Young people's views on provision of sexual health services.

OBJECTIVES: To identify the sexual health needs of young people in order to establish a service suited to these needs. METHODS: A peer designed questionnaire piloted to a small group of young people was followed by a more widely distributed, amended questionnaire. The questionnaire survey was delivered to 744 pupils aged 11-18 years in six secondary schools and a pupil exclusion unit in central London. Factors encouraging or discouraging the use of young people's sexual health services were measured. RESULTS: Several findings challenged existing models of care for young people's sexual health services. Notably, pupils wanted clinics to run more frequently than the usual once a week; the staff attributes that were most important were attitudinal rather than to do with sex, age, or physical appearance; and they did not mind if the waiting room contained older people. Many findings, however, agreed with existing data-young people wanted the clinic to be open after school; girls preferred to attend with a friend; a confidential, walk-in service was preferred. CONCLUSIONS: Large financial outlays are not necessary for the establishment of effective sexual health services for young people. Existing facilities and staff may be utilised with training of these staff to be sensitive to, and aware of, the needs of young people. Clinic opening times should coincide with school closing times. Although pupils stated a preference for female staff, this was not a high priority. More important was feeling that staff would listen to them and take their problems seriously, and that confidentiality would be maintained.

Can targeted HIV testing campaigns alter health-seeking behaviour?

This paper describes the evaluation of 'gimme 5 minutes' a multimedia HIV testing campaign aimed at gay and bisexual men in London particularly targeting those of Black and South European Origin and those under the age of 25 years old using peer images. The text linked a summary of the key issues of a pre-test discussion with detailed information on how to access testing at a specified testing centre (campaign clinic). The number and demographics of men who reported sex with men (MSM) testing at the campaign clinic were monitored and compared with those testing at two other central London clinics. There was a 4.5-fold rise (p < 0.001) in MSM testing at the campaign clinic. Increases were proportionately greater in the sub-populations targeted with peer images: South European origin, 14-fold rise (p < 0.001), Black origin, 6.5-fold rise (p = 0.003), and MSM under 25 years old, 9.5-fold rise (p < 0.001). There were no significant changes in the number of MSM testing for HIV at the two other central London clinics studied. The results suggest that including detailed information about accessing testing services may be a vital ingredient in the success of media campaigns focusing on HIV testing.

Assertion training outcome and generalization effects under didactic vs. facilitative training conditions.

One hundred and eleven college undergraduates (25% male) participated in one of two cognitive behavioral training programs, which included behavior rehearsal, modelling, coaching, cognitive-restructuring, and emphasis on the transferability of skills. Neither self-report nor behavioral outcome differences between the facilitative vs. the didactic approaches were noted. Both programs produced impressive self-report and behavioral gains in comparison to pretest scores; these gains were maintained 1 to 2 years after the program. There was also evidence of verbal and nonverbal bilateral transfer between request behavior and refusal behavior in the short term. The generalization results were interpreted on the basis that the distinctive components of request behavior (such as enunicating a statement of a problem and a specific request) are more difficult than those of refusal behavior, such than there is transfer of request training to refusal behavior, but not vice versa. Request behavior involves the mobilization and personal initiation of a complex interaction with another person rather than the more reactive non-compliance with the initiative of another, as is the case in refusal behavior.