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Advisor(s)
Abstract(s)
Adolescent pregnancy is associated with health, social, and economic burdens. Different strategies have been implemented to prevent this outcome, yet few updated data on their effectiveness exist. We aim to synthetize the available evidence on the impact of interventions to delay sexual activity onset in adolescents by means of a broader systematic review. A literature search to gather interventional and observational analytical studies published since 2010 was conducted in PubMed, Scopus, PsycINFO, CINAHL Plus, ERIC, and LILACS, being complemented by grey literature and manual searches. A total of 57 studies were identified reporting data on 60 comprehensive and 9 abstinence-only interventions. The interventions were predominantly provided in schools
(69.6%), in person (82.6%), and in groups (66.7%), by trained facilitators or educators (43.5%). The recipient of the intervention was exclusively the adolescent in 85.5% of the studies. Five out of 9 abstinence-only interventions presented a statistically favorable result towards the use of the intervention for any of the evaluated outcomes (delay/intention to delay sexual intercourse and pregnancy; this rate was 22 from the 60 comprehensive interventions. Most intervention components had similar effects as the comparator group (no statistical differences) or data was limited to reach any conclusion. This review showed a scarcity and low-quality evidence on the effectiveness of abstinence-only interventions, and the absence of robust evidence for comprehensive strategies aiming at delaying sexual practice by adolescents to avoid early pregnancy. Further well-designed and well-reported studies are needed to help stakeholders understand this scenario and enable the decision-making process within public policies for this population.
Description
This study was funded by the Ministry of Health of Brazil (MoH) and the National Council for Scientific and
Technological Development (CNPq) (no. 16/2021, procedural no. 401876/2021-7) – Brazil.
Keywords
Pregnancy Adolescent Prevention Systematic review
Citation
Rotta I, Rodrigues AT, Fernandes BD, Komoda DS, Tonin FS, Fernandez-Llimos F, et al. Effectiveness of strategies to delay sexual activity onset to prevent pregnancy in the adolescence: a systematic review. In: Rotta I, editor. Adolescent pregnancy prevention: educational strategies and implementation science for public health. Redondela: CIPF; 2023. p. 67-106.