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APHA Scientific Session and Event Listing

Recorded presentation

Christine Markham, PhD, Susan Tortolero, PhD, Melissa Peskin, PhD, Ross Shegog, PhD, Robert Addy, MA, Elizabeth Baumler, PhD, Nicole McKirahan, MPH, Kiara Spooner, DrPH, Liliana Escobar-Chaves, DrPH, and Melanie Thiel, BA. Center for Health Promotion and Prevention Research, University of Texas Health Science Center-Houston, 7000 Fannin, 26th floor, Houston, TX 77030, (713) 500-9646, Christine.Markham@uth.tmc.edu

Background: Early sexual initiation is associated with increased risk of unintended pregnancy and STI. Effective interventions for middle school youth are urgently needed. “It's Your Game, Keep It Real" (IYG) is a curriculum delivered in 7th and 8th grade that combines classroom activities with individualized, tailored computer-based activities. Purpose: To present short-term impact of IYG on behavioral and psychosocial outcomes. Methods: IYG is being evaluated by randomized controlled trial in ten Texas urban middle schools. Baseline data were collected from 1,321 7th graders in 2004. Impact data are being collected 5, 14 and 24 months post-baseline. Measures include sexual behavior and intentions (lifetime/current vaginal/oral/anal sex, condom use) and psychosocial variables. Multilevel regression analysis controls for the clustered study design. Results: Baseline sample was 57.1% female, 43.5% black, 41.9% Hispanic, mean age 12.5 (SD=0.69) years. Fourteen percent had engaged in any type of intercourse (12% vaginal, 7.9% oral, 6.5% anal). At 5-month posttest, following the first half of the intervention (7th grade curriculum only), intervention students reported lower prevalence of any type of intercourse during past 3 months (OR=0.61[CI:0.40-0.95], p=0.03) and lower initiation rates (not statistically significant). Intervention students reported positive change in abstinence beliefs (Beta=0.14[SE=0.05], p=0.01), perceived friends' beliefs about sex (Beta=0.09[SE=0.04], p= 0.04), exposure to risky situations (Beta=-0.09[SE=0.03], p= 0.00), and reasons not to have sex (Beta=0.59[SE=0.11], p= 0.00). However, sexually inexperienced students reported greater intentions to have vaginal intercourse in the next year (Beta=0.16[SE=0.06], p= 0.01). Conclusion: Implications for effective HIV/STI/pregnancy prevention in middle schools will be discussed.

Learning Objectives:

• Identify characteristics of an effective HIV/STI/pregnancy prevention intervention for middle school youth.
• Describe the advantages of using an intervention approach that includes tailored activities based on student's sexual behavior and intention.
• Discuss issues related to implementation of sexual education programs at the middle school level.

Keywords: Adolescents, HIV Interventions

Presenting author's disclosure statement:

Any relevant financial relationships? No

Recorded presentation