Academic journal article Journal of School Health

Impact of a School-Based AIDS Prevention Program on Risk and Protective Behavior for Newly Sexually Active Students

Academic journal article Journal of School Health

Impact of a School-Based AIDS Prevention Program on Risk and Protective Behavior for Newly Sexually Active Students

Article excerpt

One major challenge in the battle to slow the spread of HIV, the pathogen that causes AIDS, involves reducing the risk behaviors in young adolescents. However, because the number of AIDS cases diagnosed among teens ages 13-19 remains relatively small (1,412 or 0.42% of the U.S. total),[1] adolescents may believe they face little or no risk of HIV infection. Since most adolescents who become infected with HIV during their teen-age years do not develop symptoms for an average of eight years or more,[2] young people have little direct experience with the devastating effects of HIV/AIDS. This lack of direct, personal exposure to the negative consequences of risky sexual behavior likely reinforces feelings of invulnerability that already commonly influence adolescents' decisions, thereby reducing their motivation to change unsafe behavior. Further, adolescents tend to base their decisions on more immediate gratification than on distant and uncertain consequences of behavior. Consequently, young people may fail either to refrain from having sex or to use protective measures such as condoms and condoms with foam when they are sexually active. The term "foam" is used in this paper as a euphemism for all products containing nonoxynol-9.

Given the long incubation period between initial infection and onset of disease, the relative number of adolescent AIDS cases remains quite small. Thus, the increasing rate of HIV disease and AIDS among young adults more accurately reflects the growing presence of HIV infection in the adolescent population. Data from the past decade indicate that rates of HIV infection among teens vary widely according to ethnicity and gender, and are increasing due to the growth in the number of adolescents engaging in unprotected sexual intercourse and initiating sexual activity at a younger age.[3] Results of a CDC survey show that for large numbers of students, initiation of risk behavior begins prior to their entry into ninth grade and high school. Data from the 1990 survey of a nationally representative sample of students in grades 9-12 indicate that 54.2% of students had experienced sexual intercourse[4] and about one-third (33.5%) of male and 20.0% of female students initiated sexual intercourse before age 15.[5] Data also indicate that African-American students were more likely to have experienced intercourse (72.3%) than White (51.6%) or Hispanic students (53.4%).[4]

Among students who reported they had sexual intercourse during the three months prior to the survey, 44.9% reported they or their partners used a condom at last sexual intercourse. Male students (49.4%) were significantly more likely to report condom use at last sexual intercourse than female students (40.0%). African-Americans were most likely (47.1%) and Hispanics were least likely (38.4%) to report using condoms at last sexual intercourse; while condom use by White students fell between the two groups (45%).[5]

In the absence of a vaccine, education remains the most hopeful strategy to reduce HIV risk behavior and increase protective behavior among adolescents and adults. In recent years, numerous HIV prevention programs were introduced in school settings, but results were mixed. However, current approaches to school-based AIDS education are being developed from a stronger theoretical framework, applying the previous experience of other prevention efforts and program evaluations.[3]

Despite these efforts, relatively few studies have tested HIV risk-reduction interventions with African-American adolescents,[6] a population disproportionately at risk given the high rate of pregnancy and STDs in their communities.[3,7] For example, minorities living in urban poverty have two-three times the rate of STDs than those who have higher incomes and live in suburban or rural locations; and African-American teens have nearly twice the pregnancy rate as do White teens.[8] These statistics demonstrate that African-American youth are exposed to increased risk of HIV infection, and they demand that attention be given to developing and evaluating effective interventions for this vulnerable population. …

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