Sexual education and adolescent decision-making: knowledge, condom use, and prevention of sexually transmitted infections. A systematic review

Abstract

Sexually transmitted infections (STIs) represent a growing public health problem among adolescents. Early initiation of sexual activity, together with inconsistent condom use and limitations in sexual education, increases the risk of STIs and other adverse health outcomes. Objective: To analyze adolescents’ level of knowledge regarding sexual education, its relationship with condom use, and the prevention of sexually transmitted infections, based on the available scientific evidence. Methods: A systematic review was conducted in accordance with the PRISMA 2020 statement. The literature search was performed in PubMed, SciELO, and the Virtual Health Library (VHL) using DeCS and MeSH descriptors related to adolescents, sexual education, condom use, and sexually transmitted infections. After applying inclusion and exclusion criteria, eight studies were selected for the final analysis. Results: The included studies showed that adolescents’ knowledge of sexual education and condom use was predominantly low to moderate. Sociodemographic factors such as age, sex, educational level, family environment, and access to reliable information significantly influenced both knowledge and protective sexual behaviors against STIs. Conclusions: The available evidence reveals persistent gaps in adolescents’ knowledge and sexual protection practices. Strengthening comprehensive, evidence-based, and culturally appropriate sexual education programs is essential to promote informed decision-making and reduce the risk of sexually transmitted infections in this population.