Practical approach may cut teenage girls’ STD rate

In a study of sexually active black and Hispanic teenage girls, researchers found that a “skills-based” safer sex program offered at an adolescent health clinic helped cut the rate of sexually transmitted diseases (STDs) among girls who participated.

The program, given as a single 4-hour class, provided girls with information on HIV and other STDs, and on how to reduce their risk of infection. It also gave them practical training; girls practiced correct condom use on an anatomical model, and they role-played to practice “negotiating” condom use with their partners.

In the long term, the study found, the program was more effective in cutting risky sexual behavior and STD rates than two other approaches that gave girls information only.

Dr. John B. Jemmott III of the University of Pennsylvania in Philadelphia led the study, which is published in the Archives of Pediatrics & Adolescent Medicine.

The study included 682 sexually active African American and Latina teenage girls who attended an inner-city Philadelphia adolescent health clinic. The girls were randomly assigned to participate in either the skills-based STD-prevention class, or one of two comparison classes: an information-based class on STDs, or a class on general health.

Over the next year, the girls were periodically surveyed about their sexual behavior and screened for gonorrhea, chlamydia and trichomoniasis.

At the start of the study, more than half of the girls said they’d had unprotected sex during the previous 3 months, and 22 percent tested positive for one of the three STDs.

One year later, girls in the skills-based program were less likely than their peers to have an STD; about 10 percent tested positive, versus 18 percent in the general-health program and 15 percent in the STD-information program.

They also reported fewer instances of unprotected sex than girls in either of the other groups, and were less likely to say they’d had multiple sexual partners in the past 3 months.

There were, however, no clear differences between the groups at an earlier time point, 3 and 6 months after the classes. The apparent “delayed effect” of the skills-based program, Jemmott and his colleagues note, may indicate that it’s hard for girls to start safer-sex practices in their existing relationships. Instead, they may be better able to use what they’ve learned at the beginning of a new relationship.

Though past studies have found that teenagers in STD-prevention programs report changes in their sexual behavior afterward, this study - by actually screening for STDs - helps confirm that the changes are real, according to the researchers.

HIV/STD interventions for adolescents can, indeed, influence a health outcome, not only self-reported behavior,” they write.

And if the current findings are an indication, programs that focus on practical skills - by “empowering” teenagers to protect themselves from STDs - may be especially effective, according to the researchers.

“This is particularly important for African American and Latino adolescents,” they write, “whose rate of STDs is considerably higher than the rate among other adolescents.”

SOURCE: Archives of Pediatrics & Adolescent Medicine, May 2005.

Provided by ArmMed Media
Revision date: July 8, 2011
Last revised: by Jorge P. Ribeiro, MD