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首页> 外文期刊>Prevention science: the official journal of the Society for Prevention Research >Do School-Based Programs Prevent HIV and Other Sexually Transmitted Infections in Adolescents? A Systematic Review and Meta-analysis
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Do School-Based Programs Prevent HIV and Other Sexually Transmitted Infections in Adolescents? A Systematic Review and Meta-analysis

机译：学校的课程是否会导致青少年的艾滋病毒和其他性传播感染？ 系统审查和荟萃分析

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摘要

We systematically reviewed the literature to assess the effectiveness of school-based programs to prevent HIV and other sexually transmitted infections (STI) among adolescents in the USA. We searched six databases including PubMed for studies published through May 2017. Eligible studies included youth ages 10-19 years and assessed any school-based programs in the USA that reported changes in HIV/STI incidence or testing. We used Cochrane tool to assess the risk of bias and GRADE to determine the evidence quality for each outcome. Three RCTs and six non-RCTs, describing seven interventions, met study inclusion criteria. No study reported changes in HIV incidence or prevalence. One comprehensive intervention, assessed in a non-RCT and delivered to pre-teens, reduced STI incidence into adulthood (RR 0.36, 95% CI 0.23-0.56). A non-RCT examining chlamydia and gonorrhea incidence before and after a condom availability program found a significant effect at the city level among young men 3 years later (RR 0.43, 95% CI 0.23-0.80). The remaining four interventions found no effect. The effect on STI prevalence was also not significant (pooled RR 0.83 from two non-RCTs, RR 0.70 from one RCT). Only one non-RCT showed an increase in HIV testing (RR 3.19, 95% CI 1.24-8.24). The quality of evidence for all outcomes was very low. Studies, including the RCTs, were of low methodological quality and had mixed findings, thus offering no persuasive evidence for the effectiveness of school-based programs. The most effective intervention spanned 6 years, was a social development-based intervention with multiple components, rather than a sex education program, and started in first grade.
机译：我们系统地审查了文献，以评估基于学校的计划的有效性，以预防美国的青少年中的艾滋病毒和其他性传播的感染（STI）。我们搜索了六个数据库，包括2017年5月出版的研究。符合条件的研究包括10-19岁的青少年，并评估了美国的任何校本方案，报告了艾滋病毒/ STI发病率或测试的变化。我们使用Cochrane工具来评估偏见和等级的风险，以确定每个结果的证据质量。三个RCT和六个非RCT，描述了七次干预措施，满足了研究纳入标准。没有研究报告艾滋病毒发病率或患病率的变化。在非RCT中评估并递送至青少年前的一个综合干预，将STI发病率降至成年值（RR 0.36,95％CI 0.23-0.56）。在安全套可用性计划之前和之后的非RCT检查衣原体和淋病的发病率在3年后发现了年轻人的城市一级的显着影响（RR 0.43,95％CI 0.23-0.80）。剩下的四种干预措施发现没有任何影响。对STI流行率的影响也不显着（从两个非RCT汇集RR 0.83，从一个RCT的RR 0.70）。只有一个非RCT显示HIV检测增加（RR 3.19,95％CI 1.24-8.24）。所有结果的证据质量非常低。包括RCT的研究具有低方法质量和混合调查结果，从而为基于学校计划的有效性提供了不良证据。跨行6年的最有效的干预，是一种基于社会发展的干预，具有多种组成部分，而不是性教育计划，并以一年级开始。

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