Sex Education for HIV Prevention Among Adolescents and Young Adults (15–24 Years) Across Diverse Settings: An Integrative Review

Abstract – The global HIV pandemic disproportionately affects adolescents and young adults (aged 15–24 years), making comprehensive sex education a crucial preventive strategy. This integrative review synthesized 19 studies from 2014 to 2024 to evaluate the effectiveness and comprehensiveness of structured sex education programs against international guidelines. A systematic database search and critical appraisal were conducted on studies featuring multi-session programs targeting adolescents. Short-term outcomes consistently showed significant increases in HIV knowledge and self-efficacy. However, long-term effectiveness was mixed, constrained by methodological weaknesses (e.g., participant dropout) and a thematic overreliance on individual behavioral theories. Content analysis revealed critical gaps in addressing gender and power dynamics (covered by 32% of programs) and modern biomedical prevention (pre-exposure prophylaxis). Although immediately effective, the sustainable public health impact of these programs is limited by structural deficiencies. Future research must shift toward a socio-ecological framework, prioritize longitudinal studies, and integrate programs directly with sexual and reproductive health services.