Programs Reduce High-Risk Sexual Behavior in Teens

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 1985-2001. In addition, 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.

Dr. Blair T. Johnson and colleagues at the University of Connecticut in Storrs based the findings on a review of 44 studies involving a total of 56 interventions among more than 35,000 people ages 11-18. The impact of HIV prevention efforts was comparable to adolescent programs to prevent smoking, pregnancy and drug use, according to Johnson's team. 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 said. 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.

Programs that provided more information about condoms or gave out condoms were more likely to reduce teens' risky behavior, according to the report. 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 generic 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 wrote. Most of the data were from studies in North America, Johnson said.

The full report, "Interventions to Reduce Sexual Risk for the Human Immunodeficiency Virus in Adolescents, 1985-2000: A Research Synthesis," is published in the April issue of Archives of Pediatrics and Adolescent Medicine (2003;157(4):381-388).

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