extend intervention efficacy.
The primary outcome was self-report of ever having sexual intercourse by the 24-month follow-up. Secondary outcomes were other sexual behaviors.
The participants' mean age was 12.2 years; 53.5% were girls; and 84.4% were still enrolled at 24 months. Abstinence-only intervention reduced sexual initiation (risk ratio [RR], 0.67; 95% confidence interval [CI], 0.48-0.96). The model-estimated probability of ever having sexual intercourse by the 24-month follow-up was 33.5% in the abstinence-only intervention and 48.5% in the control group. Fewer abstinence-only intervention participants (20.6%) than control participants (29.0%) reported having coitus in the previous 3 months during the follow-up period (RR, 0.94; 95% CI, 0.90-0.99). Abstinence-only intervention did not affect condom use. The 8-hour (RR, 0.96; 95% CI, 0.92-1.00) and 12-hour comprehensive (RR, 0.95; 95% CI, 0.91-0.99) interventions reduced reports of having multiple partners compared with the control group. No other differences between interventions and controls were significant.
Theory-based abstinence-only interventions may have an important role in preventing adolescent sexual involvement.
clinicaltrials.gov Identifier: NCT00640653.
评估仅强调禁欲的干预措施在预防青少年过早发生性行为方面的效果。
随机对照试验。
城市公立学校。
共662名6年级和7年级的非裔美国学生。
一项时长8小时、仅强调禁欲的干预措施旨在减少性交行为；一项时长8小时、仅强调安全性行为的干预措施旨在增加避孕套的使用；两项时长分别为8小时和12小时的综合干预措施旨在同时减少性交行为和增加避孕套的使用；一项时长8小时、以促进健康为目的的对照干预措施针对与性行为无关的健康问题。参与者还被随机分组，以决定是否接受一项干预维持计划，以延长干预效果。
主要观察指标为在24个月随访期内自我报告的是否曾有过性交行为。次要观察指标为其他性行为。
参与者的平均年龄为12.2岁；53.5%为女生；84.4%在24个月时仍在参与研究。仅强调禁欲的干预措施减少了性行为的开始（风险比[RR]，0.67；95%置信区间[CI]，0.48 - 0.96）。模型估计在24个月随访期内曾有过性交行为的概率，仅强调禁欲的干预组为33.5%，对照组为48.5%。在随访期间，报告在过去3个月内有过性交行为的仅强调禁欲的干预组参与者（20.6%）少于对照组参与者（29.0%）（RR，0.94；95% CI，0.90 - 0.99）。仅强调禁欲的干预措施未影响避孕套的使用。与对照组相比，8小时（RR，0.96；95% CI，0.92 - 1.00）和12小时综合干预措施（RR，0.95；95% CI，0.91 - 0.99）减少了有多个性伴侣的报告。干预组与对照组之间无其他显著差异。
基于理论的仅强调禁欲的干预措施在预防青少年性行为方面可能具有重要作用。
clinicaltrials.gov标识符：NCT00640653。
