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 curriculum
• Six sessions, each lasting 50 minutes
• Experiential activities included to build skills in negotiation, refusal, and condom use
• Educator training recommended

For Use With

• Black male youth
• Urban 13- to 18-year-old youth

Evaluation Methodology

• Experimental design, including treatment and control conditions, in Philadelphia, Pennsylvania
• Urban male teens (n=157 at baseline; n=150 at follow-up), recruited from multiple venues; mean age 14.6
• Participants received a monetary incentive for participating
• Pretest, post-test, and three-month follow-up survey

Evaluation Findings

• Reduced frequency of sex
• Reduced number of sexual partners
• Reduced number of female partners also involved with other men
• Increased condom use
• Reduced incidence of heterosexual anal intercourse

Evaluators' comments: These results provide scant support for the view that matching the gender of facilitator and intervention participants enhances the effectiveness of AIDS interventions with black male adolescents.
Source: Jemmott, Jemmott, Fong, 1992

Program Description

This five-hour, six-part intervention aims to prevent HIV and other STIs among adolescents ages 13 to 18 by improving their HIV-related knowledge, attitudes, and behaviors. As such, it also addresses sexual behaviors related to pregnancy prevention, including avoiding risky situations, using condoms, and being monogamous. Through discussion in small groups of six to 12, participants learn the risks of injected drug use and unsafe sexual behaviors. Videos, role-playing, games, and exercises reinforce learning and encourage participation. Educators may receive advance training in the delivery of this program. This intervention is based on three theories of health behavior change: social cognitive theory, the theory of reasoned action, and the theory of planned behavior.[29,30]

The program is culturally appropriate for inner city, black youth. It builds on young people's sense of community and addresses the importance of protecting one's community, as well as oneself, against the potentially negative consequences of unprotected sexual intercourse. The curriculum addresses youth's self-esteem and self-respect by emphasizing that it feels good to make proud and responsible safer sex decisions.[30,31]

Evaluation Methodology

Participants (n=157) were black males from Philadelphia, mean age 14.6 years, recruited from among: 1) the outpatients at a medical clinic (44 percent); 2) students in a 10th, 11th, and 12th grade assembly in a local high school (32 percent); and 3) youth attending a local YMCA (24 percent). Most participants (97 percent) were enrolled in school. Few participants reported sharing needles (five percent), having receptive anal intercourse (two percent), or sexual relationships exclusively with males (two percent) or with both males and females (one percent).[30]

Youth's chief HIV risk was from heterosexual activities. Thirty-four percent reported more than one coital partner in the past three months and about 21 percent of those youth reported never using condoms. Only 30 percent of currently sexually active youth reported always using condoms. Risk behaviors did not vary significantly by recruitment venue. The young men completed a 90-minute pre-intervention questionnaire and were randomly assigned to the HIV/AIDS risk reduction intervention or to a comparison intervention focused on career opportunities. Afterwards, youth completed a post-test and another follow-up survey three months later. Participants were paid $15 for participating in the intervention and $25 for participating in the follow-up survey.[30]

Outcomes

• Knowledge—Intervention participants had greater knowledge of HIV and AIDS immediately after the intervention and at three-month follow-up than did control youth.[29]
• Attitudes and perceptions—At post-test and at three-month follow-up, intervention participants reported weaker intentions to engage in unsafe sexual behavior in the next three months than did control youth.[30]
• Behaviors—
  • Reduced frequency of sex—Intervention participants were significantly less likely than control youth to report coitus in the three months following the intervention. They also reported coitus on fewer days than did control youth (2.15 versus 5.48 days).[30]
  • Reduced number of sexual partners—Intervention participants reported significantly fewer sexual partners than did control youth in the three months following the intervention (0.85 versus 1.79).[30]
  • Reduced number of female partners also involved with other men—Intervention participants reported significantly fewer female partners also involved with other men than did control youth in the three months following the intervention (0.19 versus 1.75).[30]
  • Increased use of condoms—Intervention participants reported significantly fewer acts of sexual intercourse without the use of condoms than did control youth in the three months following the intervention. (In evaluation, where five = always using condoms, participants' reports equaled 4.35; controls’ equaled 3.50.)[30]
  • Reduced incidence of heterosexual anal intercourse—Intervention participants reported less heterosexual anal intercourse than control youth in the three months following the intervention (0.07 versus 0.27).[30]

Findings related to the gender of the facilitator—

• Attitudes—Intervention participants who received the intervention with a trained female facilitator had less favorable attitudes towards unsafe sexual behavior compared to participants who received the intervention with a trained male facilitator and to youth in the non-program, control group.[30]
• Behaviors—Receiving the intervention with a female facilitator was more effective in reducing HIV risk behaviors among the young men than was receiving it with a male facilitator. Specifically, significant differences emerged in frequency of coitus or coitus without a condom and on young men's reports of heterosexual anal intercourse in the previous three months.[30]

For More Information or to Order, Contact

• Select Media: Phone, 1.800.707.6334; Web, http://www.selectmedia.org
• For educator training, contact ETR Associates: Phone, 1.800.321.4407; Fax, 1.800.435.8433; Web, http://www.etr.org