Department of Economics, Harvard University, Cambridge, Massachusetts.
Department of Global Health, Yale University, New Haven, Connecticut.
J Adolesc Health. 2019 Mar;64(3):292-304. doi: 10.1016/j.jadohealth.2018.11.013.
High levels of HIV, sexually transmitted infections (STIs), and pregnancy among adolescents has motivated some countries to consider the implementation of condom availability programs (CAPs) in high schools. In this present study, we analyzed the impact of CAP on students' sexual behaviors and health outcomes.
We conducted a systematic literature review of peer-reviewed articles published between 1990 and 2017.
Twenty-nine articles from seven countries were included in this review. We found that CAP does not increase sexual activity nor lead to a greater number of sexual partners. It also does not lower the age of sexual initiation. A majority of the studies reported an increase in condom uptake and use at last sex among students with CAP. All the studies that examined STI found a decrease of STI symptoms and rates for students with CAP compared with the control group. The data on HIV rates was inconclusive. There was no difference in pregnancy rates associated with participation in CAP programs.
This global literature review showed that the fears surrounding CAP and promiscuity are unfounded. Once CAP is in place, students utilize it, and condom use increases, which translates to improved sexual health outcomes.
青少年中艾滋病毒、性传播感染（STI）和怀孕率高，促使一些国家考虑在高中实施 condom availability programs (CAP)。本研究分析了 CAP 对学生性行为和健康结果的影响。
我们对 1990 年至 2017 年期间发表的同行评审文章进行了系统文献回顾。
本综述纳入了来自七个国家的 29 篇文章。我们发现 CAP 不会增加性行为或导致更多性伴侣。它也不会降低性开始的年龄。大多数研究报告称，在有 CAP 的学生中， condom 的使用率和最后一次性行为中的使用率有所增加。所有检查性传播感染的研究都发现，与对照组相比，有 CAP 的学生的性传播感染症状和发生率有所下降。关于 HIV 率的数据尚无定论。与参与 CAP 项目相关的怀孕率没有差异。
这项全球文献综述表明，围绕 CAP 和滥交的担忧是没有根据的。一旦 CAP 到位，学生就会使用它， condom 的使用就会增加，这转化为改善的性健康结果。
