Reducing Adolescent Sexual Risk: A Theoretical - ETR Associates

studies found that concern about STD/HIV had animpact on condom use. Not surprisingly, multiplestudies also have found that teens commonly listconcern about pregnancy and concern about STD asimportant reasons why they use contraception andcondoms, respectively.Can we increase perceptions of risk and severityof pregnancy and STDs, including HIV?Multiple studies provide strong evidence that it ispossible to increase perceptions of risk of pregnancyand STDs, both in terms of susceptibility and severity(Table 4-4) (Kirby, Laris et al. 2006). Abouthalf of all the studies that measured programmaticimpact on one or more of these outcomes found asignificant positive effect. All of these outcomesexcept one were positively affected by at least oneprogram. The one exception was perception ofsusceptibility to pregnancy. It may be the case thatyoung people already know that pregnancy canoccur if they have sex, leaving little room for changeon this factor. Alternatively, young women mayhave had unprotected sex, did not become pregnant,and therefore believe they are infertile. Finally, thefailure of these studies to find an impact on perceptionof susceptibility to pregnancy may reflect agreater STD/HIV focus of many of the programs.In any case, the evidence is clear that it is possible toincrease individuals’ perceptions of their own risk ofpregnancy and STDs, including HIV, if they havesex or unprotected sex.What are effective teaching methods for improvingperceptions of risk?In general, many of the principles of effective teachingthat are discussed in the previous chapter applyespecially well to teaching about risk. In addition,a few other principles apply. Examples of activitiesincorporating these principles are presented later inthis chapter. To reduce unprotected sex, curriculaneed to:1. Emphasize the risks of unprotected sex. At aminimum, these risks should include pregnancyand STD. Because teens commonly specify bothconcern about pregnancy and concern aboutTable4-4Number of Programs Having Effectson Perceptions of RiskPerceived susceptibilityof pregnancy (N=3)Perceived susceptibilityof STD (N=2)Perceived susceptibilityof HIV (N=16)Perceived severity ofpregnancy (N=5)Perceived severity ofSTD (N=1)Perceived severity ofHIV (N=4)Had aPositiveEffectNoSignificantEffectsHad aNegativeEffect0 3 01 1 08 8 02 3 01 0 03 1 0STDs as reasons for delaying sex or avoidingunprotected sex, in most curricula, both risksshould be given strong emphasis.However, among some groups of youth, otherrisks also should be identified. These includepossible feelings of guilt, possible disapprovalfrom parents should they find out, possible lossof reputation, possible feelings of being used andother negative personal feelings.Because adolescents’ sense of invulnerability canbe constructive in many social situations, programsshould not try to undermine their generalsense of invulnerability; rather, programs shouldhelp youth realize that they are vulnerable specificallyto unintended pregnancy, STDs and possiblyother specific risks if they have unprotectedsex.2. Use a variety of teaching methods to describe,illustrate, model, and personalize the likelihoodof becoming pregnant or contracting anSTD. They should provide information, provideplausible scenarios with a cause and an outcome,increase fear arousal and produce self-evaluationand re-evaluation. The methods should include allof the following kinds of activities, if possible:46 Reducing Adolescent Sexual Risk: A Theoretical Guide for Developing and Adapting Curriculum-Based Programs