An HIV/AIDS Peer-Prevention Education Program in the Rural South

A study in the February issue of AIDS Education and Prevention evaluates a school-based sexual risk reduction intervention that sought to reduce sexual risk behaviors among peer-educator trainees in a rural southern state.

For the intervention study, researchers examined data from 21 tenth grade participants who were selected as opinion leaders by their peers and who participated in STAND (Students Together Against Negative Decisions), a 36-hour peer educator-training program.

A comparison sample participated in either a 22-hour leadership training course or in no intervention. Both the STAND and comparison subjects completed a 154-item written knowledge, attitude, and behavior survey at the beginning and end of the training, as well as eight months later.

Intervention Study Results

Communication with Peers, Adults, and Partners

• 100% of STAND participants reported talking at least once with friends in the preceding 3 months about birth control/condoms and about STDs at the 8 month follow-up. 78% of comparison subjects reported talking once with friends about birth control/condoms in the preceding 3 months and 73% about STDs.

• 85% of STAND participants reported talking at least once with a parent or other adult about sexual issues at the 8-month follow-up versus 60% of the comparison subjects.

Knowledge, Attitudes, and Beliefs

• Condom use self-efficacy among STAND participants showed an overall increase of 16% at the 8-month follow-up as compared to an overall decrease among comparison subjects of 1%.

• Over the period of the study, STAND participants reported a small increase in perceived norms favoring condom use among their peers (2.2%) while comparison subjects reported a small decrease (-2.1%).

• Perceived norms favoring abstinence decreased over the study period for both groups; -10.2% for STAND participants and -8.7% for the comparison subjects.

Sexual Behavior

• 67% of STAND trainees and 60% of comparison subjects reported being "nonvirgins" at the preintervention survey.

• 29% of STAND students and 33% of comparison subjects who had reported being "virgins" at the beginning of the study had reported sexual debut at the 8-month follow-up.

Condom Use

• At the end of the study, STAND participants reported a 54% increase over the pretest in using a condom for every act of intercourse as compared to an 18% increase among comparison subjects.

• At the 8-month follow-up, consistent condom use was still up 28% over pretest for STAND participants while for comparison subjects consistent condom use was up 15%.

The authors point out that providing effective sexuality and HIV/AIDS education programs is particularly crucial in Southern states which continue to report the highest rates of teen pregnancy, gonorrhea, and syphilis of any region of the nation, as well as an AIDS incidence rate higher than the national average.

The data suggest that the STAND peer-educator training appears to be an effective program leading to increased communication about sexual issues, improvements in sexual knowledge and self-efficacy, and an increase in risk-reducing behaviors among adolescents who complete the program.

For more information:

M. S. Smith, et al, "Students Together Against Negative Decisions (STAND): Evaluations of a School-Based Sexual Risk Reduction Intervention in the Rural South,"

AIDS Education and Prevention, vol. 12, no. 1, pp. 49-70.

Resources

Soft Smoke, AIDS in the Rural West

, a 28-minute video by Sparky Productions explores the difficulties young people experience living with HIV in a small rural community, specifically western Colorado. It is intended to help educators facilitate open, honest dialogue and involve the viewer in understanding the importance of engaging in safer sex practices.

This video is intended to educate and empower individuals to make healthy, safe decisions in risky situations. Topics in this video include: HIV transmission through IV drug use and sexual intercourse, homophobia, low self-esteem, poor medical care, and lack of resources to aid people living with HIV in western Colorado.

The video package also includes a group discussion guide that provides the facilitator with age-appropriate questions on HIV transmission, Infection, and living with HIV/AIDS. The second half of the guide addresses ways in which people react to others when learning their HIV status and how to overcome those stereotypes. The last portion of the guide focuses on visualizations and the assessment of one's feelings when dealing with issues pertaining to HIV/AIDS. Cost: $39.99 plus $4.99 shipping and handling.

For more information:

Sparky Productions
P.O. Box 2096
Telluride, CO 81435
Phone: 970/728-6290
Fax: 970/728-2023
E-mail: jfranks@montrose.net