The impact of a culturally appropriate STD/AIDS education intervention on black male adolescents' sexual and condom use behavior.

A culturally appropriate, theoretically based videotape was developed to promote condom use among African American males, ages 15 to 19, attending a municipal sexually transmitted disease (STD) clinic. The videotape's impacts were compared to those achieved by an African American health educator who delivered the same messages during a face-to-face session and by standard care. Data were obtained on participants' (N = 562) condom use knowledge, self-efficacy, and intentions; sexual and condom use behaviors; and perceived risk of infection. At posttest, "videotape" and "health educator" participants demonstrated greater condom use knowledge; "health educator" participants indicated greater self-efficacy and stronger condom use intentions with steady partners. At 6 months, participants in all conditions reported more partners and acts of vaginal intercourse (past month); however, they were more likely to report consistent condom use with steady partners (18% vs. 53%) and casual partners (26% vs. 50%). Perceived risk of infection was lower at the posttest and declined during the study period.

Subsequent infection among adolescent African-American males attending a sexually transmitted disease clinic.

PURPOSE: To identify predictors of subsequent infection among a sample of 15- to 19-year-old African-American males attending an urban sexually transmitted disease (STD) clinic in the Midwest. METHODS: During a 14-month period, 562 youth participated in a brief STD prevention intervention designed to promote condom use. They completed self-administered questionnaires (baseline, posttest, 30-day and 6-month) on their sexual and condom use behavior in the past month. Infection data (baseline, 5 years before, and 12 months after baseline) were obtained from clinic and state surveillance records. Logistic regression was used to predict infection within 6 and 12 months of the baseline visit. RESULTS: Within 12 months of the baseline, 31.3% were treated for an infection, of whom 1.4% returned within 30 days, an additional 17.1% within 6 months, and the remaining 12.8% within the last 6 months. The 12-month rate was 1.6-1.7 times higher than the rates reported for older STD clinic attendees. Subsequent infection was positively associated with age at first intercourse, number of children fathered, infection prior to and at the index visit, exchange of sex for drugs in the past year, and perceived risk of infection within the year; it was negatively associated with frequency of condom use with one's steady partner. CONCLUSIONS: Sexually transmitted disease clinic staff routinely obtain information from young African-American males that can be used to identify individuals who are most likely to become reinfected. Because repeaters account for a disproportionate number of infections, prevention efforts tailored to their needs would have a corresponding impact on STD rates.

Lessons learned from a mentoring program for teenage mothers.

PURPOSE: This study evaluated a mentoring program designed to decrease the risk of repeat pregnancy among unmarried primiparous teens, ages 12-19. METHODS: Adolescents (n = 110) completed a battery that assessed sexual/contraceptive behavior; psychological adjustment; and attitudes towards school. Teens were then randomly assigned to a mentor or control group, and reassessed at 6, 12, 18, and 24 months. Mentored teens received social support and assistance dealing with community agencies from mentors who were trained community volunteers. RESULTS AND CONCLUSIONS: At baseline, mentor and control teens had similar sexual histories, school achievement profiles (percentage enrolled, cumulative grade point average), and anticipated being the same age when they had a second child. At 24 months (n = 81), most mentor and control teens were making progress in school. Fifty percent had graduated or had advanced two grades; 10 of the 16 graduating teens were seeking additional education. However, the mentoring program did not significantly impact repeat pregnancy rates. At 33 months, 66.0% of the mentored teens and 68.8% of the control teens had experienced a repeat pregnancy. Thirty-six percent of teens had one repeat pregnancy; 24% had two or more pregnancies. Sixty-two percent of the pregnancies with known resolution (89) resulted in live births; 26% were aborted. In providing this mentoring program, several important lessons were learned.

Contraceptive compliance with a levonorgestrel triphasic and a norethindrone monophasic oral contraceptive in adolescent patients.

OBJECTIVE: This study was undertaken to assess the impact of two low-dose oral contraceptive pills on compliance and side effects in adolescent patients. STUDY DESIGN: The use of a levonorgestrel-containing triphasic pill (N = 114) was compared with that of a monophasic (1 + 35) norethindrone-containing pill (N = 110) at two different sociodemographic sites. RESULTS: No significant difference in compliance or pill satisfaction was observed between the pills. Socioeconomic factors were the overriding predictors of compliance. At 3 and 12 months of follow-up, there were significantly fewer complaints of overall side effects (p less than 0.001 and p = 0.004, respectively), breakthrough bleeding (p = 0.017 and p = 0.018), and pill amenorrhea (p = 0.002 and p less than 0.001) among users of the triphasic pill. Mean weight change at 12 months was +1.1 kg for the monophasic pill and -0.1 kg for the triphasic pill. All known pregnancies occurred among noncompliant city clinic patients. CONCLUSIONS: Adolescents experienced fewer side effects with the triphasic pill than with the monophasic one, but compliance was the same.

PIP: This study was undertaken to assess the impact of 2 low-dose oral contraceptives (OCs) on compliance and side effects on adolescent patients. The use of a levonorgestrel-containing triphasic (n=114) was compared with that of a monophasic (1+35) norethindrone-containing pill (n=110) at 2 different sociodemographic sites. No significant difference in compliance or pill satisfaction was seen between the groups. Socioeconomic factors were the overriding predictors of compliance. At 3 and 12 months of followup, there were far fewer complaints of overall side effects (p0.001 and p=0.004, respectively), breakthrough bleeding (p=0.017 and p=0.018), and pill amenorrhea (p=0.002 and p0.001) among users of the triphasic pill. Mean weight change at 12 months was +1.1 kg for the monophasic pill group and -0.1 kg for the triphasic pill group. All known pregnancies occurred among noncompliant city clinic patients. Adolescents experienced fewer side effects with the triphasic pill than with the monophasic one, but compliance was the same.