CDC Press Office Geneva
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||Monday, June 29, 1998
||11.00, Central European Time
Research Shows Critical Need for Comprehensive HIV Prevention Programs for Teens: Schools Should Enlist the Help of Parents and the Community
Geneva - Researchers from the Centers for Disease Control and Prevention (CDC) will announce today that a school-based program, called Safer Choices, prepares students to make healthier decisions when it comes to sex. CDC data show that teens are continuing to place themselves at risk for HIV infection and point to the crucial need for effective HIV prevention programs for adolescents in the U.S.
"Adolescents face many difficult choices when they enter high school. Making the right decision often takes more than knowledge. It also requires support from peers, parents, and the community. Comprehensive programs must work to create an environment that is supportive of a teenager's decision to abstain from sex, or to use protection if they are going to have sex," commented Lloyd Kolbe, Ph.D., Director of CDC's Division of Adolescent and School Health.
Today at the 12th World AIDS Conference, CDC Research Psychologist Stephen Banspach, Ph.D., will explain how Safer Choices helps to prevent HIV risk behaviors by addressing the variety of influences on adolescent behavior.
Safer Choices Prepares Students to Make Healthier Decisions about Sex
Safer Choices uses prevention efforts that do more than simply provide information. The program focuses on shaping the numerous influences teenagers encounter each day by including activities that facilitate peer leadership, parent participation, and community involvement.
"We know that schools contain many learning opportunities for students, both inside and outside of the formal classroom setting," explains Banspach. "We used this knowledge to create a program that is one of the largest, most comprehensive school-based studies focused on changing HIV risk behavior among high school students. It is also one of the first efforts to integrate classroom curriculum with school-wide activities involving students, parents, school staff, and the community."
Safer Choices was evaluated using 20 schools in California and Texas. Ten randomly-selected schools implemented the multiple-component Safer Choices program. The remaining ten schools adopted or continued standard teacher-driven HIV/STD prevention curriculum. Nearly 4,000 ninth-grade students were followed for 30 months.
Periodic interviews showed that students attending schools with Safer Choices were more likely to avoid behavior that would put them at risk for HIV infection, other STDs, or pregnancy than students attending the comparison schools. Sexually active students reported fewer acts of unprotected intercourse and increased usage of HIV and pregnancy prevention methods. Students receiving the Safer Choices program also showed significant gains in HIV knowledge, parent communication, and attitudes and self-efficacy related to protecting themselves against HIV/STD infection.
Providing Communities Effective Tools for Prevention
Comprehensive HIV education interventions are needed to provide young people with the knowledge and skills to make often difficult decisions about sex. Safer Choices is one program proven effective in creating environments at school, in the community, and at home that are supportive of students' decisions to abstain from sex or to protect themselves from HIV infection and other STDs if they do decide to have sex. Safer Choices is now being considered for inclusion in CDC's Research to Classroom project. This project identifies programs that have evidence of reducing health risk behaviors among youth. Once identified, CDC provides resources to ensure that interventions, including training, are available nationwide for those interested in using them.
"Many young people establish patterns of sexual behavior in their teens. Reaching them through the schools is an excellent way to help ensure they adopt behavior that is safe, especially if parents and the community are involved," said Kolbe.
Need to Reach Teens Early
One poster presentation at this week's AIDS conference includes data collected in the Youth Risk Behavior Survey that point to the need to prepare teenagers to make healthy decisions about sex. The Youth Risk Behavior Survey is an ongoing surveillance system providing self-reported data from approximately 12,000 students, ages 14-18 years old.
According to the survey, the median age of sexual initiation in 1997 was 16.8 years old. However, more than a quarter of teens surveyed became sexually active by the age of 15. Early initiators were less likely than late initiators to have used a condom the last time they had sex and more likely to have had multiple partners in the three months prior to the survey. These findings indicate a need for appropriately timed interventions that reach students before they establish patterns of unsafe sexual behavior.
More Facts about Safer Choices...
Some examples of Safer Choices activities include:
Student/parent homework assignments are given throughout the program. These activities facilitate communication regarding prevention of HIV, other STDs, and unwanted pregnancies. One assignment asks teens and their parents to list and discuss reasons why it is difficult to talk about sensitive issues such as relationships and sexuality, then list ways to make these discussions easier.
One activity built into the curriculum teaches the skill of refusal. Students discuss characteristics of clear "no" statements and practice the skill in large and small groups. Students then receive feedback on their performances. The practice situations are structured to increase in difficulty and enhance the students' confidence in saying "no."
Members from local community organizations form an HIV-positive speakers bureau. These speakers visit schools, giving students a first hand account of what it is like to live with HIV. Students also learn about the resources available to them in the community. Homework assignments encourage them to find out about community organizations and local youth services where they can go for more information about preventing HIV, other STDs, and pregnancy.