This proposed four year study will develop and test the relative efficacy of three theory driven empirically based interventions to increase condom use among sexually active adolescents at high risk of AIDS and other sexually transmitted diseases (STDs). An integration of Fishbein/Ajzen's theory of reasoned action and Bandura's social learning theory provides the theoretical framework for the study. The intervention applies a cognitive behavioral skills training approach which has shown promise in other adolescent high risk behaviors to increase condom use. Guided by the theories and results from our preliminary studies, we propose to develop content for the intervention which will focus on changing knowledge, beliefs, attitudes, and intentions to use condoms. The skills training component of the intervention, based on social learning theory, will change self-efficacy. These changes are predicted to change condom use behaviors. Three interventions which vary in level of intensity will be compared in attempt to determine the minimum that is necessary to promote behavioral change. All three conditions contain information designed to increase knowledge and change attitudes, skill building with regard to communicating to one's partner about using condoms, and modeling. One is a minimal intervention using a written format (pamphlets), one is an intermediate level intervention which adds a video with peer models, the third adds role playing, feedback, and peer tutoring. Within levels of race (Black, White) and sex (male, female), subjects attending urban STD clinics will be randomly assigned to one of these three intervention conditions. The experiment will be partially replicated on a group of adolescents in juvenile detention.
