One-fourth of new HIV infections are diagnosed in young people between the ages of 13 and 21 years. While a number of research studies have addressed this problem in mainstream school settings, these programs often fail to reach students who run the greatest risk of HIV infections. One possible way of reaching a higher risk population of students is through implementing programs in alternative schools. Students in alternative educational settings engage in behaviors that put them at very high risk of contracting HIV. Our data indicate that 9th-grade students attending Texas alternative high schools are greater than two times more likely to be sexually experienced than 9th graders attending regular schools but much less likely to use protection during sexual intercourse. While relatively few effective programs have been developed for mainstream school students, none have been adapted and evaluated among high-risk youth attending alternative schools. To address this need, we propose to adapt, implement, and evaluate a theoretically-based, multi-component HIV intervention entitled Safer Choices. Safer Choices is one of the few programs that has been demonstrated to be effective in reducing sexual risk-taking behaviors among adolescents.
The aims of the intervention are to reduce the number of high-risk youth who engage in unprotected sexual intercourse by reducing the number of youth who initiate sexual intercourse and by increasing condom use among those students who are sexually active. Social cognitive theory and social influence processes form the primary framework for the program. The youth development component additionally makes use of social resources theory and social bonding model. The intervention components proposed for this study include: 1) curriculum, 2) parent education 3) peer resources, 4) youth development, and 5) Community linkages and resources. We will evaluate the program using a group-randomized intervention trial among ninth-grade students attending alternative schools in Houston, Texas. The major dependent variables are unprotected sexual intercourse, number of sexual partners, and proportion having sexual intercourse in the past three months. 9th-grade students (n=1000) will be recruited from 10 alternative schools in Houston, Texas.
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