Risky Business: Curbing Adolescent Sexual Behaviors with Interventions
Psychological research shows that comprehensive sex education and HIV prevention programs are effective in reducing high-risk sexual behavior in adolescents. Based on over 15 years of research, the evidence shows that behavioral intervention programs that promote appropriate condom use and teach sexual communication skills reduce risky behavior and also delay the onset of sexual intercourse.
High-risk sexual behavior among adolescents can lead to serious long-term health consequences such as sexually transmitted diseases (STDs), HIV/AIDS and unintended pregnancy. According to the Centers for Disease Control and Prevention (CDC), approximately 870,000 pregnancies occur each year among women 15-19 years old, and about 3 million cases of STDs are reported annually among 10- 19- year- olds. Other statistical models suggest that half or more of all HIV infections occur before age 25, and is one of the leading causes of death in adolescents.
Psychologists are leading efforts to develop behavior based sex education and intervention programs designed to help young people develop good decision-making and communication skills, and increase knowledge about disease transmission and prevention. Responding to the continuing health threats associated with risky sexual behavior, the American Psychological Association passed a resolution in 2005 promoting widespread implementation of comprehensive and empirically supported sex education and HIV prevention programs for adolescents. According to the findings in the report, APA has developed the following recommendations:
Programs to prevent HIV and sexually transmitted diseases among youth should provide clear definitions of the behaviors targeted for change, address a range of sexual behaviors, be available to all adolescents (including youth of color, gay and lesbian adolescents, adolescents exploring same-sex relationships, drug users, adolescent offenders, school dropouts, runaways, mentally ill, homeless and migrant adolescents), and focus on maximizing a range of positive and lasting health outcomes.
Only those programs whose efficacy and effectiveness have been well-established through sound scientific methods should be supported for widespread implementation.
New programs to prevent HIV and sexually transmitted diseases among youth should be tested against those programs with proven effectiveness.
Using sound scientific methods, psychologists have developed innovative behavior intervention programs for young people. For example, an interactive DVD designed by researchers at Carnegie Mellon University helps educate young women about STDs and increases their ability to choose and implement risk reduction strategies. Reflecting psychologist Dr. Albert Bandura's theory of self-efficacy, the program incorporates cognitive rehearsal for these choices. Other psychologist-developed programs include the Mpowerment Project, a community-based HIV prevention program for gay or bisexual men 18-29 years old.
Experts say that continual widespread prevention outreach and education efforts are required in order to reduce the spread of STDs and HIV/AIDS among adolescents. Results from research studies conducted between 1985 and 2000 indicate that behavior intervention programs delay first intercourse and protect sexually active youth from STDs, including HIV, in addition to unintended pregnancy. Findings also show that participation in education programs decrease the number of sex partners and increase the use of condoms. In addition, participants develop better skills for negotiating lower-risk sexual encounters and increase frequency of communications about safer sex. These findings are a significant step forward in identifying the most effective behavioral intervention programs for adolescents.
A "What Could You Do?" DVD, created by psychologists at Carnegie Mellon University, is a theory-based interactive program designed to educate young women about STDs such as HIV/AIDS. The DVD also provides information about how to make less risky sexual choices and how to use condoms correctly. Watching this DVD has been shown to increase abstinence, prevent condom failure and reduce reported STD diagnosis.
The Mpowerment Project developed by behavioral psychologists from the University of California, San Francisco's Center for AIDS Prevention Studies, is the first documented HIV prevention intervention for young gay or bisexual men to succeed in reducing risky sexual behavior. It has been rigorously evaluated in two cities (Eugene, Ore. and Santa Barbara, Calif.), and in both, it reduced the rates of unprotected intercourse among young gay/bisexual men.
Centers for Disease Control and Prevention (CDC, 2004). CDC HIV/STD/TB Prevention News Update - May 11, 2004.
Johnson B.T., Carey M.P., Marsh K.L., Levin K.D., Scott-Sheldon L.A. (2003). Interventions to reduce sexual risk for the human immunodeficiency virus in adolescents, 1985-2000: a research synthesis. Archives of Pediatrics and Adolescent Medicine, 157 (4), 381-388.
CDC Youth Risk Behavior Surveillance - United States (2003)
APA Monitor on Psychology article (2003): Sex: Worth the risk?
American Psychological Association, September 15, 2006