Twenty five studies (n>64,882, range 114 to 12,800) were included in the review: eight randomised controlled trials (RCTs); 13 controlled pre-test/post-test design; and four non-experimental evaluation design.
Studies conducted in Sub-Saharan Africa, Latin America, Asia and the Pacific:
Studies that assessed short-term effects of life skills-based education reported increased knowledge (one RCT, eight pre-post intervention studies) and improved attitudes about HIV and AIDS and condom use (one RCT, seven pre-post intervention studies) compared to control groups.
Studies that investigated longer term effects of life skills-based education found increased knowledge about HIV, AIDS and/or contraception (five RCTs, four pre-post intervention studies) compared to control groups. There were improvements in changes in actual behaviour for the life skills-based education groups compared to control groups (five RCTs, three pre-post intervention studies), but such changes were not reported consistently across studies. One RCT reported a positive trend for decreased HIV-1 and HSV-2 (herpes simplex 2) incidence among women in the intervention group compared to control, but the changes were not statistically significant.
Qualitative evaluations of both short- and long-term effects of life skills-based education reported increased knowledge about reproduction and sexual health including HIV, AIDS and condoms (four studies), increased communication skills (three studies) and improved risk perception (two studies).
Regional differences:
Sub-Saharan Africa (13 studies): Life skills-based education interventions were reported to consistently increase the delay of sexual debut (three RCTs), provide a long-term increase in condom use at first sex (one pre-post intervention study) and a short-term decrease in number of sexual partners among men (one pre-post intervention study), improve HIV risk awareness (three qualitative studies) and provide short-term effects on decreased gender violence and risky cultural and sexual practices (one qualitative study).
Latin America and the Caribbean (eight studies): Increases in contraceptive use were reported in Latin American countries for life skills-based education compared to control groups (one RCT, two pre-post intervention studies), as were increases in delay of sexual debut (two pre-post intervention studies), increased condom use with casual partners (one pre-post intervention study) and reduced frequency of sexual intercourse (one pre-post intervention study).
Asia and Europe: Two Asian studies (pre-post intervention studies) and two UK studies reported no impact on reported sexual behaviour, although one UK RCT reported a sustained increase in reported enjoyment of most recent sex for the life skills-based education group.
Further results were reported.