New study shows addressing masculinities helps to prevent unintended pregnancies
On World Contraception Day 2023, a study funded by the National Institute for Health and Care Research (NIHR) UK shows that engaging boys and addressing masculinities is key to positive sex education and is successful in helping to prevent unintended pregnancy.
The study, called ‘the Jack trial’ was led by Queen’s University Belfast and involved researchers from Cardiff University, Glasgow University, University College London and the London School of Hygiene & Tropical Medicine.
The researchers conducted the first randomised trial and economic evaluation of a sex education programme, specifically targeting 14-year-old male and female students that addressed masculinities to help prevent unintended adolescent pregnancy.
The results showed the programme had a positive effect on all students’ sexual health knowledge as well as support for progressive male role attitudes, and intentions to prevent unintended pregnancy.
The results also showed that the programme had a positive effect on contraceptive use. Among adolescent boys and girls who were already sexually active, those who received the programme in schools were significantly more likely to use contraception than those who didn’t. Young people who received the programme were not more likely to become sexually active.
The trial demonstrated that engaging all adolescents early through relationship and sexuality education is important so that, as they become sexually active, rates of unprotected sex are reduced, and that doing so is likely to be cost-effective.
Lead author of the study, Professor Maria Lohan from the School of Nursing at Queen’s University Belfast, explains: “The UK has the highest rate of adolescent pregnancy in Western Europe. Adolescent pregnancy is often thought to be an issue for young women alone, but it is crucial to engage young men early in conversations around sexual health and rights alongside young women.
“Sex education in schools is the best opportunity for young people to learn and explore gender and sexual identities, and respectful and positive relationships. In this study, we have focused on positive masculinities to educate boys in schools about their role in healthy, consensual sexual relationships.”
A UK-wide trial
The UK-wide randomised trial involved 66 schools with over 8,000 students, making it the largest trial of its kind, the first to be conducted across the four nations of the UK and the first to include faith-based schools.
The programme begins with an interactive video named “If I were Jack” which was co-designed with young people and policy makers and informed by pilot work in faith and non-faith-based schools across the UK.
The video enables young men and young women to put themselves in the shoes of a young man who might be faced with fathering a child at a young age and gets young people to think about how this can be avoided in their lives.
One of the boys who participated in the trial said: “It was kind of like a first-hand thing because he’s literally saying his thoughts out loud, and it’s like as if you’re thinking with him and making the decisions with him.”
The findings also showed the intervention to be cost-effective in reducing the health and social care costs of adolescent pregnancy. An increase in contraceptive use as young people become sexually active means a reduction in unintended pregnancies as well as sexually transmitted infections, which would in-turn reduce healthcare costs over a 20-year period.
Professor Lohan adds: “Not only is the intervention effective in promoting positive sexual health and wellbeing but this is also a cost-effective intervention. The cost per student is less than £5.50 to deliver because the programme provides teachers with materials they need and want to help talk to young people about safe and positive sexual relationships as well as materials to include parents in the conversation.
“The projected cost-savings over a 20-year follow-up period arise from equipping young people with knowledge and skills to avoid an unintended pregnancy and sexually transmitted infections. This is not only a saving in terms of healthcare costs but also increases young women’s opportunities to finish school as well.”