In some ways, a peer-led approach to sex education makes sense. Who wouldn't prefer having someone their own age teach them about the birds and the bees, instead of, say, a gym teacher? In other ways, it might be a disaster—have you ever met a teen?
A study published in the Journal of Sex Research in November attempts to outline the challenges and benefits of peer-led sex ed. Researchers at the University of Hong Kong and the University of North Carolina at Chapel Hill examined 15 pre-existing reviews of peer-led sexual health education in more developed countries published from 2005 to 2015 in order to determine the effectiveness of these programs, which have been studied but never conclusively.
According to the study, the peer-led approach is "one of the most popular strategies for sex education." Well-trained peer educators are often seen by their peers as approachable role models, helping to convey sensitive information in a trusting, familiar way, and the paper's co-authors wanted to determine whether that perceived effectiveness translated into measurable improvements. They evaluated peer-led sex ed programs through six areas: knowledge, attitudes, skills, behavior, self-efficacy, and social norms.
Of the 15 studies examined, 12 saw improvements in sexual health knowledge. Thirteen studies measured changes in attitudes, and of those 13, eight saw "significant" improvements compared to control groups. Participants were also found to be more focused when the program was being led by someone of their peer group; they also "found it more interesting, possibly due to more interactive methods used in peer-led sessions." However, of the ten studies that examined changes in behavior—which could be defined by the number of sexual partners, the safe sex rate, substance abuse, and other factors, as each study measured this variable differently—longer exposure to the program was necessary to show improvement.
The importance of effective sex education is, of course, well documented, and it was a driving force in this research. Wai Han Sun of the University of Hong Kong, one of the paper's co-authors, told Broadly that the spread of STIs and unwanted pregnancies among young people are a "major public health concern," explaining that sexual health affects people both physically and psychologically.
"Effective sexual health education helps youth develop safer sex habits and can also foster positive attitudes," says Sun.
Ultimately, the authors concluded that peer-led sexual education resulted in strong to moderate effects on knowledge and attitudes about sex. However, behavioral changes after sex education were found to be "nonsignificant."
While no change in behavior is disappointing, it's not surprising, according to Sun, who says that this might be explained by the short follow-up period for evaluating participants' actions. "It takes time to translate knowledge and attitude into action," she says.
However, a sex ed program's effectiveness is not just reflected in outcomes, but in student satisfaction, too. The authors assert that "the effects of peer-led sexual health education include not only improved outcomes but also the overall learning environment and benefits to the peer educators."
According to the study's researchers, peer-led sex health education is becoming more popular in many countries, which has researchers hopeful about the possibility of increased sexual health awareness among students internationally. Peer-led sex ed sessions were generally found to be "more fun," partially because they "enabled communication through familiar language."
The researchers also evaluated the effectiveness of new advancements and changes in sex ed, which could expand in the future. While most of the health programs surveyed were conducted in school settings, some used new delivery methods, such as residential camps and social media campaigns, which both allowed for greater exposure to ideas.
Sun is hopeful that sex educators will embrace the internet to create more effective teaching methods for the future. "Combining [new technologies] with the peer-led approach can involve peers in a more flexible and cost-efficient way," she says.