This study will develop and evaluate a multi-component HIV, STD and pregnancy prevention intervention for middle school students. The study design will consist of a randomized controlled trial conducted in sixteen inner-city middle schools in Houston, Texas. Approximately 1000 7th grade students will be recruited into the study and will be followed over a two-year period. The intervention will consist of an age-appropriate classroom curriculum and a CD-ROM-based tailored intervention delivered in 7th and 8th grade. The curriculum, delivered by trained facilitators, will focus on refusal and communication skills, healthy relationships, attitudes, self-efficacy and peer norms related to dating and sexual behavior. It will be adapted from an existing HIV, STD and pregnancy prevention curriculum Safer Choices, which has been shown to be effective at reducing sexual risk-taking behavior among high school students. Given the range in physical and emotional development among middle school youth, students will also receive individualized learning opportunities by means of a CD-ROM-based HIV, STD and pregnancy prevention intervention which will provide information, resources and skill-building exercises tailored to the student's current behavior or intentions regarding dating and sexual behavior. The effect of the intervention will be evaluated by assessing sexual risk-taking behaviors (proportion of students not having sex, proportion of currently sexually active students who have unprotected sex, number of sexual partners). Since community collaboration is essential for successful implementation of HIV/STD prevention programs at the middle school level, we shall work closely with school district personnel, teachers, parents and community representatives to develop a model for obtaining -community-based input and support for program development and implementation.
