Reducing Adolescent Sexual Risk: A Theoretical - ETR Associates

1 IntroductionThis book was created tohelp others design or adapttheir own curricula.Overview of This BookUnintended pregnancy and sexually transmitted diseases(STDs), including HIV, continue to be importantproblems among young people in the UnitedStates. These problems can be addressed effectively ifyoung people reduce their sexual risk behaviors—forexample, if they initiate sexual activity later, havesex (meaning vaginal, anal and oral sexual activity)less frequently, have fewer sexual partners anduse condoms or contraception more consistently.However, programs designed to address unintendedpregnancy and STDs cannot directly control thesexual risk behavior of young people; rather, theycan only affect various risk and protective factorsthat, in turn, affect decision making and behavioramong young people.Risk and protective factors include biological factorssuch as age or maturation, community factors suchas economic opportunities or crime rates, and familyfactors such as strong families and monitoring ofchildren.However, a very important group of risk and protectivefactors is “sexual psychosocial” factors. Theseinclude knowledge, perceptions of risk, attitudes,perceptions of norms, self-efficacy and intentions.These are particularly important because 1) theyhave a very strong impact on sexual decision makingand behavior and 2) educational programs, eitherin school or out of school, can significantly improveeach of them, if curricula include the right kinds ofactivities that incorporate important instructionalprinciples.Although it is relatively easy to increase knowledge,it is not easy to markedly improve all ofthese factors. If curriculum activities fail to includeimportant instructional principles, they may fail toimprove these factors and may fail to have an impacton behavior. On the other hand, there is considerableevidence that all of these factors are amenableto change when appropriate instructional techniquesare used. Thus, these principles are important toachieve behavior change.This book is not a curriculum itself. Instead, it isdesigned to help reproductive health professionals,educators, curricula selection committees and othersdesign or adapt curricula so that they focus on riskand protective factors that are related to sexual riskbehavior and use instructional principles most likelyto improve the targeted factors. It can also be usedto select curricula that incorporate these features,Chapter 1 Introduction 1