186540 To teach or not to teach: Opinions of African American youth and adults in regard to the appropriateness of “abstinence-only” school curricula in the face of the growing HIV/AIDS epidemic in rural North Carolina

Monday, October 27, 2008

Stacey W. Lloyd, MPH , 3-C Institute for Social Development, Cary, NC
Connie Blumenthal, MPH , Cecil B. Sheps Center for Health Services Research, University of North Carolina-Chapel Hill, Chapel Hill, NC
Selena Youmans, BA , Cecil B. Sheps Center for Health Services Research, University of North Carolina-Chapel Hill, Chapel Hill, NC
Giselle Corbie-Smith, MD, MSc , TraCS Community Engagement Core, University of North Carolina-Chapel Hill, Chapel Hill, NC
Aletha Akers, MD, MPH , Department of Obstetrics, Gynecology and Reproductive Sciences, Magee-Womens Hospital, Pittsburgh, PA
Adaora A. Adimora, MD, MPH , Division of Infectious Diseases, University of North Carolina-Chapel Hill, Chapel Hill, NC
Arlinda Ellison, MS , Edgecombe County Health Department, Tarboro, NC
Barbara Council , Community Enrichment Organization, Oak City, NC
Mysha Wynn, MA , Project Momentum, Inc., Rocky Mount, NC
Melvin R. Muhammad, AA , Project Momentum, Inc., Rocky Mount, NC
Don Cavellini , Freedom Hill Community Health Center, Tarboro, NC
Background: Abstinence-based sex education (ABSE) receives substantial federal funding despite a lack of evidence on improved sexual health outcomes. In preparation for development of a HIV/STI prevention intervention, we examined perceptions of rural African American youth and adults on the impact of ABSE on HIV/STI rates in their community.

Methods: We conducted 11 focus groups: 4 with youth (n=38), and 7 with adults (n=55) including 2 with formerly incarcerated individuals (n=12). All groups were stratified by gender; youth groups were also stratified into low and high risk. The moderators' guide used the socioecological framework to explore participants' beliefs about determinants of HIV/AIDS in their community. We used crystallization/immersion for codebook development; this analysis examines emerging themes regarding sex education.

Results: ABSE was seen as a barrier to educating youth about HIV transmission and prevention. Youth and adults believed ABSE was unrealistic in a community with high rates of early sexual debut. Youth referred to ABSE as “a joke”. Both youth and adults recommended comprehensive sex education be offered earlier. Low and high risk youth differed only in their expectations that condoms be made available in schools. Formerly incarcerated adults recommended comprehensive sexual education be mandatory for students. Across focus groups, comprehensive sexual education in public schools was seen as a top priority in reducing the spread of HIV/AIDS in African American communities.

Conclusion: Adult and youth respondents overwhelmingly believed in the face of a persistent epidemic of HIV/AIDS in youth, abstinence based education should be replaced with comprehensive sexual education.

Learning Objectives:
1. List 3 reasons that community members think abstinence based education is not appropriate in the face of the HIV/AIDS epidemic 2. Articulate 3 potential changes to the abstinence based curriculum that could assist in curbing HIV/AIDS epidemic 3. Identify differences between youth and adult opinions of comprehensive sex education

Keywords: HIV/AIDS, Education

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the lead on the sex education piece of the data analysis and writing up of results
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.