Psychology and Aids Education: Reducing High-Risk Sexual Behavior
Brigham, Thomas A., Donahoe, Patricia, Gilbert, Bo James, Thomas, Nancy, et al., Behavior and Social Issues
Several years of research produced a 1-credit AIDS education class that is effective in increasing student knowledge and changing high-risk sexual behavior. The course integrates information on AIDS, other sexually transmitted infections, sexual assault prevention, and related issues with self-management and sexual decision-making skills. The class is taught in small sections led by 2-person teams of peer instructors and uses a discussion and exercise approach to present the material. Data from a two semester course evaluation indicate a substantial decrease in the percentage of students engaging in high-risk sexual behavior. The course was replicated at three other universities and is a way of actively involving psychology departments and behavior analysis programs in the important activities of AIDS prevention and peer education. Key words: AIDS/HIV education, sexual decision-making, peer instruction, self-management
The Centers for Disease Control recently released the results of the 1995 National College Health Risk Behavior Survey (Douglas et al., 1997). The report documented high levels of a variety of behaviors that put college and university students' health at risk. Of particular concern are a cluster of behaviors that increase the chance of students contracting sexually transmitted diseases including HIV/AIDs. This pattern of behavior consists of high levels of binge drinking (34%), high rates of sexual intercourse with multiple partners, and low frequencies of condom use (30% using a condom during last intercourse). Other investigators have also found that high risk sexual behaviors are common in the heterosexual college population (e.g., Caron, Davis, Halteman, & Stickle, 1993; DiClemente, Forrest, Mickler, & Principal Site Investigators, 1990). Consistent with this pattern are the findings that 50% of new HIV infections occur in people under the age of 25 with women showing the most rapid increase. Further, approximately 86% of all sexually transmitted infections (STIs) occur in persons in the 15-to-29 age range.
With over 14 million students attending the nation's colleges and universities, institutions of higher education would seem to be an ideal setting for providing instruction and training on how to deal with the issues of sexual behavior. However, designing and implementing effective programs for preventing the transmission of HIV and other STIs has proven to be difficult. Choi and Coates (1994) reviewed the area and found few programs that have actually affected AIDS risk behaviors. The exceptions to their observation have been multi-component programs, Coates, 1990; Kelly, St. Lawrence, Hood, & Brasfield, 1989, designed to impact the participants' overall pattern of behavior. To date, only two successful interventions have been reported with college students (Fisher, Fisher, Misovich, Kimble, & Mulloy, 1996; Horn & Brigham, 1996), and each used a multi-component approach.
The course described in this paper, Psychology 106, and its supporting structure are the product of analyzing literature on AIDS prevention, especially the work of Kelly and his associates (e.g., Kelly, 1995a, 1995b) and the Fishers (e.g. Fisher et al., 1996), and several years of our own research (Brigham, Gilbert, Donahoe, Thomas, & Zemke, 1997; Horn & Brigham, 1996). The resulting program has several critical features worth noting. First, as a graded 1-credit course offered as an optional component of Introductory Psychology, it has both academic and experiential content. Second, the course involves small sections of approximately 15 students with instruction based on discussion and exercises with minimal lecture. Third, students actively and systematically collect data on their own behavior and evaluate the information in relation to their own goals and values. Fourth, teams of two junior-senior-level undergraduate peer instructors trained in both the course content and instructional procedures teach the sections. …