Understanding what works and what doesn't in reducing adolescent sexual risk-taking.

Family Planning Perspectives Family dynamics and attachment also play a role: If parents appropriately supervise and monitor their children, and if the adolescents feel connected to their parents, they are less likely to engage in sexual risk-taking. Family values about sexual behavior and contraceptive use, and family sexual behaviors, also have an impact on the adolescents’ behavior. Moreover, peers’ norms and behavior regarding sex and contraceptive use affect an individual’s sexual and contraceptive behavior, as do adolescents’ partners’ support for contraception. Turning to the teenagers themselves, their age and hormone levels, their attachment to school and religious institutions, their engagement in other problem or risk behaviors, their emotional wellbeing, the characteristics of their relationships with romantic partners, any past history of sexual abuse, and their own sexual beliefs, attitudes, skills and motivations all affect their sexual or contraceptive behavior. In addition, Emerging Answers reviewed 73 studies measuring the impact of diverse types of programs. There was particularly strong evidence that four groups of programs are effective at reducing sexual risktaking or pregnancy: •sex and HIV education programs with certain qualities; •some clinic-patient protocols that focus on sexual behavior; •service learning programs that include both intensive voluntary service and ongoing small-group discussions about the service; and •the Children’s Aid Society–Carrera programs (CAS-Carrera programs), which include multiple youth development components, health services and close relationships with the staff. In addition, Emerging Answers found weaker evidence that a few other programs were effective. Douglas Kirby is senior research scientist at ETR Associates, Santa Cruz, CA. The author thanks Karin Coyle, Jill Denner and Sarah Brown for their comments on an early version of this viewpoint. Understanding What Works and What Doesn’t In Reducing Adolescent Sexual Risk-Taking