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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, sex education, and skills training curriculum
- Eight sessions, each lasting one-and-a-half to two hours, delivered once per week
- Experiential activities included to build skills in assertion, refusal, problem solving, risk recognition, and condom use
- Designed for single-sex groups of youth, each group facilitated by both a female and a male leader
For Use With - African American youth
- Youth ages 14 to 18
- Urban youth
Evaluation Methodology - Experimental design, including treatment and control conditions, in Jackson, Mississippi
- Urban, African American youth (n=246 at baseline; n=225 at 12-month follow-up); mean age 15.3
- Pretest and follow-up assessment at two-, six-, and 12-months post intervention
Evaluation Findings - Delayed initiation of sexual intercourse
- Reduced frequency of sex
- Reduced incidence of unprotected sex
- Increased condom use – among males
- Cessation of unprotected anal intercourse
Evaluators' comments: Clearly, the more explicit intervention did not promote increased sexual activity or accelerate onset of sexual activity. Instead, the skills training intervention appears to have both lowered rates of sexual activity among youth who were sexually active and deterred the onset of sexual activity for youth who were still abstinent at program entry.
Source: St. Lawrence, Brasfield, Jefferson et al, 1995 Program Description Becoming a Responsible Teen is a culturally appropriate, HIV prevention curriculum designed especially for African American adolescents in non-school, community-based settings. Consisting of eight, one-and-a-half to two-hour sessions, Becoming a Responsible Teen combines HIV/AIDS education with behavioral skills training, including assertion, refusal, self-management, problem solving, risk recognition, and correct condom use. Teens learn to clarify their own values about sexual decisions and to practice skills to reduce sexual risk-taking.[32] Based on social learning and self-efficacy theories, the curriculum's primary goal is promoting safer sexual behaviors. It encourages teens to share what they have learned and to practice their skills outside the group setting. It utilizes interactive sessions, including games, role-playing, discussions, and videos. The intervention is intended for use with gender-specific groups, each facilitated by both a male and a female group leader.[31] Evaluation Methodology In the evaluation study, 246 African American youth, attending a comprehensive health center serving predominantly low-income minority clients were randomly assigned, over a three-year period, to either a two-hour HIV prevention educational program that met one time or to a more sexually explicit, eight-week, education plus behavioral skills training intervention (Becoming a Responsible Teen). Participants met in gender-specific groups of five to 15 youth.[32] Participants' mean age was 15.3 years. Their average school grade was 9.7. Seventy-two percent were female. Participants reported an average of nearly three lifetime sex partners and two sex partners within the previous 12 months. Average age at first sexual intercourse was 12.9 years. Thirteen percent of participants already had one or more children. Nearly nine percent of participants had been diagnosed with an STI within two months of their recruitment into the study. Over the course of three years, 14 repetitions of the interventions (eight sessions each) and control intervention (one session each) were conducted. Evaluation relied on pretest and follow-up assessments at two, six, and 12 months after the intervention.[32] Outcomes - Knowledge—Although intervention and control groups received the same basic informational component, the intervention group scored higher on HIV/AIDS knowledge at both post-test and 12-month follow-up.[32]
- Skills—Youth from the intervention group demonstrated more skill than did control youth in handling pressure to engage in unprotected sex and in providing information to peers. Specifically, intervention youth more often acknowledged a partner's wishes, provided a rationale for refusal, stressed the need for safety, and recommended safer alternatives than did those in the control group.[32]
- Behavior—
- Delayed initiation of sexual intercourse—Of the youth who were sexually abstinent prior to the intervention, less than 12 percent of youth who received the education plus skills training had initiated sex one year later, compared to 31 percent of control youth.[32]
- Reduced frequency of sex—Among sexually experienced youth, 42 percent of control youth reported continuing to have sex across the following year, compared to 27 percent of skills trained youth.[32]
- Reduced incidence of unprotected sex— Compared to intervention males, females in the intervention group reported a relatively low level of unprotected sexual intercourse at pre-intervention. Unprotected sexual intercourse remained at stable, low levels for intervention females across the following year, whereas levels of unprotected sexual intercourse rose among control females and were significantly higher among control females at 12-month follow-up.[32]
Sexually experienced intervention males significantly reduced the frequency of unprotected vaginal intercourse from pre-intervention at all subsequent assessments. Sexually experienced intervention males were also less likely to report engaging in unprotected anal intercourse than were control males – a change that continued at six- and 12-months follow-up.[32] - Increased condom use—Sexually experienced intervention males were significantly more likely to report using condoms at post-intervention than were control youth (82.9 percent of the time versus 61 percent of the time, respectively). Their reports of condom use remained higher throughout the following year, while control youth reported less condom use.[32]
- Cessation of unprotected anal intercourse—Both male and female intervention youth reported entirely discontinuing unprotected anal intercourse.[32]
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