The Safer Sex
Intervention for High-Risk Adolescent Girls is an individualized, clinic-based
intervention for girls who are diagnosed with a sexually transmitted disease. An
experimental evaluation of the intervention compared with standard care found
that it had mixed impacts on sexual health knowledge and condom attitudes, which
dissipated by the 12-month follow-up, and no statistically significant impact on
condom use at any time point.
DESCRIPTION OF PROGRAM
Target population: High-risk adolescent
girls and young women under age 24
The Safer Sex Intervention for High-Risk Adolescent Girls
is an individualized, one-on-one intervention for girls who are diagnosed with
an STD. The intervention is delivered by a health educator and begins when the
girl receives treatment for the STD. The intervention is delivered in a single
session, but booster sessions can be conducted at subsequent health care visits.
The intervention begins with a 7-minute video that portrays
condoms as normative behavior and discusses condom names, buying condoms, and
negotiating condom use. The video also shows female adolescents demonstrating
how to use a condom. After watching the video, the participant has an
educational session with a female health educator. This session begins with a
self-assessment exercise in which participants use the “wheel of change” to
decide what stage they are at in changing their sexual risk behaviors. The
health educator uses this exercise to tailor the rest of the intervention to the
participant’s current state of change.
The health educator gives the participant a list of topics
and allows the participant to guide the order and emphasis of the session. The
topics on the list are: consequences of unprotected sex, risk perception,
preventing pregnancy, preventing STDs, condoms, spermicide, obtaining condoms,
secondary abstinence, and talking about sex. The educator uses a pelvic model to
discuss STD transmission and a penis model to allow the participant to practice
correct condom use. The educator also demonstrates how to use a female condom
and provides written material to the participant. Young women in both the
control and experimental groups were offered free condoms.
EVALUATION(S) OF PROGRAM
Evaluated population: Participants were
123 women under age 24 who were admitted to a pediatric hospital for treatment
of pelvic inflammatory disease or cervicitis. The median age was 17. Forty-nine
percent of participants were black, 18 percent were Hispanic, 14 percent were
white, and 17 percent classified as other.
Approach: Participants were randomly assigned to the
intervention group or a standard care control group. Participants returned for
1-, 3-, 6-, and 12-month follow-up visits. Intervention group participants
received a booster session at the first three follow-up visits. A standardized
manual was developed for the study. Condom use and STD history were assessed for
all participants at each follow-up visit.
Results: Individuals who participated in the
intervention reported statistically significant improvement in sexual risk
knowledge and condom attitudes at the 1-month follow up. At the 6-month
follow-up, intervention group participants maintained their improvement on
condom attitudes and were significantly less likely to have had a sexual partner
other than their main partner in the past month. No significant impacts were
found at the 12-month follow-up, when only 52 percent of the sample were
studied. There was no impact on condom use at any time point.
SOURCES FOR MORE INFORMATION
Shrier, L. A., Ancheta, R., Goodman, E., Chiou, V.M.,
Lyden, M. R., and Emans, S. J. (2001). Randomized control trial of a safer sex
intervention for high-risk adolescent girls. Archives of Pediatric and
Adolescent Medicine, 155(73-79).
KEYWORDS: Adolescents (12-17), Youth (16+), Young
Adults (18-24), Female Only, High-Risk, Clinic/Provider-Based, Manual Is
Available, STD/HIV/AIDS, Sexual Activity, Condom Use and Contraception
Program information last updated 5/31/12.