Get Yourself Tested Goes to High School: Adapted Sexually Transmitted Disease Prevention Campaign and Associated Student Use of Clinic Sexually Transmitted Disease Testing Services.

BACKGROUND: In an attempt to increase high school students' sexually transmitted disease (STD) testing rates, the Centers for Disease Control and Prevention's Division of Adolescent and School Health partnered with ICF and Chicago Public Schools to adapt and implement the "GYT: Get Yourself Tested" health marketing campaign for a high school. METHODS: Clinic record data and student retrospective self-report surveys (n = 193) tested for differences between the GYT intervention school and a comparison school on a number of outcomes, including human immunodeficiency virus and STD testing. RESULTS: Clinic record data showed that testing increased significantly more for the intervention than the comparison school during the GYT implementation period (B, 2.9; SE, 1.1, P < 0.05). Furthermore, the odds of being tested at the referral clinic were more than 4 times (odds ratio, 4.4) as high for students in the campaign school than for those in the comparison school (95% confidence interval, 2.3-8.2). Survey data did not show increased self-reported testing but, more students in the GYT school (92.7%) were aware of where to receive free, low-cost, or affordable human immunodeficiency virus and STD testing than students in the comparison school (76.0%; P < 0.01). Among sexually experienced students (n = 142), significantly more from the campaign school reported that they intended to test for STDs in the next 3 months (48.4% strongly agree and 33.2% agree) compared with those at the comparison school (27.4% strongly agree and 32.9% agree; P < 0.05). CONCLUSIONS: Our pilot suggests that a student-led GYT campaign in high schools may successfully increase STD testing of students. Although some of the findings from this pilot evaluation are promising, they are limited, and broader implementation and evaluation is needed. Future evaluation efforts can include more rigorous study designs, multiple schools or districts, longer campaign and evaluation across an entire school or calendar year, or in combination with other school-based testing strategies like a mass school-based screening event.

The concrete jungle: city stress and substance abuse among young adult African American men.

Substance use is prevalent among African American men living in urban communities. The impact of substance use on the social, psychological, and physical health of African American men has important public health implications for families, communities, and society. Given the adverse consequences of alcohol and drug abuse within communities of color, this study evaluated the relationship between city stress, alcohol consumption, and drug use among African American men. Eighty heterosexual, African American men, 18 to 29 years old, completed psychosocial risk assessments that assessed substance use and city stress. Multiple logistic regression analyses, controlling for age, indicated that participants reporting high levels of urban stress, relative to low levels of urban stress, were more likely to report a history of marijuana use (AOR = 5.19, p = .05), history of ecstasy and/or GHB use (AOR = 3.34, p = .04), having family/friends expressing strong concerns about their illicit drug use (AOR = 4.06, p = .02), and being unable to remember what happened the night before due to drinking (AOR = 4.98, p = .01). African American men living within the confines of a stressful urban environment are at increased risk for exposure to and utilization of illicit substances. Culturally competent public health interventions for substance use/abuse should address psychological factors, such as stress and neighborhood violence.

Examining interest in secondary abstinence among young African American females at risk for HIV or STIs.

Sexually active African American females are at increased risk for acquiring HIV or STIs. However, some reduce their risk by abstaining from sex for various periods of time following initiation, a practice known as secondary abstinence. Although this may be a valuable mechanism for reducing HIV or STI rates in this population, little is known about those interested in secondary abstinence. Baseline data were obtained from a sample of African American adolescent females, ages 14-20 years, prior to participation in an HIV-risk reduction intervention trial (N = 701). Differences in individual-level and interpersonal-level factors, as well as sociodemographic variables were examined between participants who reported strong interest in secondary abstinence and those who did not. 144 (20.5%) participants reported strong interest in secondary abstinence. Young women with strong interest in abstinence had higher odds of reporting a history of STIs and feeling negative emotions following sex because of their religious beliefs. They also had higher odds of believing their partner may be interested in abstaining and being less invested in their relationship with their main partner. Additionally, adolescents reported less interpersonal stress and more social support. African American females who are interested in practicing secondary abstinence and those who are not differ in their sexual health education needs. Findings from this study characterizing young women interested in secondary abstinence can help researchers provide more targeted health education by identifying those who may be more responsive to abstinence-promoting messages.

Employing a teen advisory board to adapt an evidence-based HIV/STD intervention for incarcerated African-American adolescent women.

This manuscript assesses priorities and challenges of adolescent females by conducting a meeting with teen advisory board (TAB) members to collect information regarding their lives and experiences pre-, during and post-incarceration in a juvenile detention facility. Multiple themes emerged regarding the impact of incarceration on young African-American females, including experiencing a loss of personal liberties, the importance of making money upon release, unfaithfulness by partners on the 'outside', substance use and lack of control over their environment upon release, including parents, peers and male sexual partners. Based on feedback from TAB members, unique barriers and challenges were identified that suggested areas where adaptations to an evidenced-based HIV/sexually transmitted disease (STD) intervention would be justified to more adequately meet the needs of this particular subgroup of young African-American women. Adaptations to the evidence-based interventions included enhancing activities related to goal setting, emotion regulation skills, decision-making, recognizing and utilizing support networks and addressing the relationship between substance use and risky sexual behavior. Future health education efforts focusing on either the creation of new HIV/STD interventions or adaptations to existing interventions should consider utilizing advisory boards with members of the priority population at the earliest stages of intervention planning.

The Influence of Health Education Teacher Characteristics on Students' Health-Related Knowledge Gains.

BACKGROUND: Studies have examined relationships between teacher characteristics and student achievement in courses such as math and science. This study is among the first to examine effects of teacher characteristics on student knowledge in a health course. METHODS: Student (N = 6143) pretest and posttest data were linked to teacher (N = 67) data. Changes in student knowledge scores from pre- to postcourse were explored using mixed-effects linear models. Teacher characteristics included professional development (PD) attendance, having a dedicated classroom, certification type, educational background, years' experience, and athletic coaching status. RESULTS: Teacher characteristics associated with greater student knowledge gains included: being certified to teach health versus not certified (p < .001), having a dedicated classroom versus no classroom (p = .017), and for middle school teachers, having attended ≥3 PD sessions versus ≤2 (p = .023). Less knowledge gain was associated with teachers that coached versus noncoaches (p = .040) and having a health degree versus no health degree (p = .049). Post hoc analyses revealed the negative effect of health degree was only significant among coaches (p = .026). CONCLUSIONS: Findings suggest opportunities for maximizing student knowledge gains through tailored selection of health teachers and provision of appropriate teaching support.

Sexually transmitted infections, sexual risk behavior, and intimate partner violence among African American adolescent females with a male sex partner recently released from incarceration.

PURPOSE: Social networks directly and indirectly influence sexually transmitted infections (STIs) risk. The objective was to explore associations between sex with a male recently released from incarceration and sexual risk and intimate partner violence (IPV) among African American adolescent females. METHODS: Sociodemographic, psychosocial, and sexual behavior data were collected at baseline, 6, and 12 months from African American females, aged 15-21 years, participating in an HIV/STI prevention trial. Among 653 participants with ≥1 follow-up assessments, generalized estimating equations tested associations during follow-up between having a recently released partner and STI acquisition, sexual risk behaviors, and IPV, adjusting for age, treatment assignment, and corresponding baseline measure. RESULTS: Eighty-three (13.6%) participants had a recently released partner at 6 months and 56 (9.3%) at 12 months. Participants with a recently released partner were more likely to have the following: vaginal (adjusted odds ratio [AOR]: 5.48), anal (AOR: 2.43), and oral (AOR: 1.51) sex, a casual partner (AOR: 1.66), sex while high/drunk (AOR: 1.57) or with a high/drunk partner (AOR: 2.27); use condoms inconsistently (AOR: .58); acquire Chlamydia (AOR: 1.80), and experience emotional (AOR: 4.09), physical (AOR: 2.59), or sexual abuse (AOR: 4.10) by a boyfriend. They had a greater number of sex partners, lower partner communication and refusal self-efficacy, were high/drunk during sex more frequently, and used condoms during oral sex less frequently. CONCLUSIONS: A recently released sex partner is associated with sexual risk and IPV among African American adolescent females. Prevention programs should inform adolescents about potential risks associated with recently released partners as well as provide adolescents with skills to establish and maintain healthy sexual relationships.