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Risk Behaviors Among Students Attending Alternative High School

December 3, 1999

The October 29th issue of Morbidity and Mortality Weekly Report (MMWR) presents national data on risk behaviors of alternative high school youth from 1998. Alternative high schools serve students who are at high risk of failing, dropping out, or being expelled from traditional high schools because of illegal activity or behavioral problems.

The Youth Risk Behavior Surveillance System (YRBS) monitors six categories of priority health-risk behaviors among youth and young adults including sexual behaviors that contribute to unintended pregnancy and STDs, including HIV.

A total of 8,918 students from 115 schools representing 50 states and the District of Columbia completed a self-administered questionnaire. Of these schools, five served pregnant teenagers, 13 served adjudicated students, 17 served students with emotional or behavioral problems, and 80 served multiple types of student populations.

National findings for students at alternative high schools include:

Sexual Behaviors

Sexual Intercourse with Multiple Partners

Condom Use

Birth Control Pill Use

Alcohol or Drug Use at Last Sexual Intercourse


HIV Education

The findings suggest that many students attending alternative high schools engage in behaviors that place them at risk for unintended pregnancy, STDs (including HIV), and other serious health problems.

To put the risk behavior of alternative high school students into perspective, this data can be compared to the results of the YRBS given to students in traditional high schools in 1997.

Such a comparison suggests that students in alternative high schools engage in more high risk behaviors than their peers in traditional high schools. For example, 89% of alternative high school students engaged in sexual intercourse during their lifetime, compared to only 48% of traditional high school students.

Twenty-two percent of alternative high school students engaged in sexual intercourse before the age of 13 compared to 7% of traditional high school students.

Moreover, while 50% of alternative high school students engaged in sexual intercourse with 4 or more partners during their lifetime, only 16% of traditional high school students reported doing so. In addition, 46% of alternative high school students reported that either they or their partner had used a condom during last sexual intercourse compared to 57% of traditional high school students. Thirty percent of alternative high school students reported that they had been pregnant or gotten a partner pregnant, as compared to only 7% of traditional high school students.

Based on the findings, the authors recommend that alternative high schools need "programs that teach specific skills to avoid initiation of sexual intercourse and increase use of condoms and other methods of contraception [in order] to reduce high rates of unintended pregnancy and STDs among youth and young adults."

For more information:

U.S. Centers for Disease Control and Prevention, "Youth Risk Behavior Surveillance-National Alternative High School Youth Risk Behavior Survey, United States, 1998," MMWR, October 1999, vol. 48, n. SS-7.

Program Highlight

HIV-Prevention Education for At-Risk Youth

New Beginnings of Lewiston, ME is a non-profit organization serving abused, neglected, exploited, and/or homeless youth. The organization's HIV-Prevention Project targets youth in group homes, shelters, and other residential programs in an effort to reduce risks of HIV infection, increase risk-reduction skills, decrease or delay sexual activity, and increase knowledge of, and ability to use, safer sex practices.

The program, HIV Prevention Education for Youth in Residential Programs, was adapted from two nationally recognized curricula, Listen to the Students and Adolescents Living Safely. This eight-session curriculum includes personal HIV-risk assessment; identification of high-risk situations; coping skills for avoiding, managing, and escaping from HIV-risk situations; coping with pressures to use alcohol and drugs; HIV-testing information and decisions; and other prevention resources. Youth who go through the program serve as HIV educators for their peers.

New Beginnings also offers facilitator training to staff at other organizations that may be interested in providing a similar program for youth in their own community.

For more information:

Mary Ruchinskas, community services director, New Beginnings, 436 Main Street, Lewiston, ME, 042470; Phone: 207/795-4070; Fax: 207/795-4080.

This article was provided by Sexuality Information and Education Council of the United States. It is a part of the publication SHOP Talk: School Health Opportunities and Progress Bulletin. You can find this article online by typing this address into your Web browser:

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