Abigail Landesman

Pd. 9
March 14, 2017

How do sexual health campaigns affect teen sexual activity, and how does this activity vary between
genders?

Introduction
For decades, sexual health campaigns have been designed to address the significant problems of
teen pregnancy and sexually transmitted infections (STIs). In this country, half of teen moms do not use
birth control when they have sexual intercourse. While this fact does not seem very surprising, a third of
teen moms didnt think they could get pregnant (Rochman, 2012). One of the main reasons for this is the
lack of effective sexual health prevention campaigns and education in the country.
There are many consequences that result from unprotected sex. These include unwanted
pregnancy and STIs. When these events affect adolescents, the consequences can be devastating.
Teenagers who become parents have reduced economic opportunities and their children have higher risk
of poverty (Bull, 2016, p.117). STIs, which affect two out of five sexually active teen girls, can cause
infertility and possibly death (Office of Adolescent Health, 2016). There is an especially pressing need
today for sexual health interventions among teenagers and young adults, as rates of STIs are climbing
(Fernane, 2012, p.4). In only one year, from 2014 to 2015, syphilis cases increased by 19 percent
(Hambrick, 2016). Effective strategies for sexual health campaigns are essential for preventing
pregnancies and STIs in teenagers.
In schools, health classes dont always reach students in ways that are productive. For some, this
is due to lack of access to health education or parents who opt their children out of the classes. For others,
it is a case of lack of attention: students are more attracted to their phones than health homework. In some
schools, the teachers are not well trained to impart the most recent health education facts. Therefore,
sexual health campaigns, which presents messages through text messaging, television, social media, etc.,
is likely to have more of an impact. Teenagers will not be interested in learning how to have safer sex
unless they are convinced that it matters and the information is presented in an engaging way.
Furthermore, it is important for campaigns to be culturally relevant and accurately reflect their target
audience. Many specific groups are at high risk for STIs and pregnancy, and these groups must be in
focus when designing campaigns. For example, new HIV infections increased 48% (between 2006 and
2009) among Black...males who have sex with other males, from 4,400 to 6,500 (Conklin, 2012, p. 2).
The research summarized in this paper describe the effects of sexual health campaigns and who
they have targeted. The results from the studies show that there is promise in message design and social
media in order to appeal to todays teenagers and get them to change some of their behaviors.

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How does normal sexual activity vary between genders?

The concept of gender has changed over time, and the gender roles that the sexes take on are
often inflicted upon them by society. For the purpose of this paper, the two genders of boys and girls will
be the focus because there is not currently enough research on other genders. For future research, other
genders could be a good topic of focus.
It appears that much of the sexual activity of males and females are affected by their peers
perceptions. Adolescent males are viewed more highly by their peers after having sex, whereas adolescent
females are viewed in a more negative light by their peers after having sex. This is shown by the decrease
in friends their own age after teenage girls had sex and the significant friend increase teenage boys saw
after they had sex. Alternatively, activities related to romance (i.e. making out, light sexual behaviors)
are encouraged more for adolescent females, and viewed more negatively for adolescent males. However,
male peers had stronger reactions than female peers to male adolescents participating in light sexual
activity. Because of this, and the fact that the varying amount of confidence and perceived relationship
power that an early adolescent boy has based on what activity he engages in, adolescent males more
strongly attempt to move towards sex in a relationship because of peer pressure and anticipated social
rewards (Kreager, 2016, p. 388).
Another aspect that contributes to why males may engage in sexual activity earlier is the activity
of masturbation. During childhood and adolescence, males are more likely to masturbate than females,
leading to them most likely experiencing sexual pleasure before forming relationships (whereas females
are more likely to be in a relationship before experiencing sexual pleasure). This has an effect on how
these two genders view sexuality, leading to boys often being less concerned with the nature of a
relationship (Society for the Scientific Study of Sexuality, 2012).

How are health campaigns used presently?

There are dozens of health campaigns used every day and produced by federal government
agencies, non-profit organizations, and advocacy groups. Most of the health campaigns in this country are
developed by the Centers for Disease Control and Prevention (CDC) and other federal agencies, such as
the USDA, FDA and National Cancer Institute. The CDC is currently conducting many campaigns
regarding HIV/AIDs, as well as other campaigns about various health issues. The most common health
campaigns for teenagers address tobacco, drugs, alcohol, and sexual health. However, these campaigns
have not shown to be as successful as other issues, such as use of seat belts. In the past, health campaigns
have been the most successful when linked to laws that the target population must follow. An example of

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this is the campaign for seat belts. The CDC emphasizes that enhanced enforcement increases seat belt
use by a median of 16 percentage points (CDC, 2011, p. 7). Unfortunately, in health areas such as sexual
health, it is more difficult for issues to be regulated by law.
In terms of sexual health campaigns, it is proven that HIV/STI prevention programs can be
effective in preventing sexual risk behavior in youth, including use of protection and fewer sexual
partners. According to a review done by the CDC, about two thirds of these programs significantly
impacted time of first sexual intervcourse and other safer sex practices (CDC, 2010, p. 1).

What strategies are most effective?

There are several strategies that have proved the most effective when conducting sexual health
campaigns. The first is to use Interactive Computed Based Interventions (ICBIs) and other forms of
technology. ICBIs are interventions that use computers, internet, or computer generated print materials.
Technology is intersectional with every aspect of an average teenagers life, as they are the largest
consumers of cell phone minutes and text messaging, and they integrate technology into their daily lives
through chats, games, and social media exchanges with their real-world peers and family (Bull, 2016,
p.117). This makes it an easy and logical way to reach adolescents. A review done in Peel, Canada to
examine most effective strategies for sexual health campaigns found that there was a statistically
significant small effect [in increased condom use] among those who received [ICBIs] compared to those
who received no intervention (d = 0.259, 95% 0.201 to 0.317) and a statistically significant positive
effect on sexual behaviour, measured by a reduction in sexual victimisation and increased condom use
among steady partners in the last three months (OR 1.75, 95% CI 1.18 to 2.59) compared to those who
received minimal interventions (Fernane, 2012, pg. 13-15). Another important technology to use is text
messaging services. These text messaging services reinforce the campaign message and can help prevent
unwanted teenage pregnancy, displayed by a study that showed significant positive differences in
pregnancy outcomes when a study used a text messaging service to cater toward Hispanic participants
(Bull, 2016, p.123). One more technology option for campaigns is through social media and TV, but one
thing that is concerning about mass media is that mass media campaigns effectively promote immediate
voluntary HIV testing and counseling, but dont show effects long term. In these types of interventions,
significant effects were shown immediately after, but no statistically significant longer term effects shown
(Fernane, 2012, p. 13).
A strategy besides technology that should be used in campaigns is one on one interventions,
specifically peer-to-peer interventions. Peels review defined peer led interventions as those that employ

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the teaching or sharing of information, values, and behaviours by members of similar age or status groups
to that of their audience/intended target (Fernane, 2012, p. 9). This strategy is one that improves
adolescent knowledge, but doesnt necessarily improve sexual behaviors. 10 of the 12 studies that Peel
examined showed positive effects on improving knowledge in the areas of STI symptoms, types of
contraceptives, and STI transmission and prevention (Fernane, 2012, p. 19).
Finally, an important strategy is tailoring the campaigns to your target audience and making them
culturally relevant. This has to do with age, gender, socioeconomic status, race, and ethnicity. For
example, with age, programs should aim to be shorter and more concentrated. A study done in the
American Journal for Public Health revealed that expectations for youths to attend 25 weekly sessions
over 9 months was unrealistic, as the mean attendance data was only 11.9 sessions of the 25 that were
required (Bull, 2016, p.123). This skews results and doesnt make the programs as effective. It is also
shown that campaigns targeted for specific gender groups are more effective than general campaigns, as
peer-led strategies were shown to be more effective with females than males (Fernane, 2012, p. 16).
Culturally, a strategy that is used is an evidential approach: using facts that directly relate to that groups
health, making the problem personal. Matthew Kreuter and Stephanie McClure write that research shows
that the perception that a problem affects others like you can stimulate thinking about the problem,
deciding to take preventive action, and planning to do so (2004, p. 446). Another slightly obvious aspect
of culturally relevant campaigns include language. Campaigns directed at a group of people that speak
mainly a language other than english must be done in that language, to ensure that messages are conveyed
clearly (Kreuter and McClure, 2004, p. 446). Generally, it is essential to consider and convey a groups
values and behaviors when creating a campaign. In a study where black participants were shown three
different videos about AIDs, the video with a black announcer and culturally specific message was rated
higher overall than the others, even in areas such as quality that hadnt necessarily changed (Kreuter
and McClure, 2004, p. 446-447).
Although each of these strategies are beneficial, a combination of many strategies is most
conducive to influencing teenage sexual activity. Additionally, it is much more difficult to change life
habits than it is to change one-time incidences, such as vaccines (Wakefield, et. al, 2010). Therefore, it is
essential for sexual health campaigns to determine what strategies work best for which audience to get
across the message.

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Conclusion
While there has been a lot of research on sexual health campaigns, there are many possible areas
for future research. For example, more research is needed on the sexual activities of genders other than
boys and girls, as well as on peer-led interventions and culturally relevant messages. Many of the studies
used in this review had the limitation of a small or specific sample. It would be beneficial to do a
nationwide study on how campaigns can be more effective for a wide array of audiences, because the U.S.
has an invested interest in preventing teen pregnancy. According to the CDC,
In 2010, teen pregnancy and childbirth accounted for at least $9.4 billion in costs to U.S.
taxpayers for increased health and foster care, increased incarceration rates among children of
teen parents, and lost tax revenue because of lower education attainment and income among teen
mothers (CDC, 2016).
Increased rates of teen pregnancy lower the education level of children in the U.S., as only 50% of teen
mothers finish high school by 22 years old (as opposed to 90% of non-teen mothers), and the children of
teen mothers are more likely to drop out of high school (CDC, 2016). Therefore, it is in the countrys best
interests to continue to study the effects of sexual health campaigns and to find the best strategies to
increase safer sex in teenagers.

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