Preventing AIDS in teenagers in the 1990s

Applying Persuasion Strategies to Alter HIV-Relevant Thoughts and Behavior

Health communication strategies are at the core of both mass media campaigns and public health interventions conducted at the community level concerning the prevention of HIV/AIDS. They are often nested in complex contexts that prevent us from being able to identify the persuasive impact of a specific message. The authors attempt to account for an array of factors contributing to the persuasiveness of messages about HIV. The aim is to synthesize the psychological literature on persuasion and thus provide a conceptual framework for understanding message effects in HIV communications. This discussion concerns fear appeals, message framing, tailoring, cultural targeting, and additional factors pertaining to the message, source, and channel of the communication. Whenever possible, recommendations for further research are formulated.

A STD/HIV prevention trial among adolescents in managed care

OBJECTIVE

To determine if sexually transmitted diseases (STDs), including human immunodeficiency virus (HIV) infection, risk assessment, and education tools provided as part of office-based primary care reduce adolescent risky sexual behaviors.

DESIGN

A randomized intervention trial with 3- and 9-month follow-up.

SETTING

Five staff-model managed care sites in Washington, DC (n = 19 pediatricians).

PATIENTS

Consecutive 12- to 15-year-olds receiving a general health examination; 81% minority. Participation rate = 215/432 (50%). Nine-month follow-up rate = 197/215 (92%).

INTERVENTION

Audiotaped STD risk assessment and education about staying safe (safer = condoms, safest = abstinence).

MAIN OUTCOME MEASURES

Adolescent-reported sexual intercourse and condom use.

RESULTS

More intervention adolescents reported pediatrician discussion on 11/13 sexual topics. Although more vaginal intercourse (odds ratio [OR] = 2.46, 95% confidence interval [CI] = 1.04-5.84) was reported in the intervention group at 3 months, this was not true of overall sexual intercourse (OR = 1.55, 95% CI =.73-3.32). More sexually active adolescents reported condom use in the intervention group at 3 months (OR = 18.05, 95% CI = 1.27-256.03). At 9 months, there were no group differences in sexual behaviors; however, more signs of STD were reported by the control (7/103) than the intervention group (0/94).

CONCLUSIONS

STD risk assessment and education tools administered in a single office visit facilitated STD/HIV prevention education. Any impact on sexual activity and condom use was short-lived. Further research is needed to develop brief, office-based sexual risk reduction for young adolescents.

Orgasm without organisms: science or propaganda?

The worldwide epidemic of sexually transmitted diseases (STDs) presents a major public health challenge to medical practitioners and educators as they seek to implement preventive educational strategies in the adolescent population. The serious consequences of many STDs and the insufficient impact of condom promotion in this high-risk group have led to increasing recognition that sexual intercourse is medically unwise for young adolescents. As a result of this recognition, some educators have proposed that adolescent sexuality education focus on the explicit teaching of noncoital sexual activities, sometimes called outercourse. This paper explores the emergence of this educational strategy, the assertion that noncoital sexual activities will positively impact the rising incidence of STDs and unplanned pregnancy in teenagers, and the hypothetical benefits of adolescent noncoital sex.