Science and Success, Second Edition: Sex Education and Other Programs that Work to Prevent Teen Pregnancy, HIV and Sexually Transmitted Infections

Full Study Report [HTML] [PDF]
Executive Summary [HTML] [PDF]

Program Components

• HIV prevention program to augment services traditionally available at shelters for runaway youth
• 30 discussion sessions in small groups, each session lasting one-and-a-half to two hours
• Experiential activities included to build cognitive and coping skills
• Health care, including mental health services
• Intensive training of shelter staff

For Use With

• Runaway youth
• Youth living in city shelters
• Black and Hispanic youth
• Urban youth, ages 11 to 18

Evaluation Methodology

• Quasi-experimental design, involving a non-randomized control trial at two residential shelters in New York, New York
• Urban, runaway youth (n=197 at baseline; n=145 at follow-up) living in shelters; average age, 15.5
• Baseline interview and reassessment at three and six months after baseline
• Participants received monetary incentives for participating in interviews

Evaluation Findings

• Reduced frequency of sex
• Reduced number of sexual partners
• Increased condom use

Evaluators' comments: This study… has potentially important implications. First, adolescents do change their behaviors in response to an intensive intervention… Second, these data indicate that programs designed to prevent HIV infection need to provide more than the two or three sessions currently being implemented with adolescents.
Source: Rotheram-Borus, Koopman, Haignere et al, 1991

Program Description

The goal of this intervention is to promote behavior change to prevent HIV infection among runaway youth, ages 11 to 18. The program is designed to augment traditional services at shelters for runaway youth. An important program component is the small group discussion, designed to:

• Develop and improve interpersonal skills
• Promote behavioral self-management
• Increase HIV prevention knowledge and
• Provide peer support for HIV preventive behaviors.

Because the program targets runaways, a group experiencing many stressful life events and highly unstable living arrangements, the program also provides access to ongoing physical and mental health care. Shelter staff receives intensive training in intervention techniques.[29]

The intervention is based on successful programs targeting: 1) other adolescent health risk behaviors, such as cigarette smoking; and 2) HIV prevention among adult men who have sex with men. Such programs have demonstrated the effectiveness of skills training, behavioral self-management, and group and social support from peers.[29]

Evaluation Methodology

Runaways were recruited at two residential shelters in New York City. Seventy-nine runaways at the non-intervention site and 118 runaways at the intervention site volunteered to participate. Ninety-eight percent of runaways were from the New York metropolitan area. Each youth was paid $2.00 for participating in the initial assessment and $20 to $25 for each follow-up interview. During six months, 145 runaways received a three- and/or a six-month follow-up interview (78 intervention participants and 67 non-intervention youth). About 64 percent of participants were female; nearly 36 percent were male. Sixty-three percent were black; 22 percent were Hispanic. Eight percent were white while the rest identified as ‘other’. The youth ranged in age from 11 to 18 years (median age, 15.5). Most runaways identified as heterosexual (93 percent of males, 99 percent of females).[29]

Runaways at the two sites did not differ significantly in age, gender, race / ethnicity, or length of time since living at home. The duration of runaways' stay in shelters varied because of the availability of permanent housing in group homes and independent living situations. However, the median length of stay was 37 days (range from one to 214 days). At baseline, 19 percent of comparison youth and 25 percent of intervention youth reported high risk patterns of behavior, including multiple sex partners. At baseline, 24 percent of sexually experienced runaways reported consistent condom use in the past three months. The only sexual behavior that was significantly related to age at baseline was abstinence. Forty-eight percent of younger runaways (ages 11 to 15) and 23 percent of older runaways (ages 16 to 18) had been sexually abstinent in the preceding three months.[29]

Outcomes

• Behaviors—
  • Reduced frequency of sex and number of sexual partners—The number of sessions attended by participants was significantly associated with a reduction in high-risk pattern (frequency of sex and number of sexual partners in the past three months) reported by participants at three- and six-month follow-up. For sexually experienced runaways, attending 15 or more sessions was significantly associated with a reduction in sexual risk behaviors from 20 percent at baseline to zero percent at three- and six-month follow-up.[29]
    
    Receiving no intervention (comparison youth) or as many as two sessions of the intervention was associated with an increase in such behaviors (from 17 to 20 percent) at six-month follow-up. Receiving three to 14 sessions was associated with a decrease in such behaviors (from 30 to 18 and from 28 to 10 percent, respectively) at six-months follow-up.[29]
  • Increased condom use—Runaways who received 15 or more of the sessions were significantly more likely to be consistent condom users at three- and six-month follow-up, compared to youth who received fewer sessions or to non-intervention youth. Among sexually experienced runaways who received 15 or more sessions, consistent condom use rose from 33 percent at baseline to 57 percent at three-month and 63 percent at six-month follow-up.[29]
    
    Among sexually experienced runaways who attended fewer than 15 sessions, condom use increased and decreased in a discouraging pattern, with reported condom use at six-months follow-up only slightly higher than at baseline for those attending 10 to 14 sessions, and less than baseline for those attending fewer than 10 sessions and for comparison youth.[29]
  • Timing of sexual initiation unaffected—Receiving the intervention had no significant effect on reported abstinence, neither hastening nor delaying the onset of sexual activity. Findings showed that abstinence at baseline was associated with abstinence at three- and six-month follow-up.[29]

For More Information or to Order, Contact

• Sociometrics, Program Archive on Sexuality, Health & Adolescence: Phone, 1.800.846.3475; Fax, 1.650.949.3299; E-mail, This e-mail address is being protected from spambots. You need JavaScript enabled to view it ; Web, http://www.socio.com