Connecticut: School-Based Program Effective in Lowering Teens' HIV Risk

A high school-based educational program led by teachers has longer-lasting effects in preventing risky sexual behavior than a program led by peers, according to a study in the March issue of Health Psychology (2002;21;2:177-186). The research also indicates that teaching young people about safe sex does not lead to an increase in their sexual activity.

The study showed that a successful HIV education program that teaches teens about which behaviors put them at risk and how to avoid STDs can be conducted with regular teaching staff at a very low cost, about $2.22 per student. The program was conducted at inner-city schools in Connecticut where about half of the students were sexually active. During a year of follow-up, the researchers documented significant increases in condom use among the 1,600 teenagers who participated in the classroom-based program, said lead author Jeffrey D. Fisher, Ph.D., of the University of Connecticut.

The program consisted of five classes in which students were given factual and myth-debunking information (e.g., monogamy without condoms does not offer protection against HIV); motivation to avoid risky behavior; and trained in skills to avoid HIV infection. This program was compared with a peer intervention in which students delivered similar education to their friends.

Although the peer intervention produced substantial increases in HIV-preventative behaviors among participants during the first three months, condom-use rates dropped back to starting levels a year later. In contrast, the adolescents who participated in the teacher-delivered educational program were slower to adopt preventative behaviors, but their condom-use rates steadily rose after three months' time.

The researchers explained that while peer influence is an important force, the beneficial effect of a peer-delivered intervention may have dissipated due to changes in the teenagers' relationships or inconsistencies in the peer-educator's own behavior. While teens already in intimate relationships may have been tentative about introducing the idea of condom use to their current partners, the short-term nature of teen relationships may have allowed them to discuss the subject at the beginning of succeeding relationships.

The researchers also commented that their data did not show that the educational program encouraged teens to have more sex or start having sex earlier. "In common with many other intervention efforts... exposure to the safer-sex message of the current interventions did not accelerate involvement in sexual activity," reported the researchers, "a fear that has often been raised since the early days of sex education."

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