Two Interventions for Incarcerated Adolescent Males

A study in the Journal of Sex Education and Therapy 1999 compares the effects of a behavioral STD/HIV risk-reduction intervention and a violence-prevention intervention on the knowledge, attitudes, and behaviors of incarcerated adolescent male offenders.

Participants were recruited upon entering a state reformatory and randomly assigned to one of two six-session programs: an anger management intervention (AM) or a sexual risk-reduction skills-training (ST) intervention.

The ST intervention was based on an abbreviated version of Becoming A Responsible Teen (BART), which included training in five skill components such as correct condom application, refusal of unwanted sexual initiation, partner negotiation for condom use, information provision to peers, and self-reinforcement for adaptive behavior.

The AM intervention was based on Positive Adolescent Choices Training (PACT), which included skill components such as positive feedback and conflict resolution.

Researchers used pre-and post-test written measures to assess knowledge and attitudes about AIDS, condoms, conflict tactics, and anger management. Correct condom use was also evaluated before and after intervention. Finally, participants' sexual behavior, drug use, and recidivism in the youth correctional system were assessed six months after release.

Results

• Youth in the ST group improved their scores and had higher scores on the AIDS knowledge test, more favorable attitudes toward condom use, and enhanced self efficacy after the intervention than youth in the AM group. Youth in both groups experienced an increase perceived risk of HIV infection.

• The ST group significantly increased correct performance on each of the condom use skills. For example, prior to intervention, 12% of the group placed the correct side of the condom on a penis model whereas after the intervention 90.8% of the group demonstrated this skill. In comparison, the skill levels of members of the AM group was virtually unchanged following the intervention.

Behavior Following Release

Participants in both groups reported improvements in risk behaviors six months after release.

They reported a higher score in the practice of safer sexual behaviors including: fewer casual sexual encounters, fewer coercions into unwanted sexual activity, and lower frequency of exchanging drugs for sexual acts.

Participants in both groups also reported less drug and alcohol use, less reliance on conflict, and fewer days in jail at six months follow up. The authors suggest several explanations for these behavioral improvements.

First, it is possible that neither intervention produced behavioral changes and that the observed changes were solely a consequence of the boot-camp-model incarceration.

Second, the authors point out that some of the skills learned in the AM program -- such as resisting peer pressure -- can be applied in sexual relationships. Thus the ability to negotiate condom use or resist unwanted sexual advances may have been an unintended outcome of the AM program.

Third, the authors suggest that the prison environment may have been a catalyst for peer exchange of information. This would allow participants in each group to learn from the experiences of their peers in the alternate intervention and could explain the decrease in sexual risk behaviors for members in the AM intervention as well as the decrease in court appearances and days in jail for members of the ST intervention.

The authors conclude that "further research is needed to determine the effectiveness of STD/HIV prevention and violence prevention programs on the behaviors of delinquent youth."

For more information:

Janet S. St. Lawrence, et al, "Sexual Risk Reduction and Anger Management Interventions for Incarcerated Male Adolescents: A Randomized Controlled Trial of Two Interventions." Journal of Sex Education and Therapy, vol. 24 (1 & 2), pp. 9-17.

For more information on BART, visit ETR Associates web site at http://www.etr.org.