Educational Differences in Sexual Health among Adolescents in Europe: A Meta-Analysis

In European countries with stratified educational trajectories, in which adolescents are separated into vocational and academic tracks, studies have shown that there are educational differences in adolescent sexual health. However, due to heterogeneity of the existing literature in terms of national educational systems and dimensions of sexual health being studied, uncertainty remains about the strength of the association between educational track and adolescent sexual health. The current meta-analysis synthesizes the available evidence on educational differences in sexual health among adolescents in Europe. Further, it tests the extent to which findings vary according to the (sub)domain of sexual health being studied, and study and sample characteristics such as study quality, gender and ethnic background of participants. This meta-analysis included 47 studies, with 159 effect sizes, and 177,169 adolescents (M_age = 16.59, SD = 2.17). Results revealed a significant association between educational track and adolescent sexual health (g = 0.279, 95% CI[0.204, 0.354], p < 0.001). Associations were significantly stronger for certain (sub)domains of sexual health, with adolescents attending vocational tracks for example having less sexual knowledge, more often having had sex (at an early age) and more often experiencing teenage pregnancies, compared to adolescents attending academic tracks. Additionally, the association between educational track and adolescent sexual health was significantly stronger in studies in which more than 75% of participants did not have a migration background. However, there was high heterogeneity (Q(158) = 1960.297, p < 0.001; I² = 80.23%) across studies, which remained significant after adding the moderators, indicating substantial complexity in this relationship that warrants cautious interpretation. This meta-analysis confirmed that there are educational track differences in sexual health among adolescents in Europe, and clarified how this relationship varies according to sexual health (sub)domains and study and sample characteristics.