SynthesisPloS one2014
School based sex education and HIV prevention in low- and middle-income countries: a systematic review and meta-analysis.
Synthesis in PloS one, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 134 papers, 16 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
134 citing papers in PubMed, 16 syntheses or guidelines pooled it, 340 citations in OpenAlex.
- Better Together?: A Systematic Review of the Effectiveness of HIV Prevention Interventions that Build or Strengthen Social Ties.AIDS and behavior · 2025Pooled it
- Pooled it
- Effective strategies for increasing the uptake of modern methods of family planning in South Asia: a systematic review and meta-analysis.BMC women's health · 2024Pooled it
- Prevalence and Trends of Sexual Behaviors Among Young Adolescents Aged 12 Years to 15 Years in Low and Middle-Income Countries: Population-Based Study.JMIR public health and surveillance · 2023Pooled it
- Shared Components of Worldwide Successful Sexuality Education Interventions for Adolescents: A Systematic Review of Randomized Trials.International journal of environmental research and public health · 2023Pooled it
- Applying technology to promote sexual and reproductive health and prevent gender based violence for adolescents in low and middle-income countries: digital health strategies synthesis from an umbrella review.BMC health services research · 2022Pooled it
- The effectiveness of using entertainment education narratives to promote safer sexual behaviors of youth: A meta-analysis, 1985-2017.PloS one · 2019Pooled it
- Do School-Based Programs Prevent HIV and Other Sexually Transmitted Infections in Adolescents? A Systematic Review and Meta-analysis.Prevention science : the official journal of the Society for Prevention Research · 2018Pooled it
- Effectiveness of School-Based Teen Pregnancy Prevention Programs in the USA: a Systematic Review and Meta-Analysis.Prevention science : the official journal of the Society for Prevention Research · 2018Pooled it
- Interventions to reduce risk for sexually transmitted infections in adolescents: A meta-analysis of trials, 2008-2016.PloS one · 2018Pooled it
- Non-specialist psychosocial support interventions for women living with HIV: A systematic review.AIDS care · 2017Pooled it
- Can Policy Interventions Affect HIV-Related Behaviors? A Systematic Review of the Evidence from Low- and Middle-Income Countries.AIDS and behavior · 2017Pooled it
- School-based interventions for preventing HIV, sexually transmitted infections, and pregnancy in adolescents.The Cochrane database of systematic reviews · 2016Pooled it
- School-based sexual health education interventions to prevent STI/HIV in sub-Saharan Africa: a systematic review and meta-analysis.BMC public health · 2016Pooled it
- School-based interventions for improving contraceptive use in adolescents.The Cochrane database of systematic reviews · 2016Pooled it
- Increasing HIV serostatus disclosure in low and middle-income countries: a systematic review of intervention evaluations.AIDS (London, England) · 2015Pooled it
- Knowledge improvement on premarital HIV counseling with PAUSEBMC primary care · 2026Trial
- Enhancing HIV/AIDS knowledge and attitudes through a healthcare-school collaborative model: a study among Shanghai high school students.AIDS research and therapy · 2025Trial
- The impact of the SKILLZ intervention on sexual and reproductive health empowerment among Zambian adolescent girls and young women: results of a cluster randomized controlled trial.Reproductive health · 2025Trial
- Process Evaluation of Teaching Critical Thinking About Health Using the Informed Health Choices Intervention in Uganda: A Mixed Methods Study.Global health, science and practice · 2024Trial
74 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 2 institutions in 1 country.
Funding
Abstract
objectivesSchool-based sex education is a cornerstone of HIV prevention for adolescents who continue to bear a disproportionally high HIV burden globally. We systematically reviewed and meta-analyzed the existing evidence for school-based sex education interventions in low- and middle-income countries to determine the efficacy of these interventions in changing HIV-related knowledge and risk behaviors.
methodsWe searched five electronic databases, PubMed, Embase, PsycInfo, CINAHL, and Sociological Abstracts, for eligible articles. We also conducted hand-searching of key journals and secondary reference searching of included articles to identify potential studies. Intervention effects were synthesized through random effects meta-analysis for five outcomes: HIV knowledge, self-efficacy, sexual debut, condom use, and number of sexual partners.
resultsOf 6191 unique citations initially identified, 64 studies in 63 articles were included in the review. Nine interventions either focused exclusively on abstinence (abstinence-only) or emphasized abstinence (abstinence-plus), whereas the remaining 55 interventions provided comprehensive sex education. Thirty-three studies were able to be meta-analyzed across five HIV-related outcomes. Results from meta-analysis demonstrate that school-based sex education is an effective strategy for reducing HIV-related risk. Students who received school-based sex education interventions had significantly greater HIV knowledge (Hedges g = 0.63, 95% Confidence Interval (CI): 0.49-0.78, p<0.001), self-efficacy related to refusing sex or condom use (Hedges g = 0.25, 95% CI: 0.14-0.36, p<0.001), condom use (OR = 1.34, 95% CI: 1.18-1.52, p<0.001), fewer sexual partners (OR = 0.75, 95% CI:0.67-0.84, p<0.001) and less initiation of first sex during follow-up (OR = 0.66, 95% CI: 0.54-0.83, p<0.001).
conclusionsThe paucity of abstinence-only or abstinence-plus interventions identified during the review made comparisons between the predominant comprehensive and less common abstinence-focused programs difficult. Comprehensive school-based sex education interventions adapted from effective programs and those involving a range of school-based and community-based components had the largest impact on changing HIV-related behaviors.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.