It's Your Game...Tech: Web-based HIV, STD, and Pregnancy Prevention for Middle School Students

Background: HIV, sexually transmitted infections (STIs), and pregnancy are significant public health problems among U.S. youth. Some effective programs exist to delay sex among middle school students; yet, the requirement for instructor facilitation and training costs can compromise their wide-scale, high fidelity dissemination. A completely computer-based program may help increase dissemination.

Methods: It’s Your Game (IYG)-Tech, a 13-lesson computer-based program, was developed and evaluated in a randomized controlled trial in 19 Southeast Texas middle schools. A-CASI surveys were administered before the program was implemented (in 8^th grade) and one year later. Sexual behavior and psychosocial variables were measured.

Results: The analytic sample (n=1374) was 59% female, 17.3% Black, 73.7% Hispanic, mean age was 14.32 (SD=0.59). Intervention students reported greater STI/condom knowledge, more positive beliefs and norms about abstinence, and greater condom use self-efficacy than control students. One year follow-up results revealed no significant differences between groups for sexual behaviors. However, conflicting school activities (e.g., testing schedules) during the field trial significantly lowered exposure to the program. Only 14% of students received all 13 lessons. Exploratory analyses revealed that those receiving all 13 lessons were less likely to initiate sex than students receiving under 5 lessons (OR=0.19, p < 0.01). Students receiving 5-8 lessons were also less likely to initiate sex (OR=0.42, p < 0.001).

Conclusions: IYG-Tech may be a promising program for preventing HIV, STIs, and teen pregnancy. However, such computer-based programs are critically dependent on strong implementation plans to achieve their dissemination potential of reach and fidelity.