Long-Term Effects of a Middle School- and High School-Based Human Immunodeficiency Virus Sexual Risk Prevention Intervention

Article excerpt

Siegel, D.M., Aten, M.J. & Enaharo, M. (2001). Long-term effects of a middle school- and high school-based human immunodeficiency virus sexual risk prevention intervention. Archives of Pediatrics and Adolescent Medicine, 155, 1117-1126.

In the introduction to their research report, Siegel, Aten, & Enaharo note that it is estimated that one fifth of people with HIV were infected as teenagers. Consequently, the design and implementation of effective HIV prevention education interventions targeting youth is an important strategy in reducing the number of HIV infections. Schools offer an advantageous setting for such interventions because they are the only venue where nearly all youth can be reached in a structured environment and because HIV prevention efforts can potentially be integrated into the sexual health education and/or family life education programs that are now mandated in most schools. A number of studies have demonstrated the behavioural effectiveness of sexual risk reduction interventions targeting adolescents, but few of these evaluations have measured program effectiveness beyond a 3 to 6 month period. In their report, Siegel, Aten, and Enaharo provide longer-term data on the effectiveness of a middle school and high school HIV sexual risk reduction intervention.

The study measured the impact of the Rochester AIDS Prevention Project for Youth (RAPP) on 4001 middle school (MS) and high school (HS) students enrolled in health classes in 10 schools in a medium-sized city in the northeastern United States. The students were assigned to one of four groups: RAPP curriculum taught by "highly trained" health educators; RAPP curriculum taught by "extensively trained" HS student peer educators; RAPP curriculum taught by regular health teachers (MS students only); and a control condition consisting of the usual health education curriculum taught by a classroom teacher. The RAPP intervention was integrated into the regular school health education schedule and consisted of 10 (HS) or 12 (MS) consecutive health class sessions delivered for 2 to 7 weeks. The intervention was based on the Theory of Reasoned Action, literature on school-based interventions, and principles of adolescent development. A combination of messages promoting sexual abstinence and safer sex were provided. The sessions emphasized self-esteem, decision-making, and skill building. Activities included games, role plays, and take-home exercises involving parental input.

Study participants completed a confidential survey questionnaire at baseline, immediately after the intervention, and at long-term follow-up. …