CAPs: In Brief

CDC researchers systematically reviewed scientific papers that evaluated school-based CAPs in the U.S.⁵ and found that no programs reported any increase in sexual activity, number of sex partners, frequency of sex, or other sexual risk behaviors.^{4, 6-9} Two school districts actually showed lower levels of sexual risk among their students in schools with CAPs, perhaps because of educational materials or messages handed out with condoms.^6,7

Of the 8 high school CAPs evaluated in 12 different studies, data showed that CAPs can lead to increased condom use among students. As many as 74% of sexually active students reported using a condom they received from a CAP.^{6, 10} CAPs may be particularly impactful for adolescents at greater risk for negative sexual health outcomes. For instance, one study found that students who started having sex at a younger age, had sex frequently, and had more sex partners were all more likely to have used a condom from a CAP than students with fewer risk behaviors.⁶

Finally, the research also shows that CAPs are widely accepted among students, and teens say CAPs are needed.^{10, 11} Awareness of CAPs was high in all studies, with one study finding 90% of students supported their high school’s CAP.¹¹ However, some students said they would be embarrassed to use CAPs and had concerns about confidentiality.^{11, 12}

The review of scientific papers also identified several key program components that were characteristic of a successful CAP. Schools and districts should consider incorporating these elements into their program:

• An oversight committee
• Trained condom distributers
• A designated program lead to order and store condoms and informational material
• Promotion materials or activities (e.g., through teachers/nurses/peers in classes including health education lessons)
• Procedures for appropriate parental/caregiver notification
• Coordination with a school-based health clinic on campus or other school programs (e.g., school-based Chlamydia screening event)
• Ensuring condoms are available in a private and confidential setting where students are comfortable accessing or obtaining them