Community-level intervention program successfully delayed sexual debut and increased the use of condoms

A community-level intervention program aimed at young adolescents delays early intercourse, increases condom use and reduces the type of risky sexual behavior that can result in sexually transmitted diseases and HIV/AIDS, a Yale researcher reports in AIDS.

The intervention consisted of AIDS education, skills training, peer influence and both family and neighborhood support to avoid and reduce high-risk behavior among adolescents. The authors said community-level interventions have proven to be successful with gay men, injection drug users and inner-city women, but this was one of the first to have targeted adolescents.

"The program successfully delayed sexual debut and increased the use of condoms," said lead author Kathleen J. Sikkema, associate professor in the Division of Chronic Disease Epidemiology, Social Behavioral Sciences Program in the Department of Epidemiology and Public Health at Yale School of Medicine. "Programs like this are needed to promote sexual health among youth and young adults."

Study participants were 12- to 17-year-olds residing in 15 low-income housing developments throughout the United States. Each housing development was randomly assigned to either the full community-level intervention, a skills-training only workshop or an AIDS education-only program. The AIDS education session was made available to all participants. Participants completed a "Teen Health Survey" at the beginning of the study and 18 months later to assess HIV risk behavior and related factors.

Trained facilitators led sessions on HIV/STD education, skills training in avoidance and resistance of unwanted sexual activity, condom use and the ability to better self-manage risk behavior. Themes of self-respect and pride were integrated throughout the community intervention and adolescents were involved in community activities and events. Workshops on HIV/AIDS risk were offered to parents.


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