Sexuality education in Italy 2016-2020: a national survey investigating coverage, content and evaluation of school-based educational activities

Comprehensive sexuality education is an important means of promoting sexual well-being amongst young people and is key to preventing sexually transmitted infections (STIs). However, sexuality education is not currently included in the formal curriculum in Italian schools. The aim of this study was to develop an inventory of schoolbased sexuality education (SBSE) activities carried out by external providers and implemented in Italy from 2016 to 2020. A desk review and survey were carried out. In the desk review online documents on STI prevention were analysed. The survey investigated the providers, objectives, content and methods used to implement SBSE activities in secondary schools. Findings revealed a highly heterogeneous situation in terms of geographical coverage, service providers, objectives and evaluation. Some SBSE activities were classified as adopting a comprehensive approach to sexuality education, while the majority focused on STI prevention, and many were single-session activities. Although most activities were said to have been evaluated no results were available. The data showed that SBSE is not systematically and equally delivered across Italy. Action is needed to provide young people with evidence-based, age-appropriate and accurate education about sexual and reproductive health and wellbeing

Infezioni Sessualmente Trasmesse e salute sessuale: introduzione di attività educative integrate nel contesto scolastico italiano

Le Infezioni Sessualmente Trasmesse (IST) costituiscono un gruppo di malattie infettive molto diffuse. I giovani non hanno una conoscenza adeguata delle IST e, spesso, non sanno a chi rivolgersi. L'educazione alla sessualità rappresenta uno dei mezzi più importanti per promuovere il benessere sessuale dei giovani e una componente essenziale della strategia globale per la prevenzione dell'HIV e delle IST in Europa. Nel quadro del progetto EduForIST, finanziato dal Ministero della Salute, è stata condotta un’analisi dei riferimenti documentali nazionali e internazionali e delle attività educative svolte nelle scuole del territorio nazionale

Co-creazione, implementazione e valutazione degli interventi pilota EduForIST nelle scuole.

Il saggio presenta il progetto educativo EduForIST nelle sue fasi di ideazione, costruzione della rete, progettazione, implementazione e valutazione. Il contributo del sottoscritto è relativo alla formalizzazione delle scelte pedagogiche

Pilot experience of comprehensive sexuality education among italian adolescents: Results from the eduforist project

Background and Objective: Comprehensive sexuality education (CSE) is an integrated approach to sexual health and wellbeing promotion, internationally recognised to be highly effective in preventing HIV and sexually transmitted infections (STIs), especially when experienced in school contexts. CSE, however, is not included in Italian school curricula. This study describes the results of a pilot CSE experience among Italian adolescents attending lower secondary schools of 4 Regions within the EduForIST project, funded by the Italian Ministry of Health. Methods: The pilot experience consists of 5 modules of 2 hours conducted per classroom. Modules have been developed by a research team of pedagogists, academics, HIV/AIDS civil-society organisations (CSOs), experts and educators from CSOs that lead the activities in the schools. The modules address the domains: A) changes in adolescence, B) emotions and relationships, C) sexual identities and diversity, D) consent, STIs/pregnancy prevention, sexual health services. The last module is dedicated to evaluation of activities, by using standardised pre/post tests and satisfaction questionnaires. Results: The pre/post-test results referred to 35 classrooms of 11 schools (566 students). Pre/post analysis showed a significance increase of correct answers for 11/15 items investigated. Domain C and D reported the major positive increase, while a higher level of uncertainty regarded domain A and B. The students reported to be overall satisfied by the activity, especially when talking about psychological changes in adolescence and STIs’ symptoms and prevention. They reported higher neutrality regarding the methods, i.e. use of innovative technological tools, and group-work. Conclusions: Pre/post-tests analysis suggested that the pilot activity was effective in providing students with correct information, enhancing knowledge and decreasing uncertainty. Evidence collected through this study and its advancements (increasing the geographical area of implementation and school grades) will foster awareness among policy makers on the value and urgency of introducing CSE in Italian school curricula

Bringing comprehensive sexuality education into Italian lower secondary schools’ practice: A pilot study

Background: Theoretical and research evidence indicates that comprehensive sexuality education (cse) positively impacts on behaviour and attitudes of young people, by improving sexual and reproductive health outcomes and empowering them to make free and informed choices. This study aims to describe the creation and development of a pilot cse activity in lower secondary schools (lss) within the context of eduforist project. Eduforist is funded by the italian ministry of health and involves academics, the italian national institute of health and hiv/aids civilsociety organisations (csos). Methods: Evidence was collected through a desk review on regional and national normative documents, international literature and guidelines regarding sexually transmitted infections (stis), relationships and sexuality education (se). An online survey was developed to collect information on duration, content and methods used to implement school-based se (sbse) in italian secondary schools from 2016 to 2020. The results of the survey and desk review, along with focus groups and open discussions involving all partners were used to define objectives, contents, methods of delivery and evaluation of the pilot activity. Additional information was added after feedback from an expert advisory board. Results: A pilot activity was designed targeting lss students, in 4 different geographical regions, for a total of 11 schools involved. The activity consisted of 5 interactive interventions per class: 4 theoretical and practical modules (each consisting of a syllabus, a theoretical slides deck and a list of activating tools) and 1 intervention focusing on evaluation and deepening topics requested by the students. The evaluation have been carried out on educators’ (swot analysis, diary of the field) and students’ level (pre/post-tests and satisfaction questionnaires). Conclusions: This pilot activity represents a first step towards the implementation of an evidence-based and integrated approach to sbse, to be promoted and implemented equally across the country

Elective caesarean-section versus vaginal delivery in prevention of vertical HIV-1 transmission: a randomised clinical trial

Background Results from observational studies suggest that caesarean-section delivery may reduce the risk of mother-to-child transmission of HIV-1 infection in comparison with vaginal delivery. We carried out a randomised clinical trial to address this issue and to assess the extent of postdelivery complications. Methods Eligible women were between 34 and 36 weeks of pregnancy, with a confirmed diagnosis of HIV-1 infection, and without an indication for caesarean-section delivery or a contraindication to this mode of delivery. Women were randomly assigned elective caesarean-section delivery at 38 weeks of pregnancy or vaginal delivery. An infant was classified as uninfected if he or she became negative for antibody to HIV-1 by age 18 months or was negative for virus by PCR or culture on at least two occasions, with no clinical, immunological, or viral evidence of infection. From 1993, to March, 1998, 436 women were randomised. Findings We present the results of an analysis updated to November, 1998, with data on the infection status of 370 infants. Three (1.8%) of 170 infants born to women assigned caesarean-section delivery were infected, compared with 21 (10.5%) of 200 born to women assigned vaginal delivery (p<0.001). Seven (3.4%) of 203 infants of women who actually gave birth by caesarean section were infected compared with 15 (10.2%) of 167 born vaginally (p=0.009). There were few postpartum complications and no serious adverse events in either group. Interpretation Our findings provide evidence that elective caesarean-section delivery significantly lowers the risk of mother-to-child transmission of HIV-1 infection without a significantly increased risk of complications for the mother

Elective caesarean-section versus vaginal delivery in prevention of vertical HIV-1 transmission: a randomised clinical trial

Background. Results from observational studies suggest that caesarean-section delivery may reduce the risk of mother-to-child transmission of HIV-1 infection in comparison with vaginal delivery. We carried out a randomised clinical trial to address this issue and to assess the extent of postdelivery complications. Methods. Eligible women were between 34 and 36 weeks of pregnancy, with a confirmed diagnosis of HIV-1 infection, and without an indication for caesarean-section delivery or a contraindication to this mode of delivery. Women randomly assigned elective caesarean-section at 38 weeks of pregnancy or vaginal delivery. An infant was classified as uninfected if he or she became negative for antibody to HIV-1 by age 18 months or was negative for virus by PCR or culture on at least two occasions, with no clinical, immunological, or viral evidence of infection. From 1993, to March, 1998, 436 women were randomised. Findings. We present the results of an analysis updated to November, 1998, with data on the infection status of 370 infants. Three (1.8%) of 170 infants born to women assigned caesarean-section delivery were infected, compared with 21 (10.5%) of 200 born to women assigned vaginal delivery (p &lt; 0.001). Seven (3.4%) of 203 infants of women who actually gave birth by caesarean section were infected compared with 15 (10.2%) of 167 born vaginally (p = 0.009). There were few postpartum complications and no serious adverse events in either group. Interpretation. Our findings provide evidence that elective caesarean-section delivery significantly lowers the risk of mother-to-child transmission of HIV-1 infection without a significantly increased risk of complications for the mother