Researchers found that students at schools with condom-availability programs have sex less often than those at schools without these controversial initiatives.
This finding, published in the latest issue of the American Journal of Public Health, is based on a survey of more than 4,000 high schoolers in Massachusetts. About 20% of the schools studied had programs that distributed condoms to students.
But Susan M. Blake, PhD, and colleagues from George Washington University stumbled across another interesting finding. Although giving out condoms in schools led to greater condom use among already sexually active teens, this appeared to have no effect on rates of teen pregnancy. One explanation: Students in schools without these programs were twice as likely to use other forms of birth control, they report.
The new research comes on the heels of another study released last week by the Kaiser Family Foundation indicating that many teens -- and boys, in particular -- feel increased pressure to have sex while in high school, and that drugs and alcohol use often leads to these encounters. The Kaiser survey is based on interviews with 1,800 Americans under age 24.
Both new studies find that than more than half of high school students report having sex before graduation. But the Kaiser survey produced some other eye-opening findings:
- Four of 10 sexually active teens, or their partners, have taken a pregnancy test while in high school.
- One of five said they personally had unprotected sex after drinking or using drugs. And seven of 10 said their peers don't use condoms during sex after drinking.
- One of six high schoolers believed that having sex occasionally without a condom was "no big deal."
- One in three boys between ages 15 and 17 feel pressure to have sex while in high school, compared with one in four girls.
More Evidence That Condom Giveaways Work
The findings from the new study looking at programs that give out condoms in schools are similar to previous research on the effects of such programs. While some argue giving out condoms in schools promotes sexual activity among teens, the research hasn't backed that belief, says one expert who is arguably the nation's most prolific researcher on these types of school programs.
"Actually, multiple studies consistently show that making condoms available to students does not increase any measure of their sexual behavior -- whether the teens have sex, how frequently they have it, or the number of partners they have," Douglas Kirby, PhD, tells WebMD. "And some studies, including one that I conducted involving thousands of Seattle high school students show, as Susan's study does, that the percentage of teens having sex declined after condoms were made available to them."
Kirby, senior research scientist for ETR Associates, a non-profit California company that does research on sex and health education programs, also conducted another study that evaluated all previous research -- some 73 studies in all -- measuring how giving out condoms in schools, along with other sex-education programs, affected patterns of teenaged sexual behavior.
"In every study, these programs did not increase sexual behavior," he says. "In some, but not all, the rates of sexual behavior actually decreased when condoms were made available to students. And in some, but not all, these programs led to increased condom and contraception use in teens who were already having sex."
When he collected that data, published in May 2001 for the National Campaign to Prevent Teen Pregnancy, there were "hundreds" of schools in the U.S. that had condom-availability programs. But it's hard to determine how many schools still have them; there is no national clearinghouse that collects these statistics. "And some schools are beginning to make them available that didn't before, some that once did no longer do," says Kirby.
Better as Part of Overall Program
But how programs that give out condoms in schools are operated or integrated into other sex education initiatives seems to impact their effectiveness at lowering sexual activity and rates of unprotected sex, says another expert.
"You can see the most positive effects when condom-distribution programs are part of or integrated with a broader sexuality and sex education program," says David Landry, researcher at the Alan Guttmacher Institute, a nonprofit organization that conducts sexual and reproductive health research, policy analysis, and public education. It also publishes the peer-reviewed medical journal, Perspectives on Sexual and Reproductive Health, where much of this research is published.
In other words, it's not enough to just give out condoms in schools. Teens are more likely to use them -- and often, are less likely to have sex altogether -- when they are also taught how to use them and the dangers of sexually transmitted diseases and unwanted pregnancy.
It also matters how condoms in schools are distributed, adds Kirby. "There is tremendous diversity in these programs," he tells WebMD. "In Seattle, which has a very successful program, the schools actually had health clinics and students could walk into these clinics to use the bathroom, which had a big basket of condoms for the taking. It was anonymous. But in other schools, you have to get the condoms from a teacher or the principal, or get their parents' permission, or the students only get a few at a time. As you would logically guess, programs that have barriers like that give out dramatically fewer condoms."