|
Adolescent Preventive Health Watch
Welcome to the 2007 edition of AMCHP’s Adolescent Preventive Health Watch! This tool is designed to provide an overview of what has been happening around adolescent reproductive health over the last year and is divided into the following sections:
- AMCHP’s Adolescent Health Work
- States in Action: All states and territories report annually on 18 national performance measures to the Maternal and Child Health Bureau including the rate of birth (per 1,000) for teenagers aged 15 to 17. In addition, several states have created their own performance measures related to adolescent reproductive health. This section contains more information about these state performance measures.
- State Innovations:State Title V MCH agencies have been advancing adolescent reproductive health in numerous ways. In this section, we take a closer look at success stories from California, Connecticut, New Jersey and New York.
- Research: This year has seen the release of two major studies about abstinence-only education, as well as continuing research about HIV/AIDS, sexually transmitted diseases, unintended and teen pregnancy, and other sexual risk behavior.
- Resources:AMCHP partners with a number of national organizations who offer resources that can be helpful to state health agencies working on adolescent reproductive health. This section highlights new resources and where you can find them.
Why focus on adolescent reproductive health?
Although adolescents are seen as a healthy population who suffer from few life-threatening conditions, many of their behaviors, especially those related to sexual risk-taking, during this developmental phase can have life-long consequences. While teen pregnancy rates, and other sexual risk behaviors, have been decreasing in recent years, the overall picture for adolescent reproductive health in the U.S. is a troubling one.
- Almost half (46 percent) of all 15- to 19-year-olds in the U.S. have had sex at least once.1
- In 2004, the CDC estimated that more than 18,000 13- to 24-year-olds in the U.S. were living with HIV/AIDS, with at least 5,000 new diagnoses in that year. Diagnoses in this age group represented 13 percent of all diagnoses.2
- For the year 2000, almost half (48 percent) of the 18.9 million annual new cases of sexually transmitted diseases (STDs) occur among 15- to 24-year-olds.3 This age group only accounts for a quarter of the sexually active population.
- Almost 750,000 15- to 19-year-olds become pregnant annually; 82 percent of these pregnancies are unplanned, accounting for about one in five of all unintended pregnancies.4
- Adolescents of color, particularly African-American and Latinos, suffer disproportionately from these negative reproductive health outcomes.
However, the good news is that HIV/AIDS, STDs, and unintended and teen pregnancies are preventable through action on the part of state health agencies. This publication is intended to help you advance your efforts to be part of the solution and achieve AMCHP’s goal of “healthy children, healthy families in healthy communities.”
AMCHP's Adolexcent Health Work
National Stakeholders Meeting
The National Stakeholders Meeting is a collaborative project of AMCHP, the National Association of State and Territorial AIDS Directors (NASTAD), the National Coalition of STD Directors (NCSD), and the Society of State Directors of Health, Physical Education, and Recreation (the Society). The meetings bring together state teams with the goal of strengthening collaboration between state health agencies and state education agencies to support and improve HIV, STD, and unintended and teen pregnancy prevention in schools. As of April 2007, 29 states have participated in a National Stakeholders Meeting. (See map below) The most recent NSM was held in April 2007, with teams from Florida, Illinois, New York, South Carolina and Texas. These teams will now be working with the four national partners as part of a year-long follow-up process to help further collaboration in their states.
Meeting of the State Adolescent Health Coordinators
The goal of the 2007 meeting of the state adolescent health coordinators was to provide an opportunity for professional development, networking, and resource-sharing for state adolescent health coordinators. This year’s meeting was held in Tucson, Arizona on March 22 – 24. The theme of this year’s meeting was Partnership – “We Thrive with a Little Help from Our Friends” and featured presentations from adolescent health partners such as America’s Promise; Center for Applied Research and Technical Assistance (CARTA); Centers for Disease Control and Prevention, Division of Adolescent and School Health; Girls, Inc.; Healthy Teen Network; Konopka Institute’s State Adolescent Health Resource Center; National School Boards Association; Merck; Public/Private Ventures; and Youth Infusion.
Forty three state adolescent health coordinators or designates attended this year’s meeting, representing 39 states, plus the District of Columbia, Puerto Rico and the Virgin Islands. Overall evaluations of the meeting were extremely positive, with especially high marks given to CARTA’s plenary session on “Partnering to Eliminate Disparities” and Merck’s plenary session on “The ABC’s of HPV,” which included a timely discussion about the new HPV vaccine. Participants also enjoyed the opportunity to network with their peers and representatives from national and federal adolescent health partner organizations.
Information about accessing materials from the meeting is available in the Resources section.
States in Action
MCHB National Performance Measure
All states and territories report annually on 18 national performance measures to the Maternal and Child Health Bureau including the rate of birth (per 1,000) for teenagers aged 15 to 17. Information about how each state and territory is meeting this performance measure can be found on the Title V Information System (TVIS) website. Search under Measurement and Indicator Data for National Performance Measures; the relevant performance measure is #8. A national map for this performance measure can be found here.
Title V Block Grant State Performance Measures
Each state reports to MCHB on seven to 10 State Performance Measures. During the 2005–2010 Needs Assessment Cycle, 17 states and territories identified state performance measures related to adolescent reproductive health. For the past decade, adolescent sexual and reproductive health concerns have increasingly been on state maternal and child health agendas. For many states, the central concern has been on preventing early childbearing and subsequent teen births while others have focused predominantly on reducing sexual risk behaviors among adolescents. The following are the 17 state and territorial performance measures focused on adolescent reproductive health, as they have defined them:
- Alabama : The pregnancy rate (per 1,000) for adolescents aged 15 – 17 years.
- Arkansas : The percentage of Arkansas high school students who engage in sexual intercourse.
- District of Columbia : Incidence of repeat births for teens less than 19 years of age.
- Florida : The percentage of subsequent births to teens age 15 – 19.
- Georgia : Percent of repeat births among adolescents aged 15 – 17 years old.
- Guam : The percent of high school students who have engaged in sexual intercourse.
- Idaho : Percent of 9 th – 12 th grade students that report having engaged in sexual intercourse.
- Maine : The percentage of births in women less than 24 years of age that are unintended.
- Marshall Islands : The birth rate (per 1,000) for teenagers age 15 – 17.
- Massachusetts : The percentage of pregnancies among women age 18 and over that are intended.
- Minnesota : Percent of sexually active ninth grade students who used a condom at last intercourse.
- Mississippi : The rate of repeat birth (per 1,000) for adolescents less than 18 years old.
- Nevada : Teen birth rate (per 1,000) among Hispanic adolescents ages 15 – 17 should be reduced.
- New Jersey : The percentage of repeat pregnancies among adolescents 15 – 19 years of age.
- New York : Teenage pregnancy rate for girls ages 15 -17.
- Puerto Rico : The birth rate among girls 10-14 years of age.
- Tennessee : Reduce the proportion of teens and young adults ages 15 - 24 with Chlamydia trachomatis infections attending family planning clinics.
State Innovations
CALIFORNIA: The Adolescent Sexual Health Workgroup
The California Adolescent Sexual Health Workgroup (ASHWG) is a standing workgroup comprised of program managers from the California Department of Health Services (DHS) and the California Department of Education (CDE) committed to working more effectively to address the sexual and reproductive health of adolescents in California. The vision of ASHWG is to “create a coordinated, collaborative, and integrated system among government and non-government organizations to promote and protect the sexual and reproductive health of youth in California.”
ASHWG was created in the spring of 2005 as a result of California’s participation in the National Stakeholders Meeting process that focused on ways that states could better integrate programs and activities for HIV, STD and pregnancy prevention among adolescents.
One of the priority areas ASHWG identified was to ensure that educators, counselors and case managers working in the area of adolescent sexuality can deliver effective behavioral interventions to protect the sexual and reproductive health of youth in California. In order to accomplish this, the need for core competencies in adolescent sexual health was identified.
Core Competencies Subcommittee
The Core Competencies subcommittee was formed in January 2006 and has been meeting since April 2006. Subcommittee members include: John Elfers (Chair, SLO County Office of Education), Anita Aguirre (CFHC), Ben Bartos (CSBA), Sharon Dolan (formerly of Health Initiatives for Youth, SF), Marsha Gelt (Center For Health Training), Paul Gibson (STD), Dorith Hertz (OA), Rosanna Jackson (OFP), Elizabeth Mendia (Whittier Rio-Honda AIDS), Erica Monasterio (UCSF), Sharla Smith (CDE), Kay Todd (ETR), Ron Valenti (Kern HS District), Ed Wolf (formerly AIDS Health Project), and Raleigh Philip (Pepperdine University).
The Core Competencies are an outline of the very basic knowledge, attributes, abilities and skills necessary to be an effective and qualified provider in the area of adolescent sexual health. The Core Competencies are intended to apply to all staff and professionals who interact with youth, including health clinic workers, test counselors, case managers, clinicians, classroom teachers, community educators and health outreach workers, to name a few.
The Core Competencies are not requirements binding a program or an agency to particular standards. They are intended as an interdisciplinary guide that programs and agencies can use across various programs of adolescent sexual and reproductive health in several ways including, self assessment; performance appraisal; recruiting and hiring staff; staff development and training; curriculum development; and quality assurance in program implementation.
This common set of competencies will increase the possibility of collaboration and joint training between agencies. They are written in the language of outcomes to better make them observable and measurable.
The Core Competencies Subcommittee has held two face-to-face meetings, seven conference calls and multiple group email exchanges over the past year. The Core Competencies document has undergone significant transformations since the initial draft that was reviewed by an expert panel of 20 practitioners in the field of adolescent sexual and reproductive health in the fall of 2006. Based on extensive feedback from this panel, the number of core competency categories dropped from 12 to five and the number of specific competencies dropped from 154 to 55. The refined Core Competencies document was then rated for applicability through a survey of a large group of practitioners in the field. Survey findings are being compiled, and this feedback will inform needed edits and clarifications which will further improve the document. Following these revisions, the Core Competencies document may be shared with a select group of national experts for their input prior to publication.
CONNECTICUT: Tell Me What You See
Tell Me What You See is a supplemental educational package for high school aged youth addressing sexually transmitted diseases, HIV/AIDS and hepatitis prevention. The initiative was created to establish a system for evaluating and continuously improving Connecticut’s adolescent health programs. It is a collaborative initiative by the state departments of public health and education and Concerned Citizens for Humanity, a community-based organization.
Tell Me What You See is unique as it integrates functional knowledge and skill development through an art-based approach to prevention education. The Tell Me What You See program goals for integrating student artwork into existing Comprehensive School Health Education lesson plans are to more fully engage the hearts and minds of students, to promote student-parent/guardian dialogue and enhance teachers’ ongoing efforts to convey actionable prevention education in their classrooms. The art and poetry used in the project were created by incarcerated youth. The initiative focuses on a multidisciplinary approach and includes various forms of student assessments that align to the Connecticut Healthy and Balanced Living Curriculum Framework.
The initial statewide piloting of Tell Me What You See found it to be a powerful tool for reaching students. Through an evaluation process, it was learned that the program is effective in stimulating communication both with peers and other significant adults. While the functional knowledge components of the program built awareness of the facts, the artwork provoked a level of dialogue and interaction that influenced the development of positive ideas and responsible behaviors. The initiative has been piloted in several different venues: public high schools in rural, suburban and urban settings; the Connecticut technical high schools; and, the American School for the Deaf. The current pilot is being conducted in a multidisciplinary approach in an alternative high school serving youth with behavior challenges.
NEW JERSEY: Plain Talk
An intra-departmental collaboration between the Division of Family Health Services and the Division on AIDS, within the Department of Health and Senior Services provided the start-up funding needed to implement Plain Talk, an evidence-based model. This collaboration will have a local impact on the community in Vineland ( Cumberland County), New Jersey, a county with the highest rate of teen births in New Jersey, and seeks to build effective partnerships.
Plain Talk is a proactive, community-based intervention that teaches parents and other supportive and significant adults in the community about comprehensive sexual education and responsible sexual behavior while also improving access to and use of contraceptive services. It also trains these adults in effective communication skills to improve the quantity and quality of adult/teen communication.
Plain Talk has three core components: community mapping; walkers and talkers; and, home health parties. The overall goals of Plain Talk are to reduce teen pregnancy, STI’s and HIV/AIDS and empowering the community by their involvement in creating the solutions for these issues.
The community mapping process was just completed during the first quarter of 2007. Public Private Ventures is in the process of analyzing the completed surveys. The cost of this analysis is underwritten by the Annie E. Casey Foundation and therefore is not a cost to either the community-based agency implementing the intervention or the Department of Health and Senior Services.
Based on their experience with Plain Talk, New Jersey recommends creating some “buzz” when introducing a potential new program by holding a meeting with a group of stakeholders to educate, garner support and identify collaborative opportunities. And, be persistent with follow-up of possible collaborative opportunities.
NEW YORK: Positive Youth Development and HIV Prevention
In 2002, the New York State Department of Health, AIDS Institute released a request for applications for HIV prevention services for young people. The request represented a change in direction for adolescent HIV prevention services in New York; away from general education and awareness activities and toward intensive long-term interventions with young people at increased risk for HIV infection and STIs. The request also introduced the concept of positive youth development as the framework in which HIV prevention services would be delivered.
This change in direction reflected the acknowledgement that young people needed more than education and skills to reduce their risk for HIV infection; they also needed the motivation to use the knowledge and skills that HIV prevention programs were providing. The introduction of a positive youth development approach and the delivery of real youth development opportunities completed the equation; knowledge + skills + motivation = reduced risk for HIV infection.
Twenty-six programs were awarded funding and started delivering services in October 2003. Programs were located in community-based organizations, community health centers and academic institutions in urban, suburban and rural communities throughout the state. Almost all of the programs use young people to deliver services.
To assist the programs in achieving the goal of integrating HIV prevention services into a youth development framework, the AIDS Institute provided several tools, training opportunities and other resources. The programs received a guidance document on positive youth development that explained the principles of youth development and provided concrete examples of how the principles can be put into practice in a prevention program. The programs were also given a guidance document on how to establish and manage a peer-led service program. This document highlighted how peer programs can also be youth development programs.
In addition to the guidance documents, the AIDS Institute arranged for the delivery of several training sessions on various aspects of youth development. In the context of regular meetings of the providers, program staff received training on such topics as the fundamentals of youth development, how to increase youth involvement, how youth voice improves program performance, and how to involve young people in program evaluation activities. All of these training sessions included opportunities for program staff to work on how they could implement the concepts in their specific prevention programs. The discussion of youth development in the context of regular provider meetings aided in the development of a common language and vision among the adolescent HIV prevention service programs.
This shared vision was also reinforced through various contract management mechanisms employed by the AIDS Institute including a youth development objective in annual contract work plans, monthly reporting requirements regarding youth development opportunities provided by the programs, and looking for evidence of the practical use of youth development principles during program monitoring visits.
The introduction and supported implementation of youth development principles into the HIV prevention programs has greatly enhanced the programs’ relationships with the young people they serve and the quality of the services they provide. By inviting and creating ways for young people to be meaningfully involved in program planning, service delivery and evaluation, the programs have become more relevant to the people they serve. Two examples of youth involvement illustrate this point. One program has trained young people to provide HIV counseling and testing services which has led to a significant increase in the number of young people testing for HIV and STIs. Another program structured the staff hiring process to include a panel of peer educators who would interview potential candidates. As a result of this process, the program hired a staff person who was determined to be the most effective in working with young people.
Finally, efforts are underway to evaluate the HIV prevention and youth development components of the programs. Programs are reporting their success in achieving core HIV prevention outcomes-increased knowledge about HIV/STIs, positive changes in young people’s beliefs and attitudes about HIV/AIDS, increased condom use, and increased number of people who know their HIV status. Programs have been recently trained on the use of a survey that is administered to young people to assess programs’ success in fostering basic social skills, caring adult relationships and decision making among the youth they serve. It is anticipated that the combination of these two evaluation efforts will provide insight into the impact of positive youth development on HIV prevention outcomes and provide guidance for further program improvement activities.
Research
- Impacts of Four Title V Abstinence Education Programs Final Report
- Abstinence Education: Efforts to Assess the Accuracy and Effectiveness of Federally Funded Programs
- Epidemiology of HIV and AIDS among Adolescents and Young Adults in the United States
- Sex and HIV Education Programs: Their Impact on Sexual Behaviors of Young People Throughout the World
- Parent Opinion of Sexuality Education in a State with Mandated Abstinence Education: Does Policy Match Parental Preference?
- Depressive Symptoms as a Predictor of Sexual Risk among African-American Adolescents and Young Adults
- A Brief, Individualized, Computer-Delivered Sexual Risk Reduction Intervention Increases HIV/AIDS Preventive Behavior
- Predictors of Inconsistent Contraceptive Use among Adolescent Girls: Findings from a Prospective Study
- Having Sex and Condom Use : Potential Risks and Benefits Reported by Young, Sexually Inexperienced Adolescents
- Predictors of Sexual Risk Behaviors among Adolescent Mothers in a Human Immunodeficiency Virus Prevention Program
- Youth United Through Health Education: Community-Level, Peer-Led Outreach to Increase Awareness and Improve Noninvasive Sexually Transmitted Infection Screening in Urban African American Youth
Impacts of Four Title V Abstinence Education Programs Final Report – Mathematica Policy Research, Inc. (April 2007)
This study was authorized as part of the welfare reform law of 1997 that established the Title V, Section 510 Abstinence Education Program. Mathematica Policy Research was contracted to provide a scientific evaluation of the overall program by looking at four different types of abstinence education programs being implemented in a variety of settings with a variety of target audiences and program strategies. The final report is based on a follow-up study of 2,057 youth, who four to six years earlier had been randomized to either participate in one of the abstinence education programs or to be in the control group who did not receive the intervention. The follow-up survey looked at both changes in attitude as well as changes in behavior and found no differences between those who had received the abstinence education and those who did not in terms of having abstained from sex, number of sexual partners, age of initiation of sex, or likelihood of having engaged in unprotected sex. The authors of the study suggest that targeting youth at young ages years before they initiate sex, as the programs in this study did, may not be sufficient to have an impact on their sexual behavior. They also suggest that programs may need to strengthen their focus on peer support for abstinence, which their study showed to be an important protective factor but one that erodes over time.
Abstinence Education: Efforts to Assess the Accuracy and Effectiveness of Federally Funded Programs, Government Accountability Office (October 2006) Full Report
This study was undertaken by the Government Accountability Office (GAO) to examine how the federal Department of Health and Human Services (HHS) and the states are assessing the scientific accuracy of materials used in federally funded abstinence-until-marriage programs and what steps are being undertaken to evaluate the effectiveness of these programs. GAO found that efforts to assess the scientific accuracy of materials used in these programs has been limited, in large part because HHS’s Administration on Children and Families (ACF), which oversees the funding for two of the three abstinence programs, does not review grantees’ educational materials for scientific accuracy and does not require grantees to conduct such review of their own materials. In addition, in looking at a sample of states receiving ACF funding, half of them also did not require a review of the materials for scientific accuracy. In contrast, the Office of Population Affairs, which oversees funding for one of the three programs, does review grantees’ materials for scientific accuracy. In terms of evaluating the effectiveness of these programs, GAO found that while there have been a number of efforts to do this, limited conclusions can be drawn thus far, largely due to poor evaluation design and the fact that some major studies, including the Mathematica Policy Research evaluation, had not been completed yet. GAO recommended, and HHS agreed to consider, that ACF develop procedures to ensure that materials being used by its grantees are scientifically accurate.
Epidemiology of HIV and AIDS among Adolescents and Young Adults in the United States (Rangel, et al) – Journal of Adolescent Health 39 (2006) 156-163 Abstract | Full Text
This article analyzed data from the national HIV/AIDS Reporting System, comprising HIV and AIDS diagnoses reported to the Centers for Disease Control and Prevention by U.S. states and territories, to better understand the trends in the HIV/AIDS epidemic among the 13- to 24-year-old age group. In particular, it finds that there are significant differences in the epidemiology among age subgroups, i.e. HIV diagnoses are more common in females on the younger side (13-15) of this age group and are largely due to perinatal transmission, while in the 20-24 age group, 67 percent of diagnoses are in males and are largely due to male-to-male sexual transmission (MSM). In all subgroups, African-American and Latino youth are disproportionately affected. The analysis also shows HIV diagnoses in young females decreased significantly between 1999 and 2003 while they increased significantly in young males, almost entirely due to male-to-male sexual contact. This article highlights the need to develop more specific prevention and treatment strategies for different subgroups of the 13- to 24-year-old age group and to specifically devise strategies for targeting young MSM of color and the approximately 10,000 perinatally infected children who are aging into adolescence. In addition, the article recommends that programs should continue to focus on encouraging testing in the adolescent population and that HIV prevention programs should be part of broader comprehensive health education programs.
Sex and HIV Education Programs: Their Impact on Sexual Behaviors of Young People Throughout the World (Kirby, et al) – Journal of Adolescent Health 40 (2007) 206 – 217 Abstract | Full Text
This review article analyzes 83 studies that examine the impact of sex education and HIV prevention curricula on sexual behavior of youth under 25 around the world in order to devise a list of common characteristics of effective curricula and programs. This article is a summary of the full report, Sex and HIV Education Programs for Youth: Their Impact and Important Characteristics, published by Dr. Kirby and his colleagues in 2006 and available online. This report is also the basis for the Tool to Assess the Characteristics of Effective Sex and STD/HIV Education Programs, included in the Resources section.
Parent Opinion of Sexuality Education in a State with Mandated Abstinence Education: Does Policy Match Parental Preference? (Ito, et al) – Journal of Adolescent Health 39 (2006) 634 – 641 Abstract | Full Text
This article reports on a statewide survey that was conducted in North Carolina to determine if the state’s policy of mandated abstinence-until-marriage education matched parental preferences for sex education content in the state’s public schools. The survey found in contrast to the current policy, the overwhelming majority of parents (89 percent) support comprehensive sexuality education in public schools, which the authors defined as including teaching about how to talk with partners about contraception and sexually transmitted infections (STIs), how to use contraception, and how to use condoms. Information about the transmission and prevention of STIs and HIV/AIDS was consistently ranked by almost all parents as one of the most important topics for sex education courses to include. In addition, the vast majority of parents felt that parents and public health professionals should determine the content of sex education in public schools, while most opposed the involvement of politicians in these decisions, in direct contrast to the current situation in the state.
Depressive Symptoms as a Predictor of Sexual Risk among African-American Adolescents and Young Adults (Brown, et al) – Journal of Adolescent Health 39 (2006) 444.e1 – 444.e8 Abstract
This prospective study analyzed the relationship between depressive symptoms and condom use in African American adolescents and young adults ages 15 to 21 in two urban areas who were enrolled in a larger HIV prevention intervention study. They found that African American adolescents who reported depressive symptoms at baseline were significantly less likely to report condom use at six-month follow-up than those who did not report depressive symptoms. When adjusting for socioeconomic and other demographic factors, they came up with an adjusted odds ratio that those who did not report depressive symptoms were four times more likely to report consistent condom use than those who did report depressive symptoms. As inconsistent condom use is a major risk factor for HIV and STI transmission and acquisition, the authors recommend that prevention interventions for African American youth should include information about depression and its relationship to sexual risk taking and consider whether interventions may need to be modified in order to more effectively address sexual risk taking behaviors in depressed individuals.
A Brief, Individualized, Computer-Delivered Sexual Risk Reduction Intervention Increases HIV/AIDS Preventive Behavior (Kiene, et al) – Journal of Adolescent Health 39 (2006) 404 – 410 Abstract
This article reports on the effectiveness of a brief, customized, computer-delivered HIV/AIDS risk reduction intervention at increasing HIV/AIDS preventive behaviors in a randomized trial conducted among college students. In comparison with the control group, who received a computerized intervention on a different health topic, the intervention group demonstrated a small but significant increase in preventive behaviors, including an increase in frequency of keeping condoms nearby and an increase in frequency of using condoms, during the 30-day follow-up period. This may be a promising intervention approach for adolescents, although the study was limited to a low-risk group of adolescents in college, and more research would need to be done to see if a similar intervention would work as well with less economically and educationally advantaged and/or higher-risk adolescents.
Predictors of Inconsistent Contraceptive Use among Adolescent Girls: Findings from a Prospective Study – Journal of Adolescent Health 39 (2006) 43-49 Abstract | Full Text
This study analyzes the psychosocial and contextual factors that impede contraceptive use among a sample of low-income, Southern, African-American females. The study found that six variables were significantly predictive of future inconsistent contraceptive use: previous inconsistent contraceptive use; some level of a desire to be pregnant; perception that their partner wants them to be pregnant; a greater number of lifetime sexual partners; less communications with partners about sexual prevention issues; and, belief that their sexual partners had been monogamous. Of note, the study found that previous pregnancy or a sexually transmitted infection had little influence on future contraceptive use. These findings could have significant implications for the development of HIV, STI and pregnancy prevention programs for high-risk, African-American, adolescent girls.
Having Sex and Condom Use : Potential Risks and Benefits Reported by Young, Sexually Inexperienced Adolescents – Journal of Adolescent Health 39 (2006) 588-595 Abstract
This study sought to increase understanding of the factors involved in young adolescent’s decision making around engaging in sexual activity and condom use. Using written surveys, a group of young adolescents were asked to respond to a scenario describing two adolescents who had sex, both with or without the use of a condom, and then identify potential positive and negative outcomes of having sex, either with or without the use of a condom. Study participants were able to identify both the risks and benefits of having sex and of using condoms or not using condoms. Study results suggest that risk reduction communication aimed at adolescents may want to reflect not only the health risks related to having sex but may also want to include both the psychosocial impacts and the perceptions of the adolescents themselves related to sexual activity.
Predictors of Sexual Risk Behaviors among Adolescent Mothers in a Human Immunodeficiency Virus Prevention Program – Journal of Adolescent Health 38 (2006) 297 – 297 Abstract
This study sought to determine whether adolescent mothers in an HIV prevention program had significantly greater perceived self-efficacy and perceived behavioral control to use condoms, and more favorable outcome expectancies and subjective norms regarding condom use than those in a health education control group.Although both groups showed substantial improvement, the HIV-prevention group showed a slight advantage.Study results suggest that in order to be successful, HIV-prevention programs for young mothers need to be comprehensive, building on theoretical concepts while addressing the realities of young mothers, e.g., addressing community-level and societal-level factors.
Youth United Through Health Education: Community-Level, Peer-Led Outreach to Increase Awareness and Improve Noninvasive Sexually Transmitted Infection Screening in Urban African American Youth. Journal of Adolescent Health 40 (2007) 499 – 505 Abstract
This study sought to determine whether a community-level, peer-led outreach program could increase awareness of and improve screening for sexually-transmitted infections in an outreach community relative to a comparison community. Evaluation study participants from both the outreach community and the comparison community were asked to complete a 43-item questionnaire to assess socio-demographic factors and sexual risk behaviors and constructs, e.g., history of STI screening, intention to seek STI screening, STI/HIV knowledge, perceived risk for STIs/HIV, perceived peer norms for STI testing, etc. Although the study found no difference between the outreach and comparison communities with regards to reporting previous STI screening or intention to be screened for STIs, the study did find that respondents from the outreach community were more likely to be aware that STI infections could be asymptomatic, perceive themselves to be at risk for acquiring an STI or worried about acquiring an STI. Study results suggest that community-level, peer-led health outreach is a feasible approach for implementing STI/HIV prevention strategies for adolescents living in communities with high rates of STIs.
Resources
AMCHP
Centers for Disease Control & Prevention – Division of Adolescent & School Health (CDC-DASH)
CDC-DASH’s website now has updated profiles of all state, territorial and local education agencies and non-governmental organizations (NGOs) that are funded for adolescent HIV prevention and other priority areas. The new pages include examples of partner activities, a link to the partner website, partner contact information, and easy access to Youth Risk Behavior Survey (YRBS) and School Health Profiles data specific to each partner (state, territory and local pages only).
Healthy Teen Network
Healthy Teen Network serves as the leading national membership organization dedicated to making a difference in the lives of teens and young families.
Healthy Teen Network supports professionals in the adolescent health field through: research and evaluation; information dissemination; training and technical support; policy and advocacy; and, organizational capacity building. Healthy Teen Network membership consists of organizations, individuals and students working or interested in the adolescent health field. Healthy Teen Network offers:
- Online resource directory of key national, regional and state contacts and programs;
- Discounts on professional journals and educational videos;
- Comprehensive website with members-only access;
- Free print resources and publications;
- Weekly email newsletters with the latest news, research, events and funding opportunities;
- Discounts and scholarships to training events, including HTN’s annual conference; and,
- The only national conference solely devoted to the issues of teen pregnancy, parenting and prevention.
Science-Based Approaches: A Year in Review
The Year in Review brochure identifies the most notable and innovative research, resources, programs and policy from the past year that employ a science-based approach in making a difference in the lives of teens and young families.
Science-Based Approaches (Front Cover)
Science-Based Approaches (Inside)
Promoting Healthy Teens
This brochure focuses on the advantages of integrating HIV, STI and pregnancy prevention education and services, tips for integrating a program or services and HIV/pregnancy prevention resources.
HIV Brochure (Front Cover)
HIV Brochure (Inside)
Helping Teens Stay Healthy and Safe: Health Care, Birth Control and Confidential Services
Confidential contraceptive services are necessary for teens to access essential preventative care. Many states in the US do not have explicit laws authorizing minors to consent for contraceptive services, causing great confusion among teens, parents and providers. The Helping Teens Stay Healthy and Safe series of brochures guides teens, parents of teens and providers regarding their right to deliver, receive and support adolescent access to confidential contraceptive services.
Introduction
A Guide for Teens: Front Cover | Inside
A Guide for Parents: Front Cover | Inside
A Guide for Providers: Front Cover | Inside
A Guide for Providers (Full Report)
Advocacy Resource Guides
Healthy Teen Network’s Advocacy Resource Guides spotlight relevant issues affecting youth, provide background information regarding these topics and present readers with various recommendations for action. Healthy Teen Network encourages members and affiliates to use our resource guides to influence the development of state, local and/or institutional policies and standards. Addressing HIV/AIDS Among Youth is one of many Advocacy Resource Guides that Healthy Teen Network offers for free at www.healthyteennetwork.org
Addressing HIV/AIDS Among Youth The HIV/AIDS epidemic continues to play a significant role in the lives of adolescents and young adults today. In 2000, youth ages 15-24 represented only 25percent of the sexually experienced population in the United States, but had 48percent of all new STIs that year (Weinstock, 2004). To make a difference in reducing HIV among new generations, youth need accurate, culturally relevant, age-appropriate information about HIV transmission and infection, as well as, how to protect themselves, including abstinence, contraception, safer sex practices and where to get tested. HIV education and services must be also readily available to all youth, regardless of ability to pay and in a variety of settings.
A Tool to Assess the Characteristics of Effective Sex and STD/HIV Education Programs (TAC)
The Tool to Assess the Characteristics of Effective Sex and STD/HIV Education Programs (TAC) gives communities the tools they need to select and implement the most effective pregnancy and STD prevention programs for youth.
The TAC is designed to help practitioners assess whether curriculum-based programs have incorporated the common characteristics of effective programs. Knowing which curriculum-based programs have incorporated the common characteristics of effective programs and which have not can help practitioners select, adapt, develop and implement more effective pregnancy, STD and HIV prevention programs in their communities.
The Tool to Assess the Characteristics of Effective Sex and STD/HIV Education Programs | Cover Letter
The TAC is $10 (plus shipping and handling) for a hard copy or download a free copy.
Kaiser Family Foundation
A leader in health policy and communications, the Kaiser Family Foundation is a non-profit, private operating foundation focusing on the major health care issues facing the U.S., with a growing role in global health. Unlike grant-making foundations, Kaiser develops and runs its own research and communications programs, sometimes in partnership with other non-profit research organizations or major media companies.
The Kaiser Family Foundation’s HIV Policy Program has several fact sheets about the HIV/AIDS epidemic in the U.S. available for free download on their website, including:
Endnotes
1 - Guttmacher Institute, “Facts on American Teens Sexual and Reproductive Health”
2 - Kaiser Family Foundation, “Sexual Health Statistics for Teenagers and Young Adults in the United States”
3 - Ibid, Guttmacher
4 - Ibid, Guttmacher
Last Updated
November 1, 2007
|
