Primary STD prevention relies on five key strategies: practicing abstinence, choosing low-risk partners, discussing partners' sexual history, using condoms consistently and not having multiple partners. Few studies have examined all of these strategies simultaneously, and few have focused on rural black adolescents, whose rates of early sexual initiation and STDs are among the highest in the nation.
In 2006, a sample of 37 black adolescents (20 female, 17 male) from two rural North Carolina counties participated in focus groups that explored their understanding of how primary prevention strategies reduce STD transmission, the common barriers they encounter in trying to adopt these strategies and the risk reduction strategies that they employ. Transcripts were analyzed using a grounded theory approach.
Adolescents understood how primary prevention strategies reduce STD transmission. However, they perceived sex as normal and abstinence as unlikely during adolescence. Furthermore, they considered the remaining primary prevention strategies difficult to implement because these strategies depend on partner cooperation and incorrectly assume that STD prevention is paramount when adolescents make sexual decisions. Adolescents reported using alternative strategies to reduce their STD risk; the most commonly used approaches were indirect assessments of partner characteristics (e.g., evaluating partners' physical appearance and sexual history) and STD testing (to identify and treat infections).
Adolescents try to reduce their STD risk, but do so by using ineffective practices. Promoting primary prevention strategies requires helping adolescents to identify opportunities to successfully employ these strategies.
[Show abstract][Hide abstract] ABSTRACT: Although the initiation of sexual behaviors in adolescence is normative, adverse sexual health outcomes disproportionately affect adolescents relative to adults. Efforts to improve sexual health and increase health promotion behaviors in adolescent populations have not been fully successful. In this paper, we propose that translational research that integrates insights from neuroscience, ecological systems theory, and decision science with adolescent sexual behavior research can lead to advances in our understanding of the etiology and prevention of sexual risk behaviors among adolescents. Moreover, these insights can be further translated to the design and implementation of clinical interventions that improve sexual health. Clin Trans Sci 2013; Volume 6: 78-81.
[Show abstract][Hide abstract] ABSTRACT: Recruiting and enrolling low income, racially and ethnically diverse adolescents into research studies can be a challenge. This paper details our research team's methodology in the recruitment and enrollment of low income and racially/ethnically diverse adolescents in three cities as part of a broader study to understand adolescent perceptions of a health risks. Our team used Florida's Medicaid and Children's Health Insurance Plan administrative databases to identify a sample of adolescents for focus group participation. Utilizing geographic information systems software we generated maps of racial and ethnic group clusters in three cities and identified community centers within each cluster to hold the focus groups. We mailed initial focus group introduction letters, conducted follow-up phone calls for recruitment and further implemented techniques to optimize participant confidentiality and comfort. We enrolled 35 participants for eight focus groups in three cities at a total cost of $264 per participant, including personnel, materials, travel, and incentives costs. As a result of our efforts, groups were fairly evenly distributed by both race and gender. Administrative databases provide opportunities to identify and recruit low income and racially/ethnically diverse adolescents for focus groups that might not otherwise have the opportunity to participate in research studies. It is important that researchers ensure these populations are represented when conducting health assessment tool evaluations.
Maternal and Child Health Journal 01/2014; 18(8). DOI:10.1007/s10995-014-1435-x · 2.24 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: African Americans in the rural Southern United States continue to experience disproportionate increases in new HIV/AIDS infections. Electronic gaming interventions hold promise but the use of HIV prevention games is limited. The purpose of this study was to assess the acceptability and relevance of a web-based HIV prevention game for African American rural adolescents. Findings from focus groups conducted with 42 participants suggested that the game was educational and somewhat entertaining but lacking in real-life scenarios and player-control. Findings are congruent with self-efficacy literature and constructivist approaches to learning. Findings have implications for gaming intervention development and further research
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