This evaluation examined the impact of a comprehensive sexual health programme for unmarried youth (ages 15-24) living in urban areas in China. The intervention included:

• community-based sexual health counselling and contraceptive services at a youth health counselling centre
• sex education through youth-focused pamphlets and lectures
• group activities, including interactive discussion, on sexual health issues
• contraceptives and condoms made available free of charge to young people
• sexual health videos, shown at local cinemas prior to popular movies
• training for family planning providers in provision of youth-friendly services
• meetings of community leaders and parents

In April 2000, two towns in Songjiang district, Shanghai, China, were selected for the intervention study. Non-random sampling was used to select the intervention and comparison sites, and all unmarried youth ages 15 through 24 were eligible to participate in the study, irrespective of school status, so long as they had no intention at baseline to marry or to leave the town within one year. No eligible subject refused to participate.

A total of 1,220 unmarried youth in the intervention site and 1,007 in the comparison site were interviewed at baseline, including 1,304 out-of-school youth and 923 high school students. At follow-up (20 months later), 91.7% of eligible youth completed a second survey, including 94% from the intervention site (n=1,148) and 89% from the comparison site (n=894). Both baseline and follow-up surveys were self-administered under conditions that helped ensure anonymity and privacy to youth.

At follow-up (20 months after baseline), nearly 100% of youth in the intervention site reported receiving the educational materials and about 76% said they had read most or all of the materials. About 79% reported seeing at least one video and 50% reported seeing two or more videos. Nearly 33% reported participating in one or more discussion groups.

Counselors provided 328 counseling sessions to youth. Providers reported distributing the following free products to young people: 4,348 condoms, 137 packages of oral contraceptive pills, 146 packages of films, 107 tubes of cream, 870 suppositories, 106 packages of emergency contraceptive pills, and 93 pregnancy test kits.

Between baseline and follow-up, the proportion of youth who reported making joint decisions (communicating) with a partner about contraception rose significantly among sexually experienced males in the intervention site (50 to 77%). In contrast, joint decision making dropped somewhat among males in the comparison site (67 to 63%).

However, reports of joint decision making dropped slightly among females in the intervention site (from 86 to 83%) and rose somewhat among females in the comparison site (65 to 77%).

Increased use of contraception - Proportions of youth reporting ever use and/or consistent use of contraception rose significantly among sexually experienced youth in the intervention site between baseline and follow-up.

• At the intervention site, reports of ever use of contraception rose significantly among all youth (from 65 to 99%), among males (68 to 99%), and among females (60 to 99%). Among sexually experienced youth at the comparison site ever contraceptive use rose, but less so (75 to 83%). The rise in ever use of contraception was statistically
  significant for females and for all youth at the intervention site.
• The proportions reporting regular use of contraception rose significantly among sexually experienced youth from the intervention site between baseline and follow-up overall (34 to 89%) as well as among males (33 to 88%) and females (36 to 90%). At the same time among sexually experienced youth at the comparison site regular contraceptive use remained unchanged (44 to 45%).

Increased use of condoms - The proportions of sexually experienced youth at the intervention site reporting ever use of condoms rose significantly between baseline and follow-up, overall (74 to 97%) as well as among males (76 to 98%), and females (71 to 97%). In the comparison site, condom use among sexually experienced youth also rose, but not significantly (71 to 81%), primarily due to increased use among females (68 to 85%) a rise that was not statistically significant.

Evaluators note that findings on use of contraception and condoms strongly support the idea that a youth-friendly intervention can enhance safer sex behaviours.