A human immunodeficiency virus peer education program for adolescent females.

Black adolescent females living in urban environments are at high risk for human immunodeficiency virus (HIV) infection. Our objectives were to develop an HIV peer education program and to pilot-test its effect on knowledge and sexual behavior. Between September 1989 and March 1990, all females aged 12-19 years attending an inner-city, hospital-based adolescent clinic were invited to meet individually with trained peer educators (10 females aged 16-19 years) to discuss acquired immunodeficiency syndrome (AIDS) and its prevention. Each participant completed a modified version of the AIDS Knowledge and Attitudes Survey immediately before and 2-6 weeks after the counseling session. Of the 283 counseled patients, 241 (85%) completed the follow-up questionnaire and comprised the study sample. Mean age was 15.6 years, mean Hollingshead (parental occupational) score was 3.4, and 216 (90%) patients were black. Baseline knowledge about routes of transmission was high and did not improve on follow-up. Comparison of individual baseline and follow-up responses revealed improvements (p less than 0.05) in routes by which HIV is not transmitted, methods of prevention, individuals at risk, and general information about AIDS. The improvement in total score between baseline and follow-up was 38% for patients with low baseline scores, 13% for middle scores, and 3% for high scores (p less than 0.05). At baseline, 50 (21%) patients reported sexual intercourse within the preceding 2 weeks, compared to 33 (14%) at follow-up (p less than 0.05). Of the sexually active patients, 22 (44%) reported no condom use at baseline, compared to 11 (33%) at follow-up (p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Pediatricians and breastfeeding promotion: attitudes, beliefs, and practices.

Abstract This study investigated both the degree to which pediatricians promote breastfeeding in their practices, and the attitudes and beliefs about breastfeeding which are associated with their breastfeeding promotion activities. We interviewed a sample of 59 pediatricians from a large urban area who had a variety of practice types and differing patient populations. Almost one half of the pediatricians in this study reported they did not routinely recommend breastfeeding to the mothers of their patients. In addition, few specific interventions to assist in breastfeeding continuation were reported. However, the overwhelming majority of pediatricians sampled reported very favorable attitudes toward breastfeeding promotion by pediatricians. Infrequent prenatal pediatric visits and the lack of formal training in breastfeeding and its management are discussed as potential barriers to more active participation of pediatricians in current efforts to achieve increased rates of breastfeeding.