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.

Agency
National Institute of Health (NIH)
Institute
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Type
Research Project (R01)
Project #
5R01HD038457-04
Application #
6526367
Study Section
Special Emphasis Panel (ZHD1-DRG-A (15))
Program Officer
Newcomer, Susan
Project Start
1999-08-01
Project End
2004-07-31
Budget Start
2002-08-01
Budget End
2003-07-31
Support Year
4
Fiscal Year
2002
Total Cost
$655,070
Indirect Cost
Name
University of Texas Health Science Center Houston
Department
Miscellaneous
Type
Schools of Public Health
DUNS #
City
Houston
State
TX
Country
United States
Zip Code
77225
Markham, Christine M; Escobar-Chaves, Soledad Liliana; Addy, Robert C et al. (2009) Knowledge and Risk Perception Regarding HPV Among Latino Alternative School Students in Houston, Texas. Tipica 5:32-38
Tortolero, Susan R; Markham, Christine M; Addy, Robert C et al. (2008) Safer choices 2: rationale, design issues, and baseline results in evaluating school-based health promotion for alternative school students. Contemp Clin Trials 29:70-82
Bell, Stephanie G; Newcomer, Susan F; Bachrach, Christine et al. (2007) Challenges in replicating interventions. J Adolesc Health 40:514-20
Markham, Christine M; Tortolero, Susan R; Addy, Robert C et al. (2007) Factors associated with frequent vaginal douching among alternative school youth. J Adolesc Health 41:509-12
Peters, Ronald J; Tortolero, Susan R; Johnson, Regina Jones et al. (2005) The relationship between future orientation and street substance use among Texas alternative school students. Am J Addict 14:478-85
Tortolero, Susan R; Markham, Christine M; Parcel, Guy S et al. (2005) Using intervention mapping to adapt an effective HIV, sexually transmitted disease, and pregnancy prevention program for high-risk minority youth. Health Promot Pract 6:286-98
Markham, Christine M; Tortolero, Susan R; Escobar-Chaves, S Liliana et al. (2003) Family connectedness and sexual risk-taking among urban youth attending alternative high schools. Perspect Sex Reprod Health 35:174-9
Escobar-Chaves, S Liliana; Tortolero, Susan R; Markham, Christine et al. (2002) Violent behavior among urban youth attending alternative schools. J Sch Health 72:357-62