Sexual health knowledge and its promotion in adolescents: three years of interventions in Udine

Background The WHO defines sexual health as a state of comprehensive well-being in relation to sexuality and education is essential for reducing inequality and addressing needs of vulnerable groups. The Italian educational system overlooks sexual education, so no baseline information levels have been defined. The purpose of this study is to evaluate the efficacy of a sexual health educational project in five heterogeneous high schools of Udine (North-Eastern Italy) as a part of the WHO Healthy Cities project. Methods The intervention took place between 2014 and 2016 involving a multidisciplinary team (psychologists, doctors and others). Students with minimum age of 14 were given six hours of lectures in three subsequent weeks, regarding psychological, bio-anatomical and infection prevention subjects respectively. To test the efficacy of the intervention, a self-designed questionnaire had been administered to participants both before and after the cycle. The focus of 11 questions was on STDs and contraception (maximum score: 19 points). Medians of scores were calculated and compared using the Wilcoxon-Mann-Whitney test. Results Total questionnaires were 6033 (46% males, 52% females and 2% not declared). Educational paths of students were not equally represented (scientific 15%, technical 34%, social sciences 21%, arts 13%, commerce 17%). Comparing medians of pre- and post-intervention scores, they increased globally by year (+37.5% in 2014, +57.1% in 2015, +57.1% in 2016, p < 0.001 for all). They increased in each school as well by year, ranging from +25% (technical school in 2016) to + 71.2% (scientific and commerce schools in 2016), with p < 0.001 for all. Conclusions The results show a widespread increase in knowledge after this intervention, suggesting the efficacy of a multi-professional sexual health promotion project. Further analyses could evaluate specific subjects or schools in detail, helping to redesign and fine-tune the project according to educational needs. Key messages: Sexual education and sexual health promotion show their efficacy on a broad audience when a multidisciplinary team is involved. Monitoring knowledge about sexual health themes in different contexts can help to tailor an appropriate intervention.