Programs Reduce High-Risk
Sexual Behavior in Teens

NEW YORK (Reuters Health) - Intensive programs designed to prevent HIV infection in teens can delay the onset of sexual activity, decrease the number of sex partners and increase the use of condoms, according to a review of studies conducted between 1985 and 2001.

In addition to using condoms more often and having sex less frequently, teens who participated in intensive HIV risk-reduction programs developed better skills for negotiating lower-risk sexual encounters and talked about safer sex more often with their partners than teens who did not participate in HIV programs.

The impact of the HIV-prevention efforts was comparable to adolescent programs to prevent smoking, pregnancy and drug use, according to a team led by Dr. Blair T. Johnson at the University of Connecticut in Storrs.

Despite concerns that talking with students about sex and HIV may increase their sexual activity, this did not occur in the behavioral programs.

"In fact, the effect is just the opposite," Johnson told Reuters Health. The interventions "all pattern essentially in the same direction, reducing sexual frequency."

If all adolescents in school participated in intervention programs of comparable scope to those described in the report, "we could avert a ton of infections," he added.

Johnson's team based the findings on a review of 44 studies involving a total of 56 interventions among more than 35,000 people ages 11 to 18.

Several factors influenced the success of the prevention programs, according to the report in the Archives of Pediatrics and Adolescent Medicine. For instance, programs that provided more information about condoms or gave out condoms were more likely to reduce teens' risky behavior.

The researchers uncovered evidence that preventing risky behavior in teens may involve more than simply telling students about the birds and the bees.

In studies in which adolescents in HIV-prevention programs that taught students behavioral skills were compared to students who received generic sex education, the gap in risky behavior tended to be larger, with students in the sex-ed classes less likely to use condoms.

This finding is "our clearest indication that information alone is insufficient to alter condom use behavior," the authors note.

Johnson noted that most of the data were from studies in North America. To address the dearth of research regarding interventions in other areas, his group is initiating a study of interventions in Romania.

In an accompanying editorial, Drs. Ralph J. DiClemente and Gina M. Wingood, of Emory University in Atlanta, advocate establishment of "a sustainable and coordinated infrastructure" to stimulate and support further research.

Such research "can marshal new kinds of data, ask new and broader questions regarding adolescents and their risk of HIV, and most important, create fresh options for prevention," they conclude.

SOURCE: Archives of Pediatrics and Adolescent Medicine 2003;157:319-320,381-388.

Reference Source 89

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