The implementation of a culturally based HIV sexual risk reduction program for Latino youth in a Denver area high school.

In the United States, Latino youth experience disproportionately higher rates of teen pregnancy and sexually transmitted infections (STIs) than non-Latino Whites. As a result, organizations serving Latino youth seek culturally appropriate evidence-based prevention programs that promote sexual abstinence and condom use. Cuídate! is an efficacious HIV sexual risk reduction program for Latino youth aged 13-18. The program incorporates cultural beliefs that are common among Latino youth and associated with sexual risk behavior, and uses these beliefs to frame abstinence and condom use as culturally accepted and effective ways to prevent unintended pregnancy and STIs, including HIV/AIDS. Cuídate! has been successfully delivered in community agencies and after-school programs but has not been integrated into an existing school curriculum. This brief case study describes efforts to implement Cuídate! in a predominantly Latino urban high school in Denver. Ninety-three youth participated in the program from October 2007 to May 2008. Cuídate! was adapted to accommodate the typical class period by delivering program content over a larger number of sessions and extending the total amount of time of the program to allow for additional activities. Major challenges of program implementation included student recruitment and the "opt in" policy for participation. Despite these challenges, Cuídate! was implemented with minor adaptations in a school setting.

Trends in sexual risk behavior and unprotected sex among high school students, 1991-2005: the role of substance use.

OBJECTIVES: To determine the trends in sexual activity and unprotected sex among substance-using youth, we examined data from the 1991-2005 Youth Risk Behavior Surveys on drug and alcohol use and sexual risk behaviors. METHOD: We examined the association of alcohol and illicit drug use with recent sexual activity and unprotected sex. We assessed linear trends in behaviors and assessed logistic regression models to examine the relationship of alcohol and illicit drug use on trends in the behavioral outcomes. RESULTS: Strong associations exist between recent sexual activity and alcohol and illicit drug use from 1991 to 2005. In the multivariate model, the odds ratio of having sex in the past 3 months for lifetime illicit drug users compared with nonusers was 3.84 (CI = 3.48-4.23). Among past-month alcohol users compared to nonusers, the odds ratio was 3.23 (CI = 2.93-3.58). Overall, the trend in sexual activity was downward but not for users of alcohol and illicit drugs. Among the sexually active, unprotected sex was not associated with alcohol use over this time period but was associated with illicit drug use. CONCLUSIONS: Illicit drug and alcohol use have a strong association with being recently sexually active. Trends in reported sexual activity declined during 1991-2005, but the trends among alcohol and drug users have not. Many youth remain at dual risk from both substance use and sexual behaviors.

The association between sex education and youth's engagement in sexual intercourse, age at first intercourse, and birth control use at first sex.

PURPOSE: Sex education is intended to provide youth with the information and skills needed to make healthy and informed decisions about sex. This study examined whether exposure to formal sex education is associated with three sexual behaviors: ever had sexual intercourse, age at first episode of sexual intercourse, and use of birth control at first intercourse. METHODS: Data used were from the 2002 National Survey of Family Growth, a nationally representative survey. The sample included 2019 never-married males and females aged 15-19 years. Bivariate and multivariate analyses were conducted using SUDAAN. Interactions among subgroups were also explored. RESULTS: Receiving sex education was associated with not having had sexual intercourse among males (OR = .42, 95% CI = .25-.69) and postponing sexual intercourse until age 15 among both females (OR = .41, 95% CI = .21-.77) and males (OR = .29, 95% CI = .17-.48). Males attending school who had received sex education were also more likely to use birth control the first time they had sexual intercourse (OR = 2.77, 95% CI = 1.13-6.81); however, no associations were found among females between receipt of sex education and birth control use. These patterns varied among sociodemographic subgroups. CONCLUSIONS: Formal sex education may effectively reduce adolescent sexual risk behaviors when provided before sexual initiation. Sex education was found to be particularly important for subgroups that are traditionally at high risk for early initiation of sex and for contracting sexually transmitted diseases.