Youth United Through Health Education: community-level, peer-led outreach to increase awareness and improve noninvasive sexually transmitted infection screening in urban African American youth.

PURPOSE: To evaluate the effectiveness of the Youth United Through Health Education (YUTHE) program, a community-level, peer-led outreach program to increase awareness and improve noninvasive sexually transmitted infection (STI) screening in youth residing in the targeted community. METHODS: Sexually experienced youth, aged 12-22 years, anonymously participated in the YUTHE program (a 15-minute encounter, including a risk assessment with feedback and prevention messages). A street- and venue-based intercept approach using a nonequivalent control group design was implemented to evaluate the YUTHE program. RESULTS: YUTHE community respondents were more likely to know that STIs could be asymptomatic (odds ratios [OR] 1.36, 95% confidence interval [CI] 1.08-1.72), know about urine-based STI screening tests (OR 1.34, 95% CI 1.04-1.72), perceive themselves to be at risk for STIs (OR 1.71, 95% CI 1.11-2.62), and worried about acquiring an STI (OR 1.50, 95% CI 1.04-2.18). No other community differences were identified. However, respondents who reported a single contact (OR = 2.12, 95% CI = 1.11-4.03) or multiple contacts (OR 2.78, 95% CI 1.81-4.26) with the YUTHE program were more likely to have been tested for STIs in the previous six months. CONCLUSIONS: We did not accomplish our overall goal of increasing STI screening in our outreach community relative to the comparison community; our findings suggest that a peer-led, street- and venue-based community outreach approach is a feasible means for reaching large numbers of adolescents for STI prevention.

Youth united through health education: building capacity through a community collaborative intervention to prevent HIV/STD in adolescents residing in a high STD prevalent neighborhood.

The early detection and treatment of STDs is an effective strategy for slowing the sexual transmission of HIV. The goal of the YUTHE (Youth United Through Health Education) program, a collaborative effort between the San Francisco Department of Public Health (SFDPH) and the University of California, San Francisco, is to increase sexually transmitted disease screening and treatment among adolescents in a neighborhood with a high incidence of STDs in San Francisco. Youth health educators residing in the intervention neighborhood recruited sexually active youth between the ages of 12 and 22 years to participate in the YUTHE program's intervention between January 2001 and May 2002. Sixty-three percent had two or more sexual partners, 47% did not use condoms consistently, and 18% had a history of STDs. When the intervention neighborhood was contrasted with a sociodemographically matched comparison neighborhood results indicate that both females and males in the YUTHE intervention neighborhood were significantly less likely to have Chlamydia trachomatis infection than their counterparts in the comparison neighborhood.

The influence of parental monitoring on adolescent sexual initiation.

OBJECTIVE: To explain the influence of parental monitoring on adolescent sexual initiation within the context of a cognitive behavioral model. DESIGN, SETTING, AND PARTICIPANTS: Virginal youth (N = 307) recruited from a health maintenance organization adolescent medicine clinic were interviewed at baseline and at 6 months about parental monitoring and other known cognitive factors associated with the initiation of sexual behavior. Participants were followed up at 6 months and potentially at 12 months to assess the initiation of sexual intercourse. RESULTS: Adolescents reporting successful parental monitoring (accurately knowing the adolescents' whereabouts and activities outside the home) significantly expressed cognitions less favorable of initiating intercourse, while adolescents reporting more unrestricted time were more likely to express cognitions that favored initiating intercourse. In adjusted analysis, cognitions (attitudes, perceived peer behaviors, and subjective norms) that favored intercourse significantly predicted a greater intention to engage in intercourse. However, adolescents who reported successful parental monitoring significantly expressed less sexual intention, and successful parental monitoring moderated the effect of attitude on the intention to initiate intercourse among female subjects. Overall, behavioral intention was the only significant predictor of actual sexual onset. CONCLUSIONS: These findings are useful in directing further research and in designing interventions to delay the onset of sexual intercourse in adolescence. More research is required to understand how attitudes toward sexual initiation are formed during adolescence and how parents may facilitate the formation of these attitudes. Parental interventions that promote successful communication and support effective parental monitoring may be an important component of interventions designed to delay sexual initiation during adolescence.