Impact of health education on sexual safety among Hungarian adolescents

BACKGROUND: The aim of sexual health education is to raise awareness of sexual safety, i.e., to prevent unwanted pregnancies, sexually transmitted infections, and emotionally harmful experiences. The Balassagyarmat Health Education Program (BEP) is a comprehensive health education program covering different areas of health, including sexual health, targeting all high school students of a Hungarian town. The goal of our study is to measure the impact of BEP on adolescents' knowledge of sexual safety. METHODS: Tenth-grade students from three academic years (2018-2020) were included in our analysis. Since the class of 2018 received no intervention, it was considered as the control group. Tenth-grade classes of 2019 and 2020 each took part in the health education program (2 out of 10 sessions on sexual safety). After the intervention, students filled out an online questionnaire regarding their sexual attitudes and health behaviors. Open-ended questions were evaluated with quantitative content analysis done by two independent coders. Participants were asked to identify the safest form of protection, and those who offered an appropriate explanation were considered as “conscious” students. Proportions of answers within each academic year were compared with Chi-squared tests. RESULTS: 768 students completed our questionnaire (group 2018: 315; group 2019: 274; group 2020: 179). Compared to the control group, a significantly higher proportion of students in the intervention groups considered the condom to be the safest protection method (76.2%; 90.9%; 81.0% respectively) and fewer considered the same for contraceptives (21.6%; 7.7%; 16.8%). The intervention groups also exhibited a significantly higher proportion of conscious students compared to the controls (21.6%; 49.8%; 30.3%). CONCLUSIONS: Even though our study confirmed that adolescents' knowledge of sexual safety can be improved, a relatively low proportion of students is aware of the purpose of protection. KEY MESSAGES: • Health education programs are effectively able to improve knowledge of sexual health and safe sex practices with a higher proportion of health-conscious individuals as a result of the intervention. • Since better knowledge is associated with more health-conscious behaviors, the purpose of protection should be emphasized more as students were not always able to explain their choice of protection.