16 programs that combine pregnancy, STD, and HIV/AIDS prevention.

Organizations nationwide are integrating information about pregnancy, STDs, and HIV/AIDS into their prevention programs. These efforts have resulted in many new, comprehensive peer programs, lesson plans, curricula, certification programs, coalitions, partnerships, agency consolidations, and media programs.

SIECUS recently requested information on integration efforts from organizations throughout the nation. We are sharing responses and providing contact information in an effort to raise awareness and provide encouragement.

If you know of other integration efforts, send descriptions to Mac Edwards, SIECUS Report Editor, SIECUS, 130 West 42nd Street, Suite 350, NewYork, NY 10036-7802. You can also send them by e-mail to [e-mail]

1

ADOLESCENT COMMUNICATION AND EDUCATION

A Program of the Institute of Women and Ethnic Studies

New Orleans, LA

The Adolescent Communication and Education Program (ACE) was developed by the Institute of Women and Ethnic Studies to empower inner-city youth in New Orleans, LA, to reduce unintended pregnancies, STDs, HIV/AIDS, violence, and other negative sexual health outcomes.

Two of its most successful programs are Teen Expression, which produces a teen talk show on cable television where young people discuss sexual and reproductive health issues, and Pillow Talk, which organizes peer-led slumber parties and group meetings for African American females between the ages of 13 and 22, where they become aware of STD, HIV, and pregnancy issues.

Teen Expression is essentially a talk show for and by teens. Students from high schools throughout New Orleans are recruited to participate in the Teen Expression Core Group, which plans, organizes, and facilitates the show. Group members are involved in every step of the development--from working the cameras and directing the show to serving as hosts, reporters, and audience members.

Teen Expression was designed to get adolescents to talk positively about social and health issues and to begin to change high-risk behaviors. During the show teens discuss such topics as HIV/AIDS, STDs, drug use and abuse, dating and relationships, teen pregnancy, and violence. A panel of experts is regularly invited to answer questions and provide facts. The program airs every Saturday at noon on New Orleans cable access television, channel 77.

Pillow Talk sessions are held at a variety of sites including college women's centers, bed and breakfasts, and private homes. They are led by students from local universities and colleges who have participated in a two-day peer training and HIV risk-reduction program utilizing the Power Moves curriculum.

During an eight-month period, approximately 30 high school students (in groups of 15 each) attend one Pillow Talk session per month, where mentors lead them in small group discussions, role-playing, skits, and individual counseling, which results in open and direct dialogue about sexual health.

Upon completion of the project, the high school students participate in a community-based event where they share their knowledge with parents, teachers, relatives, friends, and other groups.

Overall, the ACE Program has increased young people's awareness and positive attitudes about healthy sexual behaviors by: engaging them in critical thinking and organizing that increases their ownership of social and health issues; giving them a broader audience for their ideas, questions, and opinions; relating to young people and their ideas; building their self-esteem through skill building; supporting their ideas with resources and positive feedback; and broadening their perspectives on options and information relating to social issues and behaviors that influence sexual health outcomes.

Successful strategies employed by ACE include: combining youth development and health education through media production; supporting young people in designing and implementing their own youth-driven initiatives and projects; and creating audience-centered and culturally specific project approaches.

Contact information: Euna August, director, Institute of Women and Ethnic Studies, 1600 Canal Street, Suite 706, New Orleans, LA 70112. Phone: [phone]. Fax: [phone]; E-mail: [e-mail] Web site: http://www.iwes.org

2

AMIGO A AMIGO

A Program of Planned Parenthood of Santa Barbara, Ventura & San Luis Obispo Counties

Santa Barbara, CA

Amigo a Amigo (Friend to Friend) is a peer education and referral program developed by Planned Parenthood of Santa Barbara, Ventura & San Luis Obispo Counties to promote family planning and sexual health among lower-income, higher-risk Latino teens.

Based on the MexFam promotores program developed in Mexico, Amigo a Amigo involves recruiting, training, and supervising teen peer educators who serve as role models promoting healthy social sexual norms, providing emotional and practical support, sharing information, and connecting with the people with whom they have the greatest influence (their friends and family).

The peer educators help their peers make thoughtful and appropriate life decisions related to sexual health. The most frequently discussed subjects are contraception, STD/HIV prevention, relationships, and clinical services. The peer educators provide such information within the broader context of human sexuality, life goals, social relationships, and Latino culture. In many cases, they accompany their peers to clinics or social service agencies.

Peer educators are recruited by bilingual, bicultural program coordinators through schools and other youth-serving organizations. Interested teens are screened for commitment to program goals and philosophy, access to peers, and effective communication skills.

Thirty hours of training in reproductive health, family planning, peer outreach, community resources, and related topics are provided. Training is interactive and is presented in the context of Latino and youth cultural norms. It also includes field trips to local medical and social service referral sites.

Each peer educator provides outreach to at least 30 peers. This outreach involves sharing reproductive health information, modeling target behaviors, making referrals, distributing literature and condoms, and accompanying peers to clinics or service groups.

Peer educators document peer contacts and interview a sample of 50 percent of peers two to three months after initial contact to evaluate changes in knowledge and behavior. Each peer educator receives a stipend of $200 following completion of outreach and follow-up.

To date, over 300 promotores ranging in age from 13 to 17 have provided outreach to over 10,000 peers. The majority are female (60 percent) though the number of males is increasing. The majority of peers were friends or family members of the promotores.

The peer educators were overwhelmingly positive about the program, with several peer educators reporting that the program had profound effects on their self-esteem and social status. One male peer educator became known as the "condom guy" and now distributes and demonstrates proper use of condoms regularly. One female peer educator became known as "Dr. Ruth" and was frequently sought for advice on sex and relationships. Several peer educators are pursuing careers in health education or a related field as a result of their program experience.

Follow-up evaluations indicate that 85 percent of the peers demonstrated increased knowledge of the topics they discussed with the peer educators. Sixty-five percent indicated that they had limited their sexual activity and/or increased use of contraception.

At a cost of about $80 per person, the Amigo a Amigo program is a cost-effective model for promoting family planning and reproductive health among at-risk Latino youth.

Contact Information: Scott McCann, Planned Parenthood of Santa Barbara, Ventura & San Luis Obispo Counties, 518 Garden Street, Santa Barbara, CA 93101. Phone: [phone], extension 22. E-mail, [e-mail]. Website: www.ppsbvslo.org.

3

NEW JERSEY TEEN PREGNANCY EDUCATION

A Program of the Princeton Center for Leadership Training

Princeton, NJ

The New Jersey Teen Pregnancy Education Program was developed by the Princeton Center for Leadership Training as an alternative or elective school-based, peer-led comprehensive sexuality education program among high school students.

Called Teen PEP, it is sponsored by the New Jersey Department of Health and Senior Services in collaboration with the Princeton Center for Leadership Training and Princeton HiTOPS, Inc. (Health Interested Teens' Own Program on Sexuality).

Faculty advisors help students acquire extensive knowledge about sexual health issues and skills to effectively conduct for-credit prevention education outreach workshops with their peers. They also help the students learn about group leadership, facilitation, dynamics, and presentation.

The Teen PEP peer leaders conduct sessions on such subjects as unplanned pregnancy, HIV/AIDS, other STDs, homophobia, dating violence, date rape, sexual harassment and other sexual health concerns. They also help their peers build critical skills such as communication with other peers and parents, problem-solving and decision-making, negotiation, refusal skills, and self-management.

Program evaluations have compared new peer educators (students who were selected for Teen PEP peer education training but have not yet participated in any training) to veteran peer educators (those who have participated in the program for one year). Results indicate that veteran peer educators demonstrate greater knowledge of sexual health topics, are able to identify more sexual health resources in the community, have a better understanding of how to access these resources, and are more likely to utilize these resources.

Important attitudinal and behavioral differences were also evidenced between veteran and new peer educators. Veteran peer educators showed increased awareness of susceptibility to the risks associated with various sexual behaviors, a greater understanding that the benefits of behavioral changes would outweigh the costs associated with the behavioral change, and a greater feeling that they had the skills to effect behavioral change.

As compared to new peer educators, veteran peer educators also reported more specific behaviors associated with avoiding HIV, other STDs, and unplanned pregnancy, including more effective and consistent contraceptive use, and insisting that partners be tested for STDs.

Evaluation results also indicate that Teen PEP provides adolescents with increased opportunities, skills, and confidence to discuss sexual health issues with adults and peers. Veteran peer educators reported that they were more likely to engage in conversations with peers and partners about topics related to sexual health. Veteran peer educators were twice as likely as new peer educators to name a teacher as someone they could approach with sexual health questions, problems, or concerns.

In addition, parents who attended a Teen PEP family night event indicated that they felt more comfortable talking with their teen about sexuality and were more likely to initiate a conversation about sexuality with their child because of their participation in the workshop.

Contact information: Princeton Center for Leadership Training, 12 Vandeventer Avenue, Princeton, NJ 08542. Phone: [phone]. Fax: [phone]. E-mail: [e-mail] Web site: www.princetonleadership.org

4

OUR WHOLE LIVES

A Curriculum of the Unitarian Universalist Church and the United Church Board for Homeland Ministries

Our Whole Lives is a series of sexuality education curricula for five age groups--grades K-1, grades 4-6, grades 7-9, grades 10-12, and adults--developed by the Unitarian Universalist Church and the United Church Board for Homeland Ministries.

Boston, MA

Grounded in a holistic view of sexuality, Our Whole Lives provides not only facts about anatomy and human development but also helps participants to clarify their values, build interpersonal skills, and understand the spiritual, emotional, and social aspects of sexuality. As a result of their study, participants are able to make informed and responsible decisions about their sexual health and behavior.

The curriculum supports abstinence from sexual activity as one of a number of healthy choices individuals can make at any point in their lives. Abstinence is consistently stressed as the best way to prevent STDS, including HIV, as well as unintended pregnancy. It also emphasizes the maturity and responsibility required for sexual activity and presents abstinence as the best choice for young adolescents.

The curriculum also contains up-to-date and age-appropriate information on symptoms for STDs, including HIV. It stresses the importance of safe behavior and testing.

Our Whole Lives teaches individuals about self worth, sexual health, and responsibility. Each level offers up-to-date information and honest, age-appropriate answers to all participants' questions, activities to help participants clarify values and improve decision-making skills, and effective group-building to create safe and supportive peer group education about sexual health issues.

The curriculum helps participants recognize that healthy relationships are based on responsibility, respect, love, and commitment. It also teaches that healthy sexual relationships are consensual, non-exploitative, mutually pleasurable, safe, developmentally appropriate, and based on respect, mutual expectations, and caring.

Overall, the curriculum gives participants the opportunity to evaluate and strengthen their values and to act on them.

Contact information: Adrienne Ross, Unitarian Universalist Association, 25 Beacon Street, Boston, MA 02108-2800. Phone:[phone], extension 361. Web site: http://www.uua.org

5

PREVENTING ADOLESCENT PREGNANCY 

A Program of Girls, Incorporated

Preventing Adolescent Pregnancy is a four-component program developed by Girls Incorporated to increase young women s skills, motivation, and resources for avoiding pregnancy during the teen years. Many of the young women who participate in the program face some of the highest risks for HIV and other health problems: belonging to a racial/ethnic minority, living in poverty, and experiencing at-risk situations.

Indianapolis, IN

The program components are: "Growing Together," focusing on the communication skills of girls nine to 11 years of age as well as their parents; "Will Power/Won't Power," building the assertiveness and resistance skills of young women 12 to 14 years of age; "Taking Care of Business," increasing the motivation, skills, and resources of young women 15 to 18 years of age; and "Health Bridge," connecting teens 12 to 18 years of age in Girls Incorporated settings with community healthcare providers.

The program was expanded in 1994 to include information about preventing STDs, including HIV. In the expanded program, Girls Incorporated achieved integration of STD and HIV prevention in a number of ways.

First and foremost, it emphasized the importance of sexual partners using barrier protection (female or male condoms) with other forms of birth control wherever contraception was addressed.

Second, it updated and expanded its information on STDs and HIV. In particular, it added a session to its "Growing Together" components specifically to give girls and their parents an opportunity to understand and talk about HIV.

Girls Incorporated also increased the variety and number of situations, scenarios, and role plays that could help participants think about risks for STDs and HIV, with and without other forms of birth control. This gave program facilitators several options for helping participants sharpen negotiation skills concerning abstinence and condom use.

Girls Incorporated also reinforced the importance of abstinence as the best way to avoid pregnancy and HIV/STDs. However, it recognized that young people could and may want to participate in a range of sexual activities that would have little risk of pregnancy, might be perceived as abstinence, but also entail varying degrees of risk for STDs and HIV.

Consequently, curricula give participants opportunities to consider these activities and their risks for STDs and HIV and to develop the skills, motivation, and resources for reducing those risks.

Finally, Girls Incorporated ensured that its resource lists contained sources of HIV and STD prevention information and materials relevant to girls.

Contact information: Bernice Humphrey, director, Healthy Girls Initiative, Girls Incorporated, 441 W. Michigan Avenue, Indianapolis, IN 46202. Phone: [phone], extension 124. E-mail: [e-mail]

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REDUCING THE RISK:

A Curriculum of ETR Associates

Reducing the Risk: Building Skills to Prevent Pregnancy, STD, and HIV is a curriculum that goes beyond the facts about abstinence and protection to present an approach to prevention of teenage pregnancy and protection against HIV that motivates students to change their risk behaviors.

Scotts Valley, CA

Throughout its 16 lessons, Reducing the Risk emphasizes teaching refusals, delaying tactics, and alternative actions students can use to abstain or protect themelves.

There are three program concepts that provide the foundation for this curriculum. They are: (1) abstaining from sexual activity or refining unprotected sexual intercourse are the only responsible alternatives for teenagers; (2) correct information about pregnancy, protection, and STDs, including transmission of HIV, is essential for responsible sexual behavior; (3) effective communication skills about abstinence and refusal skills related to unprotected sexual intercourse contribute to responsible sexual behavior.

As a result of participating in classes that use this curriculum, students are able to evaluate the risks and lasting consequences of becoming an adolescent parent or becoming infected with HIV or another STD; recognize that abstaining from sexual activity or using contraception are the only ways to avoid pregnancy, HIV infection, and other STDs; conclude that factual information about conception and protection is essential for avoiding teenage pregnancy, HIV infection, and other STDs; and demonstrate effective communication skills for remaining abstinent and for avoiding unprotected sexual intercourse.

Although information alone does not keep young people from having sexual intercourse, becoming infected with HIV, or getting pregnant, Reducing the Risk points out that accurate information about the consequences of unprotected sexual intercourse may strengthen a young person's resolve not to have sex or not to have it without protection. It also points out that many young people will understand they have the option to abstain when they know that many of their peers do not have sex.

In order for information to influence decisions, Reducing the Risk points out that students must understand that the information is about them. Students participating in the curriculum must complete several activities that bring the implications of becoming a teenage parent or becoming infected with HIV into their daily lives. They must also describe their own reasons for abstaining from sexual intercourse or using protection. Through this program, participants discuss these reasons with parents or guardians and they practice stating their opinion during role plays, class activities and discussions, and homework assignments.

The greatest emphasis of Reducing the Risk is teaching students the interpersonal or social skills they can use to abstain or use protection. No judgment is made about which of these responses is best. Rather, students learn that they must consult with their parent(s) and their consciences to decide what to do. The curriculum provides ideas, skills, and practice to do it effectively.

The key skills are (1) refusals--responses that clearly say no in a manner that doesn't jeopardize a good relationship but which leaves no ambiguity about the intent not to have sex or unprotected sex; and (2) delaying tactics and alternative actions--ways to avoid a situation or delay action until the person has time to decide what to do or say or until she or he is better prepared to implement a decision.

These skills are incompatible with impulsive and unprotected sex that can lead to unintended pregnancy, STDs, and HIV.

As part of an evaluation, 13 California high schools in 10 school districts implemented the Reducing the Risk Curriculum during 15 consecutive class periods. Four hundred twenty-nine ninth and tenth grade students received the curriculum; 329 students served as a comparison group and received the standard sexuality education class taught at each school.

After 18 months, students who had not had sexual intercourse before the intervention reported significantly less initiation of intercourse than students in the comparison group.

Those who were sexually active 18 months later reportedly used contraception more often than those in the comparison group. The curriculum also increased the proportion of students who reported talking with their parents about abstinence and contraception.

Students in the intervention group also had a greater increase in knowledge about the risk of pregnancy and STDs and proper use of condoms and other forms of contraception than did students in the comparison group.

Contact information: Lori A. Rolleri, senior training manager, ETR Associates, 4 Carbonero Way, Scotts Valley, CA 95066. Phone:[phone], extension 118. E-mail: [e-mail] Web site: http://www.etr.org

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REPRODUCTIVE HEALTH CLINIC

A Consolidation within the Municipality of Anchorage 

The Municipality of Anchorage, AK, recently merged its Sexually Transmitted Disease Clinic and its Family Planning Clinic into one Reproductive Health Clinic to meet the reproductive health needs of the community while also better utilizing the city's resources in terms of staff, supplies, and office space.

Anchorage, AK

This process took place during a two-year period when staff cross-trained, the clinic was remodeled, and policies and procedures were revised.

Clients participating in the integrated program receive STD assessment, testing, treatment, and partner notification services; HIV risk assessment, counseling and testing, and risk-reduction education; pregnancy prevention counseling; pregnancy options counseling; and emergency contraception counseling.

The new program also provides a colposcopy clinic for follow-up of abnormal pap smears for low-income women. These services are now provided in one visit, rather than multiple visits to different clinic sites.

The program staff collaborate with other medical clinics, social service agencies, schools, and teen groups within the Anchorage community. The clinic staff includes nurse practitioners, public health nurses working in an expanded role, family service aides, and clerical support.

The integrated clinic also provides nursing services at off-site clinics, which reach high-risk teens and men and women who have limited access to services. It also serves as a tinning base for health care professionals.

During the past six months, the clinic hosted students from training programs in the Pacific Northwest. These students were physicians, nurse practitioners, physician assistants, nurses, and medical assistants. They were able not only to learn more about reproductive health issues but also about the administrative and financial efficiencies of integrating these issues.

Contact information: Cathy Feaster, program manager, Reproductive Health Clinic, Department of Health and Human Services, Municipality of Anchorage, 825 L Street, Suite 102, Anchorage, AK 99501. Phone: [phone]. Fax:[phone]. E-mail: [e-mail] Web site: http://www.ci.anchorage.ak.us

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SAFER CHOICES

A Curriculum of ETR Associates

Safer Choices is a curriculum developed by ETR Associates to test the effectiveness of a program to prevent HIV infection, other STDs, and unintended pregnancy among high school students.

Scotts Valley, CA

The Safer Choices program is designed to reduce the number of students engaging in unprotected sexual intercourse by reducing the number who have sexual intercourse during their high school years, and by increasing the use of condoms and other methods of protection among students who have sexual intercourse.

The program seeks to modify several factors related to sexual risk-taking behavior, including students' knowledge about HIV and other STDs; students' attitudes about sexual behavior and condom use; students' perceived peer norms regarding sexual behavior and condom use; students' belief in their ability to refuse sexual intercourse or unprotected sexual intercourse; students' safer sexual practices; students' perceived barriers to condom use; students' perceived risk of becoming infected with HIV and other STDs; and students' communication with parents.

The Safer Choices program consists of five primary components: (1) school organization with a School Health Promotion Council made up of teachers, students, parents, administrators, and community representatives, to plan and conduct program activities; (2) curriculum and staff development, where peer leaders are trained to help facilitate certain classroom activities (such as leading small-group role plays); (3) peer resources and school environment, where young people on a Peer Resource Team meet with an adult peer coordinator to plan and host school-wide activities designed to alter the normative culture of the school, (4) parent education, where parents receive newsletters with information on the Safer Choices program, background on HIV, other STDs, and teen pregnancy, and tips on talking with teens about these issues (including student/parent homework assignments and parent participation on the School Health Promotion Council); and (5) school-community linkages, where students have homework assignments re quiring that they obtain information about local resources and participate in a session led by HIV-positive speakers.

The uniqueness of the multiple component intervention in Safer Choices is its focus on school-wide change and the influence of the total school environment on student behavior. By involving teachers, parents, community members, and students, the program is designed to have a positive influence on adolescents' decisions regarding sex and to help them feel supported in making the safest choices.

As part of an evaluation, schools implemented activities across all five of the Safer Choice components. Students received their most intensive exposure to the program from the curriculum and the school-wide, peer-sponsored events.

Thirty-one months following the baseline survey, Safer Choices reduced the frequency of intercourse without a condom (during the three months prior to the survey), reduced the number of sexual partners with whom students had intercourse without a condom (during the three months prior to the survey), and increased use of condoms and other protection against pregnancy at last intercourse.

Thirty-one months following the baseline survey, Safer Choices students scored significantly higher on the HIV and other STD knowledge scales than comparison students; expressed significantly more positive attitudes about condoms; and reported significantly greater condom use self-efficacy, fewer barriers to condom use, and higher levels of perceived risk for HIV and other STDs.

Safer Choices students also reported greater normative beliefs about condom use and communication with parents; these differences neared statistical significance (P=0.06 for each variable).

Contact information: Lori A. Rolleri, senior training manager, ETR Associates, 4 Carbonero Way, Scotts Valley, CA 95066. Phone:[phone], extension 118. E-mail: [e-mail] Web site: http://www.etr.org

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SEXUALITY EDUCATION CURRICULUM SERVICES

A Program Series of Planned Parenthood League of Massachusetts

The Sexuality Education Curriculum Services program developed by Planned Parenthood League of Massachusetts is designed to help both teachers and students understand the importance of preventing of STDs, HIV, and unintended pregnancies in tandem.

Boston, MA

The programs include a Sexuality Education Certification for professionals; a Positive Transitions curriculum for middle school students; a Heart to Heart curriculum for high school students; a Healthy Choices curriculum for high-risk youth; and an HIV Infection (HIP) program for HIV-infected youth.

The Sexuality Education Certification Series (SECS) is designed to provide professionals who work with youth with information on physiology, puberty, contraception, HI V/AIDS, STDs, healthy decision-making, sexual orientation, cultural competency, negotiation skills, and inclusive teaching strategies.

Each session addresses specific subject areas and includes lectures, discussions, and "hands on" practical experience. Certification is awarded upon successful completion of all sessions.

Positive Transitions teaches middle school students to understand emotionally what makes them feel good about themselves and why understanding this is so important. It also challenges them to understand themselves and their bodies from a biological perspective, comprehending the changes taking place during puberty and how these changes will influence their adolescence and later lives.

Rooted in factual information, Positive Transitions focuses on five essential points: all individuals need to develop tools to better understand themselves; self-perception and self-esteem plays a crucial role in the decisions and choices we make as individuals; puberty is a "normal" process and everyone will go through it; individuals are allowed and encouraged to ask any question about sexuality; individuals should have, or learn how to find, people or places that can help answer their questions.

Heart to Heart is a comprehensive sexuality education program for high school students that was developed in collaboration with the Massachusetts Department of Education. Topics include dispelling myths about sex and sexuality; building effective communication skills; negotiating healthy relationships; preventing STDs, including HIV/AIDS; creating SAFER sex protection options; and accessing health services.

Heart to Heart emphasizes medically accurate information, decision-making, and communication skills to promote self-respect, self-esteem, and protection from STDs, HIV/AIDS, and pregnancy.

Healthy Choices is designed to provide comprehensive sexuality education to "high risk" youth. It is funded by the Keep Teens Healthy (KTH) program that is managed by the Massachusetts Department of Medical Assistance. KTH defines "high risk" youth as people between the ages of 10 and 20 who are at risk for becoming pregnant, fathering children, and/or contracting STDs, including HIV/AIDS.

Healthy Choices is presented in a variety of community settings as well as at Massachusetts Department of Youth Services (DYS) and Massachusetts Department of Social Services (DSS) facilities. Educators typically meet with a group of youth on a weekly basis for 10 weeks. Topics include anatomy and physiology, self esteem, protection methods, relationship building, peer pressure, risk taking and homophobia.

HIP (HIV Infection Prevention) is a community outreach program that links underserved/high-risk adolescents and women with information and resources necessary to prevent the spread of HIV and STDs as well as reduce unintended pregnancy.

HIP educators conduct educational sessions at agency locations (such as shelters, teen parents programs, drop-in centers, and substance abuse treatment programs) serving low-income women and high-risk youth.

Participants learn about sexual health, including STDs, HIV, and protection methods. Educators also help facilitate participant referrals and connections to medical centers and other services.

HIP services are regularly provided to the same agency sites. This helps educators to develop trusting relationships with participants and empower individuals to take steps to reduce harm and increase quality of health and wellness.

Contact information: Jill Kantrowitz, Director of Education and Training, Planned Parenthood Leagne of Massachusetts, 1055 Commonwealth Avenue, Boston, MA 02215-1001. Phone: [phone]. Fax: [phone] E-mail: [e-mail] Web site: http://wwwpplm.org

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SPECIAL TOPICS: HEALTH

A Program of Morgantown High School 

Special Topics/Health is a health elective at Morgantown High School in Morgantown, WV, where educators teach eleventh and twelfth grade students about STD, HIV, and pregnancy prevention; test their knowledge on these subjects; and prepare them to become peer educators for ninth and tenth-grade students.

Morgantown, WV

The health elective has proven so popular that Morgantown High has expanded the programs conducted by these eleventh- and twelfth-grade students to include not only ninth- and tenth-grade classes but also faculty senates, parent groups, middle schools, teen conferences, West Virginia University classes, and other community groups.

The peer education program has expanded into two levels of classes with the addition of Special Topics: Health/2, which is solely peer education as opposed to teacher/student education. Students are trained in facilitation skills to present lessons to all grade levels and adults.

In this class, students become certified peer educators through the American Red Cross/West Virginia Bureau of Public Health AIDS Programs. They are required to learn about protection from STDs, HIV/AIDS, and pregnancy, as well as information on relationships (bullying for the younger grades), decision-making, substance abuse, cultural diversity, and teaching techniques.

Part of the Special Topics/Health 2 training involves visits to the county health department as well as to Healthright, the local teen health clinic. At these two sites, students learn how clinics function, what birth control and STD tests are available, and how to utilize these services.

This helps students learn firsthand about available resources at the local level. They eventually incorporate clinic information (including print materials) in their own presentations.

At the conclusion of their training, the peer educators must demonstrate their knowledge by taking a test, and their ability to teach by conducting several "teachbacks" to their class. Many of these "teachbacks" become part of their interactive lessons.

The peer education program has benefited significantly from the expertise of the health educators at West Virginia University, who conducted training classes for Morgantown High School students on STDs, AIDS, pregnancy prevention, relationships, and substance abuse.

In addition, the Morgantown City Police Department has made presentations on substance abuse. Caritas House, the regional organization that assists people who are infected with or affected by HIV/AIDS, has also scheduled presentations by people who are living with HIV/AIDS.

The most important support that any school-based program can get is from its State Department of Education. This has proven one of the most rewarding aspects of the program's success to date.

Contact information: Ann M. Simon, health educator, Morgantown High School, 109 Wilson Avenue, Morgantown, WV 26501. Phone: [phone]. Fax: [phone]. E-mail: [e-mail] Web site: http://boe.mono.kl2.wv.us

11

STUDENTS TOGETHER AGAINST NEGATIVE DECISIONS (STAND)

A Program of the Mercer University School of Medicine

Macon, GA

The Students Together Against Negative Decisions (STAND) Program was developed by Dr. Mike Smith, director of AIDS Education and Research at the Mercer University School of Medicine in Macon, GA, to help reach individuals in this rural southern community with important sexual health messages.

Specifically, STAND is a curriculum that promotes both sexual abstinence and risk reduction strategies focusing on information, skill building, personal values, and norms. It has been adopted by two high schools in the Macon area--one public and one private.

STAND has three primary goals: (1) to promote abstinence from sexual intercourse, (2) to reduce risk behaviors among teens who choose not to abstain, and (3) to change student norms and make sexual risk behaviors less acceptable.

STAND is a 32-hour course in HIV/AIDS, STD, and pregnancy prevention that trains teen opinion leaders to become role models and peer educators to promote abstinence and risk reduction among their friends.

They learn about STDs, AIDS, and pregnancy prevention; personal values; goal setting; problem solving; personal commitment; personalization of risk; visualization; safer sex; sexual norms; and sex in the media.

Students nominate 18 tenth graders to receive the training over four months and to participate in a day-long team-building course. The peer educators then teach the curriculum in middle schools, participate in planning risk reduction activities for high schools, and--in one-on-one encounters--inform, support, and encourage peers, friends, and relatives to reduce sexual risk behaviors.

STAND teachers are local, respected, and well-trained adults as well as teen co-facilitators who have already completed STAND training. STAND encourages parents to participate in a parent training course and to discuss STAND with their children.

A 12-month impact evaluation of the STAND program found that only 29 percent of middle school participants who had not initiated sex at the time of the course later initiated sex as compared to 42 percent of the control group.

When comparing the peer educators to a control group of tenth graders, the peer educators increased their condom use eight times more than the control group. Comparing numbers of reported acts of unprotected sexual intercourse, the peer educators nearly halved their numbers in the preceding three months while members of the control group more than doubled theirs.

Contact information: Mike Smith, director of AIDS education and research, Mercer University School of Medicine, 707 Pine Street, Macon, GA 31201. Phone: [phone]. E-mail: [e-mail]

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TEEN ADVOCATES SHARING KNOWLEDGE (TASK)

A Program of the Malden YWCA 

Malden, MA

Teen Advocates Sharing Knowledge (TASK) is a peer education program developed and sponsored by the Malden YWCA in Malden, MA, to encourage young people to communicate among themselves and with their parents and teachers about pressing issues ranging from self-image and trust to pregnancy and STDs.

Each month after school, during school vacations, and on some Saturdays, approximately five to 10 TASK teen advocates conduct workshops where they share information with other students, parents, and teachers. These interactive sessions create opportunities for growth and development not always available in school.

TASK workshops cover a variety of subjects such as leadership training, media literacy/advocacy, sexual assault/ harassment, health decision-making, health relationships, self-image, racism, sexism, homophobia, HIV/STDs, teen pregnancy, teen dating violence, eating disorders, drugs and alcohol, and teamwork/trust building.

TASK teen advocates also conduct a "Parent University" workshop, which brings a youth perspective to issues faced by parents of teens. Subjects include unintended pregnancy, STDs, HIV/AIDS, and other sexual health issues. In addition, TASK advocates conduct workshops for youth leadership groups in the Boston area in which they encourage involvement relating to social change for comprehensive sexuality education.

In collaboration with the Malden Health Education Department, TASK advocates also host interactive health tables each month at Maiden High School. Students are encouraged to answer questions related to sexual decision making and win prizes. A good mix of male and female teens participate. High school faculty and staff frequently participate in an effort to share knowledge and to identify information gaps in school curricula. Results are discussed confidentially at the YWCA's HIV Community Task Force meetings.

TASK also sponsors "Ladies Rap," a monthly program where female teens come together to discuss their opinions on a wide variety of subjects in a safe space. Young people lead the program, which often focuses on teen sexuality and its effect on the Malden community.

"Ladies Rap" sessions are open to all female students at Malden High School and are facilitated by a qualified health educator. Participants are free to express their opinions and are encouraged to speak openly and honestly with their peers and adult facilitators. It is empowering for them to have such a voice.

Results of the "Ladies Rap" events are reported confidentially during monthly HIV Community Task Force meetings.

Contact information: Abby Francis, Peer Educators of the Malden YWCA, 54 Washington Street, Malden, MA 02148. Phone: [phone]. Fax: [phone]. E-mail: [e-mail]

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TEEN ADVISORY COUNCIL OF THE CENTER FOR ADOLESCENT PREGNANCY PREVENTION

Pittsburgh, PA

The Teen Advisory Council (TAC) was developed by the Center for Adolescent Pregnancy Prevention in Pittsburgh, PA, in 1997. Since that time, it has evolved into an incubator for community-based teen leaders in Pittsburgh, PA.

TAC, which consists of 25 young people, meets weekly to talk about current events and local activities in an open environment called "Speak Out." They also discuss articles in the teen newsletter Sex Etc. This gives them the chance to set goals to prevent teen pregnancies, STDs, and HIV/AIDS among their peers in terms of day-to-day realities.

In addition to its weekly meetings, TAC is also involved in street outreach. Members target communities with high teen pregnancy, HIV/AIDS, and STD rates. They then pass out print information on protection as well as on access to family planning resources. They have recently expanded their focus to include information on breast cancer screening and pap smears.

TAC also serves as an information resource to help the Center for Adolescent Pregnancy Prevention understand how teens feel about sexuality issues and sexuality education. In return, the Center provides guidance to help TAC members stay in school, reach their goals, and remain safe and healthy.

Contact information: Amy G. Nevin, Center for Adolescent Pregnancy Prevention, Family Health Council Inc., 960 Pennsylvania Avenue, Suite 600, Pittsburgh, PA 15222. Phone: [phone], extension 165. E-mail: [e-mail]

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TEEN OUTREACH PREGNANCY PREVENTION PROGRAM (TOPPP)

A Program of the New York City Public Schools

New York, NY

The Teen Outreach Pregnancy Prevention Program (TOPPP) offers guidance and counseling to teenagers and their families within New York City public high schools, and provides staff development in adolescent pregnancy, STD, and HIV prevention programs.

TOPPP also forms a vital link between the schools and various community-based agencies to get essential information and services to youth at risk of unplanned pregnancy and STDs.

Specific TOPPP programs include:

* Information and referral to any individual who requests it

* Workshops and staff development focusing on adolescent sexuality--including goal setting, values clarification, decision making, psychological/sociological and physiological aspects of sexuality, STDs, and family planning, including abstinence

* Individual and group counseling in adolescent sexuality and related issues for students

* Presentations, discussions, and classroom lessons aimed at helping students acquire information, make informed decisions, resist peer pressure, and develop positive self images

* After school health resource centers that provide opportunities for adolescents to discuss sexuality and initiate activities which foster empowerment

* Guidance to prevent two common outcomes of teen pregnancy: dropping out of school and jeopardizing and/or forfeiting life options

In collaboration with private, nonprofit organizations, TOPPP brings related services and experience into New York City schools. Among those programs represented are the Teen Reach Program of Maternity Infant Care Women's Health Services, Inwood House's Teen Choice Program, Planned Parenthood of New York City, and St. Mary's Episcopal Outreach Program.

Contact information: Donna L. Orr, M.P.H., Teen Outreach Pregnancy Prevention Program, 22 East 128th Street, Room 507, New York, NY 10035. Phone: [phone]. Fax: [phone].

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Programs of the Teen Pregnancy Coalition of San Mateo County

TEEN TALK AND PLAIN TALK FOR PARENTS

San Mateo, CA

Teen Talk and Plain Talk for Parents are two programs of the Teen Pregnancy Coalition of San Mateo County in San Mateo, CA, committed to developing positive and honest communication between adults and youth to help young people make healthy choices to reduce teen pregnancy, STDs, and HIM

Teen Talk is an eight- to 10-hour comprehensive sexuality education program, and Plain Talk for Parents is a two--part workshop designed to teach parents effective communication skills to help them comfortably discuss the subject of healthy sexuality with their children.

Teen Talk topics include anatomy, birth control and STDs, as well as other topics ranging from sexual assault to communication and decision making, based on participants' needs. The curriculum consistently addresses the prevention of unintended pregnancy, STDs, and HIV. For example, an activity in which students examine different methods of birth control always asks them to consider whether the method also prevents STDs and HIM

More than 4,300 eighth- through twelfth-grade students from 21 area schools participated in Teen Talk during the 2001-02 school year. An evaluation indicates it was successful in improving knowledge, in increasing communication with parents, and in encouraging attitudes consistent with choosing not to have sex or choosing contraception if already sexually active.

Plain Talk for Parents provides parents with the information and tools they need to communicate with their children about sexuality. It includes frank discussion about the need for young people to protect themselves from unintended pregnancy, STDs, and HIM Parents are encouraged to examine their own values about sexuality and practice communicating those values with their children.

Over 500 parents at various school and community sites have participated in Plain Talk during the past three years. When asked, they said they would recommend Plain Talk to other parents.

Contact information: Shelly Masur, MPH., associate director, 703 Woodside Road, Suite 7, Redwood City, CA 94061. Phone: [phone]. E-mail: [e-mail] Web site: www.teenpregnancycoalition.org

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A Program of Family Health International Research

YOUTHNET

Triangle Park, NC

YouthNet is a global program to improve reproductive health and prevent the spread of HIV/AIDS and other STDs among people 10 to 24 years of age.

It is primarily a collaboration with the young people whose lives it is designed to improve. Yet in concept and practice, it also involves the energy, insight, and experience of parents, schoolteachers, employers, policymakers, the media, health professionals, non governmental organizations, religious and community leaders, and other youth networks.

Supported by the U.S. Agency for International Development, YouthNet conducts research, disseminates information, improves services, and strengthens policies and programs related to the reproductive health and HIV/AIDS-prevention needs and rights of young people around the world.

The principles of YouthNet are that: (1) young people are capable of positive reproductive health behavior when they have good problem-solving and decision-making skills; (2) young people must be full partners in reproductive health and HIV/AIDS-prevention programs if those programs are to have real impact; (3) young people should live free of violence and discrimination, with access to information, skills, and services for healthy, productive lives; (4) gender equity promotes reproductive health through responsible sexuality and mutual respect between the sexes; (5) building on existing capacities helps achieve high-quality programs of reproductive health and HIV/AIDS prevention and improves sustainability.

YouthNet works with other cooperating agencies and local partners to develop, implement, and evaluate country-specific programs to reach the largest number of young people. It seeks to develop and implement large-scale programs to promote the following key prevention behaviors: promoting abstinence; delaying sexual debut; reducing/limiting number of sexual partners; using condoms for disease protection and pregnancy prevention; practicing effective contraception; and seeking early care in pregnancy seeking early treatment if infected with a sexually transmitted infection, including HIV/AIDS.

YouthNet also works in concert with global youth networks such as the United Nations Population Fund, the World Young Women's Christian Association, the World Organization of the Scout Movement, the World Association of Girl Guides and Girl Scouts, and affiliates of the International Planned Parenthood Federation.

Contact information: Nancy B. Williamson, YouthNet program director, Family Health International, Institute for Family Health, P.O. Box 13950, Research Triangle Park, NC 27709. Phone: [phone]. Fax: [phone]. E-mail:[e-mail] Web site: www.fhi.org/youthnet